Your Introductory Guide to Making a Difference
The world of nursing is constantly changing as policy makers and governing bodies consider new ideas and revisions to the rules that govern your practice.
Earlier this year, readers learned of Linda Stanich’s appointment to the Oregon State Board of Nursing, the Board’s first-ever nurse specialized in care for older adults and adults with disabilities.
Stanich’s appointment marked a clear turning point for community-based care (CBC)––a field traditionally overshadowed by the dominant presence of hospital and clinical-based nursing. With this change, CBC will finally have its voice at the table.
Stanich’s representation on the Board is powerful. It means that the real-world experience of CBC nurses will be considered when the Board exercises its principal role of interpreting and revising nursing regulations laid out in the Oregon Nurse Practice Act
This historic appointment and the representation it allots to CBC would not have been made possible without the devoted advocacy of CBC leaders who worked behind the scenes to shine a spotlight on CBC and make sure the field was represented on the new Board.
With this critical addition, we are reminded of the importance of nurse advocacy––at all levels. Where there are nurses, there must also be advocates and leaders ready to amplify nurse voices, perspectives, and concerns. And, collectively, that advocacy amounts to meaningful changes for nursing.
Without CBC advocacy, issues pertinent to CBC nurses would––and do––easily fall by the wayside, overcrowded by the mountains of other issues that leaders and decision-makers are tasked with on a daily basis.
Advocacy Through Elected Office
The Oregon legislature is a critical venue for nurse advocacy. To speak to navigating nurse advocacy in the legislature, NurseLearn invited Oregon State Representative Travis Nelson, a lawmaker, a registered nurse, and staunch nursing advocate, to talk to nurses in our Enhanced Program.
Representative Nelson represents Oregon’s House District 44 encompassing North and Northeast Portland from the airport to the St. Johns peninsula. As a House Representative, he crafts and passes bills on behalf of the constituents in his district at the State Legislature in Salem.
“If you would have asked me twenty years ago if I would have become an elected member of our Oregon Legislature, I would have told you no. That was not something on my radar at all,” he says, recalling his humble beginnings in politics.
Rep. Nelson was born to teenage parents in a rural town in North Louisiana. As a young child, his parents decided to relocate the family to the Pacific Northwest in search of better opportunities.
“I still remember the culture shock of moving from an almost all Black community in Louisiana to an almost all white community in Washington. Looking back on it, I can tell how being the only Black kid had an impact on me.”
Rep. Nelson did not take a linear path into nursing. “I went to work at the age of 14 and barely got though high school by the skin of my teeth,” he says. “After high school, I was determined not to go to college because I thought it wasn’t for me.” Several years in the workforce later, however, Rep. Nelson thought he would give college a try, and after some convincing from his mother, decided to embark on nursing school. “Fellow nurses will understand; it was one of the hardest things I’ve ever done,” he remembers.
“It was while I was working as a nurse that I decided to get involved with the Washington State Nurses Association (WSNA), where I first got my start in politics,” Rep. Nelson recounts.
In the years that followed, he went on to run for local office within WSNA, volunteer to door-knock for the 2008 presidential election, serve in leadership roles within the American Nurses Association, and become more active in state and national party politics. “Prior to that, I would not have considered myself someone very political,” he reflects.
“Then, in 2022, folks in the party contacted me and told me that I should run for office–– that they needed a candidate with my background and a nursing perspective. I have been representing the good people of Oregon House District 44 ever since,” he says, fondly.
Now, Rep. Nelson is the first-ever openly LGBTQ+ African American to serve in the Oregon State Legislature. “I say that proudly, firstly because it is a shame it took over 150 years for that to happen, but also because I want to be someone that open doors for others––other people of color, other nurses, other LGBTQ+ folks,” he says.
In his time as an elected official, Representative Nelson has used his seat at the table to make an impact on the issues that matter to him and his nursing community.
“I’ve had the great fortune of being a part of several fantastic pieces of legislation here in Oregon. We recently passed a historic nurse-to-patient ratio and CNA-to-patient ratio staffing bill,” he lists, referring to House Bill 2697 passed in 2023. “I was also co-chief sponsor of Senate Bill 1089 which started the Universal Healthcare Governance Board in Oregon. That Board has started doing their work, and they are tasked with coming up with a universal healthcare plan for Oregon,” he shares. “I am thrilled to be able to continue to do the work that I do.”
