When we began our health policy activism, we thought being involved was limited to politicians and lobbyists. Through many years of “on the job training,” leadership, advocacy, and ultimate successes in changing numerous health related legislation and scopes of practice, we came to realize the importance of advocacy in healthcare matters. A frequent quote we use to motivate others is “You are either at the table or you are on the menu!”
As a Nurse you may be saying, things like, “I don’t have enough time to be involved, I don’t know how to start or how to be involved.” At first, we were novices at interacting and educating health policy makers and legislators. Like you all, we were frustrated about current policies and politics but lacked the tools or resources needed to effect change. So, how do you begin making a difference?
First, join SCNA, the South Carolina Nurses Association. SCNA has mentors and tools to help you “learn and get active”. Join the SCNA Legislative Committee. Joining that Committee and networking with colleagues provided us the platform and tools to learn and get active! WOW…AND we have learned a lot. Call 803-252-4781 and ask to join! Joining is a professional investment for you and your profession.
Second, find your legislator. Go to this website: www.scstatehouse.gov. You can find your state and federal legislators with their contact information. Next, schedule an appointment to meet with your legislators. Introduce yourself at that meeting and tell them your concerns. It is vital you leave personal information with them such as your name, title, email, address, and a phone number so they can reach out to you if they have questions or to solicit your input. We suggest you take a seasoned policy nurse or mentor when meeting with them. Always dress professionally and give them written materials concerning your issue.
Third, attend local meetings like: City/County Council meetings, local school board meetings, local Republican, Democrat, and/or Libertarian meetings, League of Women Voters, and other advocacy groups. Attending these meetings keeps you in the loop of current issues affecting your communities, your patients, and your profession. Always, consult your mentor and stay aligned with your professional groups including The South Carolina Nurses and The Coalition for Access to Health Care. There is strength in numbers.
Fourth, identify a problem or issue you are passionate about and find a legislator champion who is like minded. Things to consider:
- What causes you distress or concern in healthcare?
- Who can you partner with for advocacy on your idea?
- Identify the cost/benefit for a policy change regarding your idea.
- Is this policy change something others can support or oppose? If so, why or why not?
- Develop communication tools like one-page talking points with facts that support your cause and the needed change. Always “Follow the money!”
- Does this policy change have naysayers to overcome? If so, what are your strategies to build your support base and refute arguments for change.
- Know the pros and cons of your issue.
- Does this policy issue require a statute bill change?
- Find a legislator in the House and Senate who will sponsor your bill idea. You can actually write the bill yourself using legislative language. Here is a recent bill introduced in the SC General Assemble for you to template: 2023-2024 Bill 423: Compassionate Care Act – South Carolina Legislature Online (scstatehouse.gov)
- Hire a lobbyist who can assist your group to navigate the bill through the General Assembly.
In South Carolina, legislative bills have a two year timeline for passage. Sponsors of the Bills can pre-file in December in either the House or the Senate or both. When the House and the Senate reconvene in January (usually the second Tuesday in January), legislative bills are assigned to a subcommittee where the public can provide oral testimony and/or written comments.
As a Nurse, you can provide testimony on a bill in the House and/or Senate subcommittees. Tips for presenting testimony at a Legislative subcommittee:
- Testimony is usually limited to three (3) minutes.
- Practice your testimony before presenting.
- State facts only.
- Take written copies of your oral testimony to give to the subcommittee members (about 6 copies).
- Dress professionally.
- Introduce yourself and your role title at the beginning of your testimony.
- Always be kind and respectful because the enemy today may be your best ally tomorrow.
After testimony and written comments are deliberated by the Subcommittee, they can vote the bill out favorably or unfavorably and forward their recommendation to the full committee. Assuming the bill favorably passes the subcommittee and full committee, the bill is read two (2) more times on the floor of the House or Senate (wherever the Bill originated) and then passes over to the other chamber for the same process and deliberations. Once the bill has three successful readings in the House and the Senate, the Governor can opt to sign the Bill or veto the bill. If a bill is vetoed, a 2/3 vote of the legislative members is required to override a veto. As a free service to all of us, you can monitor a bill through the www.scstatehouse.gov website.
Hiring a lobbyist who can articulate and negotiate your bill as it moves through the General Assembly is a wonderful asset. The South Carolina Nurses and the Coalition for Access to Health Care contracts with Wanda Crotwell who advocates for all nurses! She is an amazing lobbyist and a friend to healthcare issues.
Bottom line, for over 20 years nurses have been cited as the “most trusted profession”, and within the US there are over 5 million nurses. With this trust comes responsibility. The American Nurses Association (ANA) in 2021 stated that about 42% of nurses vote. The ANA “Code of Ethics” states we need to promote and advocate for and protect the health and safety of patients, individuals, family units, systems, or a community (provision 3). In Provision 7 of the ANA Code, it speaks of advancing the profession through …..health policy. Influencing politics and policymaking is advocating for patients, families, communities, and your profession.
So get involved!! Patients, families, and communities look to you as a trusted nurse who understands the health care problems and gaps. Nurses are “solutions oriented” and get the task done! You must be the voice for those whose voice is not heard or ignored. Get involved by joining those who are “at the table.” Let your voice be heard and be a change agent. Your patients need you!
References
American Nurses Association. View the Code of Ethics for Nurses | ANA (nursingworld.org).
Clay Doyle, Charles; Mieder, Wolfgang; & and Shapiro, Fred R. (2012). The Dictionary of Modern Proverbs, Quote Page 248. Yale University Press, New Haven.
Coalition for Access to Health Care. Coalition for Access to Health Care | Home. https://www.coalitionforaccesstohealthcare.com/
Compassionate Care Act. 2023-2024 Bill 423: Compassionate Care Act – South Carolina Legislature Online (scstatehouse.gov).
Milstead, J. & Short, N. (2017). Health Policy and Politics: A Nurse’s Guide 6th Edition. Jones & Bartlett Learning.
South Carolina Nurses Association. www.scnurses.org
