Nurse Advocacy from the Clinic to the Statehouse and Beyond

Welcome to Heart to Heart Nurses, brought to you by the Preventive Cardiovascular Nurses Association. PCNA's mission is to promote nurses as leaders in cardiovascular disease prevention and management.  

Geralyn Warfield (host): I’d like to welcome our audience today where we're speaking with Liz Aquino. Liz, could you introduce yourself to our audience?  

Liz Aquino (guest): Yeah. Thank you for having me. I'm Liz Aquino. I have been a registered nurse for 18 years. I started as a surgical trauma ICU nurse, and then once I completed my PhD, moved into academia. And so now, I'm an Associate Dean for Academic Affairs at the University of Illinois at Chicago.  

I have a long history of volunteering for the American Heart Association and other professional nursing organizations. I'm the Past Immediate President of the American Nurses Association of Illinois. So, a lot of these organizations, I've really participated in the advocacy efforts, [00:01:00] which is part of my passion and part of why I'm here talking to you today. 

Geralyn Warfield (host): Well, thank you again for taking time out of your amazingly busy schedule and all the complexities therein, to really help us understand and know a little bit more about advocacy for nursing. And could you talk about the importance of nurse advocacy?  

Liz Aquino (guest): Absolutely. So, advocacy is really ingrained in nursing. It's in our nursing code of ethics. We do it on a daily basis with the care that we provide our patients. But actually, on the PCNA website, they have this perfect quote that I absolutely love. 

”Advocacy is like magic. It allows you to help more than one patient at a time.” I love that quote because as I said, nurses do this work [00:02:00] every single day on a personal one-to-one level.  

But if you think about how advocacy can also have, how we can scale that impact through advocacy, how we can actually create systemic changes by really sharing our experiences, using our voice to share our stories where decisions are being made, to really inform elected officials about the issues that we see and deal with every day.  

And so that is really important. And I think nurses have the experience, the training, and as I said, we do this every day. Let's just do it at a different level.  

Geralyn Warfield (host): I really am grateful to you for making that continuity of what we do, it's a relatively easy transition to go from bedside advocacy to a little bit wider role. And for nurses who perhaps haven't seen themselves in that light before, or who aren't sure what the next steps should [00:03:00] be in order to get involved, could you talk a little bit to our audience about what that might take or what that might look like? 

Liz Aquino (guest): Yes. It can take a couple different pathways. It depends on your comfort level, also the issue that you're passionate about.  

So, in the work environment, I think that's kind of one of the, probably, most comfortable places that maybe a staff RN would be able to advocate in, if you're seeing an issue in your unit, think about how you can actually create some changes. That getting involved in a unit level council or committee, or do you need to go up higher levels of governance to make the issue known and try to create that change you want to see. 

Outside, if you think about the role that elected officials have through legislation and the decisions that they're making every day, there's different ways that you can connect with those legislators in order to inform them of the issues.  

So, you can [00:04:00] write letters. You can try to meet with them in their district offices. You can attend rallies or town halls. You can ask to be part of their council--so if they have a health council where they have healthcare providers who can help advise them on specific issues, some legislators have that. 

So, there's just a number of different approaches. It really depends on the issue, the urgency of the issue, and then again, your comfort level.  

Also, there's professional nursing organizations just like PCNA who do advocacy work. It can be a matter of you signing up for advocacy alerts, so you'll be sent emails where, “Hey, there's this legislation, we'd love for you to submit a letter to support this or oppose this particular legislation.” 

And they make it very easy for you. You can just type in your name, your email address, your home address, and they [00:05:00] will find out who's your legislator, populate a pre-draft letter and you just hit ‘submit’ and it goes straight to your elected official.  

And then oftentimes you'll get like either an immediate response or you know, a few days after the elected official or their staff will send you a response to that legislation and what your ask is. 

So, so many different ways and I think that, again, depending on your comfort level, and your time and availability to do this work, you can get involved in different ways.  

Geralyn Warfield (host): And for those nurses who are still a little bit hesitant about the importance of being involved at whatever level it is, if it's sending that email, if it's actually meeting with legislators, I think something to keep in mind is, no one knows more about what you, your colleagues, and your patients need than you do. 

And if you're not sharing that information, how is it actually going to be heard? And in my mind, it's. In some ways, like that old game of telephone where you might [00:06:00] sit in a circle or a line and somebody starts the conversation and whispers something into somebody else's ear, it gets passed down the line, and by the time that information gets to the end, it's not quite the same message. 

And so, having a strong, unified voice is really important for what we do every day, isn't it? 

Liz Aquino (guest): Absolutely. If we think about the number of nurse legislators. It's like 1%.  

Geralyn Warfield (host): Wow.  

Liz Aquino (guest): In the state, at the state level. So, there's about 76 state legislators from a 2022 audit, and that's only within 36 states. So not even every single state has a nurse in the legislature.  