Individual Advocacy: Becoming a Voice for Nursing
Not all of us want to become an elected official (or maybe you do!), but many nurses still feel pulled in the direction of advocacy, and that pull is worth exploring.
It’s easier to engage in nurse advocacy than one might think (hey, you’ve already done half the work by being a nurse and reading this article). The skills you’ve learned as a nurse have already likely positioned you to be a great nurse-leader and elevator of nurse voices.
“I am a much better legislator because of my nursing background,” Rep. Nelson comments. “As nurses, we are used to operating within processes, we have to be good listeners, we have to be able talk to people who are perhaps disgruntled or angry or who we disagree with on a regular basis. Those skills have helped me build relationships across the aisle as well as engage with constituents and advocates, and they have helped me in crafting legislation. I’ve been as successful as I’ve been as a policymaker, precisely because of my experience at the bedside,” Rep. Nelson shares.
So, you already have the skills to engage with others. How do you get involved in the legislative process?
Connect with People in Advocacy Spaces
In order to understand how to navigate the political and social dynamics of being involved in advocacy, you have to learn from those who are already active in this space and have a general lay of the land. Here are a few suggestions on how to do that:
- Find Mentors:
“My advice to nurses interested in becoming advocates, whether it is in some sort of leadership role, becoming more active in government, or running for elected office. . . Having mentors is very important––people you can shadow, that you can talk to, bounce ideas off, who can share their experience with you,” Rep. Nelson advises.
- Join Nurse Community Groups:
A great way to connect with other nurses to talk about the challenges they are facing is to do so through an existing organization, such as the Oregon Center for Nursing.
The Oregon Center For Nursing (OCN) is Oregon’s nursing workforce organization, and their mission is to understand and support the Oregon nursing workforce. They conduct workforce research, provide nurse resources, and connect the nursing community through virtual and in-person events.
You can join OCN every Friday for their weekly Friday Huddle call where nurses from all fields across the State connect informally to talk about what is going on in their nursing community and discuss pathways forward.
- Connect with your legislator
Your legislators are great conduits to understanding how to propose new legislation, track the progress of proposed bill, and provide guidance on getting a bill through the legislative process. These are the experts on how the legislative sausage gets made. Your legislator wants to know you so don’t be afraid to introduce yourself and offer your expertise and ideas.
To find which legislators represent your area, plug your home address into the Find Your Legislator mapping tool.
Stay “In the Know”
There is so much information in the world of politics and advocacy, and it can be hard to keep up. Luckily, there are individuals and groups who work to keep folks up to date on legislative and policy happenings within healthcare and nursing. Here are a few suggestions that will help you stay “in the know”:
- Plug into Governing Bodies:
State Agencies like the Oregon State Board of Nursing or the Oregon Department of Human Services regularly provide updates––often via newsletters, magazines, or webinars––on changes made within those bodies that affect nurses and healthcare settings.
The Oregon State Board of Nursing, for example, is currently working to revise Rule 47 on RN delegation within community settings and will soon announce the dates for when they will open those revisions to public comment. Following their social media pages or signing up for their news updates will help you stay informed on proposed regulation changes and opportunities to provide feedback on those changes.
Plugging into legislative news happening at the local (cities, counties) and state level is an additional avenue for staying up to date. Often, legislators, cities, and counties will provide updates on proposed healthcare bills, including where the bill is in the legislative process and when you as a member of the public can provide comment or testimony on a proposed bill, in their office’s newsletter.
For news on healthcare and nursing bills at the state-level, first identify legislators who focus on healthcare and nursing issues. Then visit their legislative website on oregonlegislature.gov to subscribe to their newsletter. State Representative Travis Nelson and other legislators who serve on legislative healthcare committees are a great place to start:
- Plug into Organizations:
Organizations like LeadingAge Oregon and the Oregon Health Care Association dedicate their entire platform to advocacy for the care of older adults and adults with disabilities, and much of that advocacy takes place in the legislature. Members in these organizations have access to their summarized updates on legislative happenings related to their mission and their advocacy on those issues inside the legislature.
Activate Your Voice
There are endless ways to use your voice as a nurse to advocate for issues that affect your practice, whether it’s contacting your elected representatives about an issue your sector is facing, getting involved with advocacy groups like those mentioned above, proposing an idea for a bill in the legislature, or signing up to provide testimony at a public hearing for a proposed bill or rule change.
Through it all, it is worth remembering: “We are powerful,” says Rep. Nelson. “Oftentimes, as nurses, I don’t think we realize just how powerful we are.”