Every day nurses advocate. It's in our DNA. And, it starts with our patients. Nurses, including advanced practice registered nurses (APRNs), advocate for our patients at the bedside, within the organization, and at the state, regional or national level. We also advocate for our practice. Why? Why advocate? I think this Dr Seuss quote from The Lorax says it all:

Unless someone like you cares a whole awful lot, nothing is going to get better. It's not.

What is advocacy? The best definition that I found is active support of a cause. We advocate to influence views, choices, and, most importantly, actions of individuals, communities, organizations, and our government. Engagement is an essential element of advocacy. Recently, I've learned more about the concept of engagement from an organizational standpoint. At my organization, we are moving away from an employee satisfaction survey to an employee engagement survey. The key difference between the terms satisfaction and engagement is emotional connection. Engaged employees have an emotional connection to the organization versus an employee who is satisfied but not involved in the organization. Clinical nurse specialists (CNSs) must be engaged in the advocacy process.

There is an opportunity for us to do more advocacy at both the state and national level. Engagement in advocacy is critical for the survival of the CNS role. In addition, CNSs must lead the way to advance healthcare in our country. I challenge each of you to think about your role as a CNS and to advocate for your profession and your practice.

I'm sure by now you are asking yourself-How do I find the time to do this? How do I balance work life, personal life, and, in addition to that, advocacy? There is no easy answer. But, it is important to make time-time that benefits both your cause and your professional growth. To bring about change, we must engage stakeholders, experts, and legislators.

The profession of nursing has a long tradition of advocacy for the common good. A great example of this is Florence Nightingale. She advocated for better hospital conditions for patients in the Crimean War and better education for nurses. Through her advocacy, she influenced governments, policy makers, philanthropists, and physicians. She advocated for continuous improvement in health conditions and better care of the sick and vulnerable. Sounds familiar, right? In Notes on Nursing, Nightingale wrote, "Were there none who were discontent with what they have, the world would never reach anything better." What a powerful statement.

Take a moment to reflect on your professional and personal interests. What causes, issues really matter to you? What initiatives in the region, the nation, or globally do you want to help advance? I can think of at least one issue that we all have in common-full practice authority for APRNs. The value of the CNS role is another. There are many more issues that require our advocacy, and the National Association of Clinical Nurse Specialists (NACNS) is involved in many of them-thanks to you, our volunteer members. NACNS provides commentary on proposed federal regulations; we share our expertise on ongoing issues, such as the opioid crisis, and participate in coalitions to influence our legislators on key issues such as the Title VIII Nursing Workforce Reauthorization Act, the Behavioral Health Coverage Transparency Act, Workplace Violence Prevention for Health Care and Social Service Workers, and so on.

I would be remiss if I did not mention the National Provider Identifier (NPI) initiative that NACNS launched earlier this year. I see this this as a form of advocacy for the CNS role. If you are not familiar, let me share. In 2006, the NPI was implemented because of the Health Insurance Portability and Accountability Act to create standardization of provider information for Medicare and other insurers. All providers must obtain an NPI. It is not only for providers with prescriptive authority. Therefore, all CNSs should have an NPI. An NPI identifies the role as a healthcare provider regardless of prescriptive authority status. Obtaining an NPI increases the visibility of the CNS role. To sign up, click on the following link: https://npiregistry.cms.hhs.gov/. It takes less than 5 minutes. All you need is your registered nurse/APRN license information. I challenge each of you to take a few minutes and sign up for an NPI today. Then spread the word to fellow CNS colleagues and let's achieve the goal to have all 70,000+ practicing CNSs obtain an NPI.

Finally, the National CNS Recognition Week is on September 1 to 7. During this time, please take a moment to share your CNS Week celebrations on social media using #CNSWeek on Facebook and Twitter. Happy CNS Week! Let's show off our CNS pride.