So, probably more than likely, you'll be speaking to a legislator that has no healthcare background. So, think about that influence. If they aren't informed on the issues that we know very, very closely about based on our personal experience, [00:07:00] on our education backgrounds, it's really important that we are speaking to those legislators and informing them. 

And, through our stories, again, through our experiences, I mean the stories, I think, is really a key part here. I think people remember the stories that we tell. More than probably anything, more than the numbers we're giving them. So, I, just want to remind nurses that sharing that personal experience that you have can be so impactful in these conversations. 

You don't even have to do all, I mean, you do need to be prepared when you meet with legislators, but just sharing what your experience is with that issue, the impact it had on you or the patient that you took care of, those are the things that the legislators want to hear about. What is happening? Why is it a problem, and what can be done about it? 

And what I have been lucky to have is the mentors in this advocacy space. And so, when I [00:08:00] first started out, I would participate in lobby days, which is also another great way to get involved. And so, through a professional nursing organization, a group of us went to the Capitol. 

And I was nervous. I had all my talking points ready, but I was still really nervous. 

So, in that first session, I actually kind of sat back and, and watched how the other nurse leaders in the room who had that more experience in doing advocacy work, how they talked, how they talked to the legislators, how they really engaged in conversations and the stories that they shared.  

And oftentimes, you don't have much time to get out all of the information that you want to share. So, you really have to be prepared and deliberate in the things that you're saying. So, there is kind of a good, there is a method to being able to speak to legislators when you're doing advocacy.  

And part of that is, you know, number [00:09:00] one, always introducing yourself and your background. So, you know, your name, your title, your role. Basically, setting the tone for why you're talking about the issue, what you know about the issue, why they should be listening to you about the issue.  

And then you need to talk about the problem. So, identify it. Share any story, share any data. Again, this needs to happen very succinctly, very quickly, depending on the space that you're in and the amount of time you have with them. 

And then you have to come with a solution.  

So, what can be done to address that issue? Is there legislation being proposed? Is there money that should be allocated in the budget? So, that's where your research comes in, and we'll move into the ask that you're going to make.  

So, are you going to ask them to support legislation? [00:10:00] Are you going to ask them to oppose legislation? Or are you just going to thank them for the work that they've done, that you have seen the impact on the other end, whether it's for you or the patients or the communities that you serve. 

Geralyn Warfield (host): We’ve been in conversation with Liz Aquino. And we're going to take a quick break and we will be right back. 

 

Geralyn Warfield (host): We are back talking with Liz Aquino about the importance of advocacy on the part of nurses.  

And Liz, we had you discuss for us kind of the ways to be involved. And you had talked a little bit about joining those letters to legislators. We talked about visits to the statehouse, but there are some other ways that we can get involved and I'm hoping you can address those for us, please. 

Liz Aquino (guest): Yes. I think we can utilize social media platforms to our advantage as a way to really get our message out to other people who may not be informed about [00:11:00] particular issues. 

Whatever your preference is in terms of using social media platforms, you can certainly share the legislation maybe that is being proposed, informing people about what the issue is, and what actions can be taken. 

So, I strongly encourage for nurses to be actively involved in social media. Have a presence. Many of us have followings or follow others, so making sure we're tagging others so that that message then can be exponentially shared through social media.  

Geralyn Warfield (host): I think that's an amazing way for people to be able to get involved on a regular basis and have a large impact with not terribly much input.  

I know we've had other guests on the podcast that have just wanted to remind the audience that if you are providing an opinion, that you just check in with your organization’s methodology for being involved and follow [00:12:00] those guidelines so that you know, you are knowing that you are representing yourself rather than your organization. 

But social media is an incredible tool, and it's a very powerful tool to be involved. So, we appreciate you sharing that. 

And I know you had a few other tips that you wanted to share with our audience as well.  

Liz Aquino (guest): Yes. So, I don't think you can ever [over] prepare when you're meeting with a legislator. As I said, you need to do your research. 

Number one on who you're speaking to. You know, is it the right person? Do they have any control over the issue? Can they actually help to create change? So that's kind of the first part, knowing that you're speaking to the right person.  

And then doing your research on them, seeing how they may be connected to the issue in some way. Maybe they've personally, if you're thinking about cardiovascular health, maybe they had a cardiac event themselves, or someone in their family, and you can really tie the issue to their personal experience. Sometimes. that's a really [00:13:00] great way to get an ally to support the issue.  

You also want to make sure that you're thinking about how much time you have with them. And being really prepared in terms of what is the, being able to state what is the issue, what you want to use as a solution or the resolution, and what you're actually asking them.  

Also try to avoid using any medical jargon. Make it very simple. Again, you're probably not speaking to somebody who has any healthcare background, so you really want to help them understand the issue. And in that way, you want to simplify the language you're using. 

And also have a fact sheet or some information that you can leave behind. Leave your business card or information so that if they do have any follow-up questions, they can reach out to you that you can be a resource for them, and let them know that you're willing to be a resource on that issue or anything else healthcare related. 

