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Alene Nitzky is an oncology nurse, author of Navigating the C: A Nurse Charts the Course for Cancer Survivorship Care, Blue Bayou Press, 2018. She is a cancer exercise trainer and health coach, and is CEO/Founder of Cancer Harbors®.

As Nurses, We Must Advocate for Ourselves

This is the second in a series of 3 articles about nurses as advocates.
Nurses must advocate for our own roles. We must influence support systems so we are able to provide safe and effective care for patients, which is a top priority in our work.

Practices and policies in the workplace can dramatically impact a nurse’s ability to provide care for patients. Here is a list of practices for which nurses can and should advocate to make work safer, more effective and satisfying, and less stressful.
  1. Reasonable, safe, and tolerable working conditions. This should include but is not limited to adequate staffing, proper training and technical support, availability of breaks, time for stress management, mental health support, decompression, and emotional support after traumatic incidents.
  2. Adequate pay and compensation. These can include mental health days, sick pay, and vacation pay. Organizations such as National Nurses United, and other unions can help.
  3. Inclusion and representation on hospital boards and committees. These groups make decisions that affect our work and workloads. Think of the number of nurses working at your hospital compared to overall staff numbers and you will realize we comprise a huge number of staff and should be represented proportionally. Grassroots organizations can often be more representative of working nurses, where larger organizations sometimes will defer to administration and management priorities. Search social media for the hashtags #NursesTakeDC and #ShowMeYourStethoscope for more information.
  4. Responsible attitudes toward absences. Nurses should not be pressured to work while sick or injured. Search social media for the hashtag #ExcuseSickNurses for more information.
  5. Protection from and recourse for workplace violence. These are actions against nurses and healthcare workers by either patients or family members. Silent No More Foundation is an organization that protects healthcare workers before, during, and after an assault. Search social media for the hashtag #SilentNoMore for more information. 
  6. Enforced policies against lateral violence. There should be a culture of respect from administration, physicians, and other staff. “Confident Voices in Healthcare is a blog by Beth Boynton, RN, MS, that aims to help healthcare staff improve communication and the work environment in general.
  7. Encouragement of responsible, professional portrayals of nurses in the media. This can be in the form of television, entertainment, images, and news, both in print and online media. Reporters who are looking to write articles on certain topics often reach out to physicians when they could be asking nurses, which would give nurses’ voices more impact and visibility in print media. The Truth About Nursing aims to challenge nurse stereotypes and educate the general public about the value of nursing. Help a Reporter Out is a media resource nurses can join to be called upon as subject matter experts when journalists are looking for sources.
Speaking out in the workplace can be intimidating or difficult. You can get involved in a larger organization where you can safely air your thoughts and get support without identifying you to your workplace. Establishing connections with other nurses, especially on social media and outside of your workplace, will help.

Local media may be unwilling to cover issues that reflect poorly on their major advertisers, such as healthcare organizations. It may be hard to get them to report on topics related to nurse advocacy. 

It is empowering and very satisfying to feel you are part of the solution. Even if you feel afraid to speak out on certain issues, talk to people outside of your immediate work area, or nurses you know in other places. Discuss the issues with them, find out how they feel, or if they have witnessed effective advocacy efforts. You can also write letters to your representatives in Congress or state legislatures. The Oncology Nursing Society has advocacy courses for continuing education that apply toward recertification. While it takes time and patience, establishing rapport, developing a relationship, and building trust with a member of your workplace’s administration is important, and you will be listened to more readily.

Related Articles
Advocating for a Better Healthcare System
Six Ways Nurses Can Advocate for Patients

Talk about this article with nurses and others in the oncology community in the General Discussions Oncology Nursing News discussion group.
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