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The Importance of Professional Advocacy

      Nurse practitioners (NPs) and other advanced practice nurses are the front-line health care providers to millions of people every single day. Research demonstrates we provide high-quality care equal or superior to other health care providers, yet our restrictions in scope of practice are many. Common issues we face include difficulty achieving third-party payor designation, federal policies that ultimately are costlier to the system than a more streamlined approach, state-level limitations on practice that prevent us from working to the highest scope of our education and practice, and institutional restrictions that lead to fragmented care. The boundaries are many and, frankly, not evidence based. Additionally, as the number of licensed NPs reaches over a quarter of a million strong, the threats to our critical work are ever increasing and prevalent. This is why it is time for everyone reading this to increase their advocacy game.
      Now I am certain some of you read the previous statement and said, “that's not me.” I understand that belief, it was mine 10 years ago. Many have heard me speak of how it was one friend who inspired me to get involved, first in my chapter, then with special interest groups and committees. I hope I can be that person for you right now. I honestly did not think I had it in me to do more. I was relatively young in my career, and I was married with three kids at home. The days were long and the work responsibilities were intense (I worked with a physician in a solo practice and took crazy call without an exchange and shared rounding on newborns). Then, I had my responsibilities at home. My family has always been my number one priority, as it should be. What allowed the change to happen? Honestly, it was the kids.
      We nurses pride ourselves on our role as advocates. We argue that our view of the whole person as a spiritual, physical, and emotional being means we don't just focus on one aspect of care. As pediatric folks, we absolutely realize that health and wellness do not happen in a vacuum and that no one exists alone. We all have family by birth or selection that genetically and environmentally influence our wellbeing. We don't think twice about fighting a broken system to ensure that one child gets the care they need or one family has the wrap-around services needed to ameliorate complex social determinants. We dig in our heels at interdisciplinary team conferences and go through the insane peer-to-peer insurance process. And we don't think twice about it. We just do it. It might take us a little bit after leaving our educational programs, but every single one of us does this. We know our patients, we know what they need, and we don't doubt ourselves. We just do, because it is the right thing.
      None of us are afraid to be the advocate for a child or family. Why are we so afraid to go to the next step? To advocate on a larger stage? I think it is because many of us confuse politics and policy. For the record, I hate politics. I hate the divisive games all parties play in an invisible chess game. I often worry that the real focus on who that game is supposed to benefit slowly faded away years ago. And I absolutely despise how we have lost our national center and common ground. But, I have learned that the secret is the overwhelming majority of those in elected office are good people who entered into the world of policy for altruistic reasons. The majority get their knowledge of health care from being a patient or from navigating the system with a loved one. And they clearly hear what the lobbyists have to say. Who better to hear from than the child advocates who see the real-world implication of policy on a daily basis? Those who see the direct cost and burden of policy. All it takes is an email. Don't be too wordy, keep it simple. By sharing stories about people, you educate and illuminate issues. And, it can be done in those odds times of quiet we have in our personal lives. I usually call and leave messages at 6:30 AM, right after the coffee kicks in and when I have had enough quiet time to tell my story. Advocating in NAPNAP is easier. Attend a chapter meeting or a special interest group meeting; come to our annual conference once (disclaimer- you will get hooked). The next time you see that we need volunteers for a project, throw your name in the hat. Most commitments are only a couple of hours a month, if that. Because if you can do so much for one child, through advocacy, you can help change the system and help thousands. And, this system is so broken if we don't do it, then other health professionals, business people, and technology experts will.
      It has been my greatest professional honor to serve you as president of NAPNAP this last year. Thank you, from the bottom of my heart, for this amazing opportunity. There are so many special moments that will forever live in my mind and which are now deeply ingrained in my heart that I am certain will bring me a smile for decades to come. I have tried to honor your trust and hope to have moved the dial forward even a millimeter or two. I leave you in great hands with an outstanding new president, a top-notch executive board, and the most passionate and dedicated professional staff I have ever known. And maybe, I've inspired one or two new folks to step up in the workplace, chapter, or special interest group to bring a new perspective to the team. I look forward to cheering each of you from the sidelines as long as God allows.