Also, if you [00:14:00] get asked a question that you don't know the answer to, don't lie, just say, “I don't know. I don't have that information with me today, but I can certainly follow up with you.” And absolutely follow up with them. Make sure you're following through. 

And don't get upset if somebody says that they can't support your issue. 

You don't want to burn bridges. You know, there's lots of reasons why people may decide to support or not support an issue. Sometimes we don't understand that because we're very passionate about the issue and think that there's a very simple solution. But in politics, there's many different things happening that could determine why someone would support or oppose a particular legislation. 

You don't want to burn that bridge because that person may be helpful on the next legislation or issue that you want to impact.  

And then be mindful of time and space. [00:15:00] So, you know, we talk about elevator speeches. So yes, you may run into a legislator in the elevator, and you have 60 seconds or less to make your pitch.  

Be mindful that that is a short amount of time to get your message across, and that that legislator probably has other things on their mind, you know, didn't expect to run into you. And so, you know, you want to make sure that it is the right timing to bring up issues whenever you interact with them. 

And also, think about the space. So, don't follow a legislator into the bathroom or a private space. You know, they also need their time and the right space to be able to take in the information that you've provided.  

So, think about those things and then ultimately, have fun, right? This is an issue that you know a lot [00:16:00] about, that you are passionate about, and legislators can feel that energy. And so, you want to make sure that you're not getting too nervous or getting overly passionate about the topic. That may blind the ability to really share that message that you want them to get.  

So, those are just some tips.  

Geralyn Warfield (host): So, as our audience is considering how to approach a state lawmaker, let's say, most of them have an office at the Capitol area and then a home office or several home offices, is there any benefit to trying to address them in either of those locations, or both of those locations? 

Liz Aquino (guest): Both would be great, but I will say typically when legislators are in the Capitol, they're super, super busy. So, you definitely want to make sure you're on their schedule. You may set up a meeting—this has happened to me often when I go to DC—I set up a [00:17:00] meeting with my congressperson or US Senator and you don't sometimes actually meet with the elected official. 

You'll meet with their staff. And those are just as important people as the elected officials. They can be gatekeepers. They are actually really informed on many of these issues. And so, you want to maintain good relationships with the legislative staff.  

And then when elected officials are in their home office, they’re in district office, it's also a great time. I feel like it's not as busy, typically, as when they're in session. So that's also a great opportunity, I would say.  

I don't know if one over the other but, obviously, depending on the urgency of the issue, you want to speak to the legislator whenever is quickest, and they’re available to hear you. 

Geralyn Warfield (host):  Great advice, and you've already spoken about some of the resources in terms of advocacy toolkits, and [00:18:00] information that you can get pushed notifications towards you about, but there's some other things that are on the horizon that I know that you would love to share with us.  

Liz Aquino (guest): Yes. I'm so passionate about getting nurses to actually run for elected office. 

I think it's something that we don't, we do a really great job of talking about nurse advocacy, even in nursing education, right? It's ingrained in our code of ethics. We know that nurses do this on a daily basis at the bedside.  

But what about taking that advocacy to another level? And in elected roles where they're actually able to make decisions that will create that systemic change? 

So, I've created a nursing training academy to run for elected office at the state level. It's supported by my state nursing association. And it's a six month program where we go over a number of different topics, including fundraising, which is not everyone's favorite thing [00:19:00] to do, but how to get their message out. How to create a platform that's focused on health equity. 

How to tell your story. How to run for office, and feel prepared, and have the confidence. 

Because running for elected office is not easy. If we don't have the training and support that we need to be successful, then you know, that can hurt us, right? We want more nurses to know that it is an option.  

We have some really great examples. In my own state of Illinois, we have Congresswoman Lauren Underwood, who is one of my favorite elected officials, and you can see the great work that she's doing. And because she's a nurse, she comes with this experience, and this lens, that can really help influence health policy. That we can see then that impact at the state level, at the federal level. 

So, that's really, one of the things, the next level of [00:20:00] advocacy that I'm really trying to push.  

And I know there's a number of different other programs that are offered even nationally.  

So, I think if any nurse has even any thought of potentially running for elected office, try to participate in these programs because it really does give you access to extra tools and resources and a network that can really help support you in your run. 

Geralyn Warfield (host): You have given us a wide array of information today, and I'm going to ask you to, if you will, come up with your elevator speech at the very end here and select one key takeaway for our listeners today.  

Liz Aquino (guest): Number one, anytime I'm in front of nurses or speaking to nurses, I want to encourage them to run for elected office. 

But I also just want to encourage nurses. You have the stories, you have the voice. Please share them with the elected officials so that they can be informed about the decisions that they're making, that impact all of us, the [00:21:00] patients that we serve, and the communities that we live in.  

Geralyn Warfield (host): Liz Aquino. It has been a delight spending time with you today.We are so grateful to you for sharing this great information with our audience. This is your host, Gerald Warfield, and we will see you next time. 

Thank you for listening to Heart to Heart Nurses. We invite you to visit pcna.net for clinical resources, continuing education, and much more.