Are you the kind of nurse whose blood boils when you see a patient short-changed because of short staffing? Do you worry about the number of uninsured children in an inner city school district who don’t receive the asthma care they need? Are you the kind of nurse who wants to know how political power is generated and how health issues get to be debated and acted upon at the federal or state level? You may want to consider a nursing career in health policy.

Our nation, communities, and health care institutions need nurses who are well versed in politics and know how to move an issue to the legislative agenda. The central purpose of health policy is to enhance health or facilitate the pursuit of good health by all. Nurses know how the many factors related to health, such as safe neighborhoods and drug-free schools, accessibility to smoking cessation programs, and adequate hospital and nursing home staffing, impact the lives and well being of patients, their families, and communities. Often, however, when important policy decisions are made, nurses are not at the table and miss contributing to the debate about an issue as it moves toward becoming a law or regulation.

The Medicare Improvement and Modernization Act passed in fall of 2003 provided a prescription drug benefit to Medicare beneficiaries. It serves as a good case in point. This legislation was discussed and debated behind closed doors. Nurses did not visibly add to the debate, yet many do have a lot to say about how elderly patients struggle with high prescription drug bills and often trade off other essentials like heating and food to pay the hefty price for their medications. Nurses know that the high price of prescription drugs is not only a problem for poor elderly; it impacts the middle and even upper income elderly as well. Nurses also know that longevity must be matched with a decent quality of life and prescription drug coverage has to be a well-financed benefit under the Medicare program.

During the 2004 elections, candidates presented many health care issues. What kind of political force did nurses exert? It’s important to be politically visible at election time because nurses can take their ideas and experiences and help shape the debate that ultimately places the winner in the White House or the State House. Nurses who embrace the field of politics and policy will be sought after for their knowledge, expertise, and patient advocacy role. The times are ripe for nurse power and policy expertise.

Nurses can gain credentials for health policy through experience and education and fashion a career in health policy in many different areas. A number of graduate programs prepare nurses to become policy analysts or lobbyists. Students learn to use their skills in policy and issue analysis to compare proposals and make the best policy choice. Nurses can also use their political skills in networking and coalition building to ensure their issues make their way through the maze of the legislative or regulatory process. Nurses who work in the field of health policy may also become government relations’ experts for health care associations and insurance programs. Many policy nurses have expert knowledge of Medicare, Medicaid, or private insurance programs and consult with health care institutions that need to comply with insurance rules and regulations. Some nurse policy experts run for political office and use their competencies in policy and politics to write and introduce legislation.

Some of the content areas required for a career in health policy are political science theory, the history and role of health insurance, health economics, health care financing, models for policy analysis, health services research, quality initiatives, the policy and legislative process, the regulatory process, program evaluation, and government role in health care. Most graduate programs run about 37 credits and take two years to complete (including a summer). An increasing number of undergraduate nursing programs also include content on policy and political advocacy in their curricula. Additionally, experiences like supporting a candidate running for political office or working in a policymaking setting help to launch a career in health policy.

An individual nurse can exercise political power through knowledge of the legislative and policy process, by understanding the principle policy players and party politics, and by developing a sense of proper timing for the most effective intervention. A nurse can participate in the process by sending letters and e-mails (and urging colleagues to do the same) to policymakers, visiting with key staff, and volunteering to give testimony before a legislative committee if nursing expertise is needed. Of course, every nurse has a vote, and exercising that right is extremely important. Let members of the legislature know that you do vote and that you will support issues that are important to your patients and the profession.

Belonging to a professional organization helps nurses magnify their power base. Policymakers listen when large numbers of nurses come together as one voice. The Nurse Reinvestment Act was passed in part because nursing organizations were able to come together and influence a large number of key legislators. The legislation increases the amount of federal money for nursing education, encourages nursing workforce diversity, and helps to alleviate faculty shortages.

Health care will continue to undergo enormous change in this century. Nurses can be architects of any reform effort at the federal or state level. Embracing a career in health policy and gaining political savvy are hallmarks of a new professionalism in nursing. Harnessing the power of nursing in this way can fuel the drive toward quality health care from the bedside to the classroom to the home.

Carole P. Jennings, RN, PhD, FAAN, is associate professor, deputy director of the Center for Health Policy, Research and Ethics, College of Nursing and Health Science, George Mason University, Fairfax, VA. She is founding editor in chief of Policy, Politics, & Nursing Practice.