Effective advocacy begins at the grass roots level. Too often, nurse practitioners (NPs) find themselves in defense mode when it comes to laws and policies governing their practice. They react when they discover reimbursement or other policies that restrict their ability to provide services or when onerous legislation is introduced. Frequently, it is an uphill battle. Becoming involved in policy development or legislative movements before the decisions are made is a more effective method for attaining goals and allows NPs to be proactive rather than on the defense.

Individual Voices

Many NPs believe that they cannot make a difference as individuals in an overwhelming bureaucracy. However, in our system of government, the movement for change begins with the voices of individuals. Nurse practitioners can make a difference.

This is not to say that our local, state, and national organizations do not play an important role, but the voice of these organizations is only as strong as the membership. If individuals do not step up to make their voices heard through their professional organizations, the organizations cannot succeed.

Know the Players

With national and state elections looming in the near future, it is time for NPs to get behind candidates who will support our profession. One way of discovering who will support the causes important to NPs is to ask the candidates questions. Candidates can be queried through personal conversations, at public forums, or through letters requesting responses to questions. It is also important to pay attention to statements made when others ask questions. Sometimes, responses to other's questions can tell you as much about a candidate as if you had asked yourself.

State organizations may compile questionnaires giving voice to the concerns of individuals. The Kentucky Coalition of Nurse Practitioners and Nurse Midwives has developed a questionnaire for candidates running in the Kentucky gubernatorial primary and has plans to send questionnaires to candidates in future elections.

The Ohio Association of Advanced Practice Nurses published one in 2006. Other organizations have also found this to be an effective method of communicating candidates' views and informing voters.

Questionnaires can be mailed to candidates with responses posted in newsletters and on Web sites. The questions asked will help candidates become aware of issues important to their constituents, and the answers will help guide NPs with their vote.

Additionally, NPs should attend public forums or town hall meetings where candidates speak on the issues and citizens are allowed to ask questions. All of these are good ways to become educated on the views of the candidates, but there is another benefit. By asking questions, NPs increase their visibility and, therefore, candidates pay more attention to the views held by NPs.

The opinions of voters matter. When candidates hear from many voters voicing the same view, the viewpoint becomes important. The perspective of one or two NPs may not have an effect, but the voices of many will not be ignored. This is why a grassroots effort is so crucial to any movement.

So while NPs will need to continue to oppose arbitrary reimbursement, practice barriers, and regulatory hurdles, the profession has advanced to the point that defensive tactics are not enough. As individuals and as a group, NPs must develop a proactive agenda and set the standards for our own profession. The time has long past for allowing others to determine our professional path. Electing officials who support NPs and the health issues that are important to the profession is one way to accomplish this goal.