Registered nurses are the largest healthcare workforce nationally and statewide, consistently voted as the most trusted and ethical profession for more than two decades. Yet, nurses are still among the least represented in policy, politics, and news media.
Currently, not a single nurse serves in the California State Senate or Assembly. On the other hand, physicians currently hold two elected offices.
Nationally, nurses represent just 6% of all hospital board seats while physicians represent 20% (data valid through 2023).
Who makes policy decisions for nurses in California?
The reality is physicians, political analysts, financial consultants, and lawyers are the people who currently make decisions about nursing policy and legislation.
Are you confident they will make decisions that are in the best interest of your profession? Your practice? Your patients?
This begs the question: If nurses don't lead changes in nursing legislation, regulations, and policies, who will?
You don't need to become the next California Senator or Assemblymember, hold a hospital board seat, or launch a new campaign to create positive changes in nursing.
But, in order for you to effectively educate the public at large, policymakers and news media, you will need to learn how to communicate your message.
So, let's recap.
So far, the Advocacy Institute has covered:
Barriers nurses face when advocating,
Processes behind creating change for legislation, regulation, and policy in nursing,
Five steps to creating your own advocacy campaign,
How to determine the political will behind your topic, and
Potential stakeholders you need to influence.
In the next two subsections, we will give you tools and tips on how to effectively write and deliver your message to both policymakers and news media.
DELIVERING THE MESSAGE TO A POLICYMAKERS
Elected officials and policymakers have a sworn duty to protect and serve their districts and the State of California.
But it’s easy to forget that a lot of policy decisions are made by politicians who don't have expertise in your industry or field. And that many discussions around these policy decisions are not happening on social or public platforms.
Instead, new ideas are usually implemented 'below the radar', spearheaded by purpose-driven public servants, foundations, non-profits, associations, and others in the social sector.
That's because policymakers face many political and practical constraints that require education and influence from subject matter experts.
Due to this, legislators generally expect your message to convey three things:
What are you experiencing?
What are your patients experiencing?
Why do you think this policy would help or hurt your profession or patients?
But in order for a message to be truly successful, you should first consider:
how you will identify the right policymaker(s),
what your method(s) of communication will be,
how you can answer or alleviate key constraints, and
best practices for delivering your message.
HOW TO IDENTIFY POLICYMAKERS
Policymakers care about issues that illustrate one of their values, interests, or priorities - or better yet all three!
By creating a “bridge" between these priorities, you can show them how acting
on the issue you care about also helps them to accomplish their own goals.
The following tips will walk you through how to find common ground with any policymaker:
What are their current and prior occupations?
What committees do they sit on?
What are the economic and cultural interests of the geographic area they represent?
What bills or policies have they sponsored (written) or co-sponsored?
What are some things that their constituents care about?
DECIDE YOUR METHOD OF COMMUNICATION
There are a variety of methods of communication with your policymakers, including:
Emails and letters
A well-crafted letter sent by email or direct mail is a common method for communicating with members of the California Legislature. Their offices are set up to receive, log, and respond to constituents’ letters but the volume of emails received is extremely high. Your letter should be clear, concise, focused, polite and compelling, supported by evidence, and limited to one page.
A phone call demonstrates that you are highly engaged and deeply committed to your cause. While it is highly unlikely that you'll get connected directly to your representative, it does allow you to communicate directly with a live staff member who can relay information.
Most members of the California Legislature use social media platforms to interact with and push information out to their constituents directly. Twitter and Facebook are still some of the most commonly used social media platforms by legislators but audiences can be found on nearly all platforms (including the recent rise of political messages on TikTok).
Appointments (In-Person or Virtual)
Want to have a longer-lasting impact with more immediate results than letters, phone calls, or social media? Personally visit with an elected official or their staff in their local district office or via an online meeting. District offices are staffed with people whose job it is to communicate with constituents like you. There are no barriers to contacting these local offices and establishing relationships.
Note: Are you thinking, "Why would I meet with staff?" Often it is not the elected representative with time to meet constituents but rather legislative aids. Do not be discouraged! Legislative aids are invaluable contacts because they spend their time listening, researching topics, and reporting back to the representative.
HOW TO ALLEVIATE KEY CONSTRAINTS FOR POLICYMAKERS
In the realm of policymaking, key constraints can often hinder progress toward achieving desired outcomes. These constraints may take various forms, such as legal limitations, budgetary restrictions, or political obstacles.
However, removing these constraints can be a daunting task.
They require careful analysis and strategic planning to identify potential solutions that balance competing interests and priorities.
Policymakers must navigate complex decision-making processes, engage with stakeholders across different industries, and often work against short deadlines to implement effective policy changes.
Here are six tips to help you communicate that you understand the key constraints the policymaker is facing:
Respect Their Time
Aim for short, concise writing focused on one main point with no more than three subpoints. Legislators don't spend hours debating issues with lobbyists or constituents - you'll be lucky if you get more than five minutes.
Create Timelines & Expectations
Outline step-by-step implementation processes and how the idea can be scaled over time. Big changes take a long time and laws last for years, so finding a manageable path to implementing changes over time will help you make complex issues more palatable.
Be Upfront About Risks & Challenges
List out potential negative, unintended, and legal consequences for policy recommendations. Using precise language is key to a bill's success and in reducing confusion about the bill's intent.
Deliver Concrete Results
Share short-term and long-term evidence on the impact of the policy recommendation but avoid factual overload. You can only understand the true value or effectiveness of something by putting it into practice or by testing it. Legislators like to see evidence that the policy recommendation will work before they decide to implement it more broadly.
Partners & Resources Needed
Get clear on who the policymaker may need to work with to achieve success and what money or resources they may need along the way. By understanding the different stakeholders involved, policymakers can better navigate the complex web of relationships and interests that often arise in policymaking, including other government agencies, interest groups, community organizations, and individuals who will be impacted by the policy.
Decide How You Will Communicate
Utilize messaging best practices and templates to keep communication short and concise. This may involve breaking down complex policy issues into more manageable pieces, using concrete examples to illustrate key points, and removing confusing industry jargon. By using pre-designed templates, you can save time and resources, while still ensuring that your messages are effective and consistent.
View the next section of the Advocacy Institute Guide to access our templates.
Note: Don't have a specific legislative bill in mind when gonig to meet with your district legislator? No problem. Introduce yourself as a constituent and offer to be a point of contact in case they want to speak to someone who is an expert in nursing and healthcare.
5 BEST PRACTICES FOR DELIVERING YOUR MESSAGE TO POLICYMAKERS
The important thing to remember is to be yourself and speak with facts, knowledge, and heart. If you are a constituent in their district, your legislators will especially value what you have to say.
Here are five best practices for delivering your message to policymakers:
Know who your legislators are and what they advocate for.
Get on your legislator's email list as a constituent.
Inform legislators of important information that impacts fellow constituents, their communities, the nursing profession, and your patients.
Use simple messaging suitable for public hearings and open comments.
Ask Legislative committees for recommendations.
Once you have perfected delivering your message to your decision maker, you can work towards delivering your message to the media.
DELIVERING THE MESSAGE TO NEWS MEDIA
Developing an advocacy campaign requires more than your personal or professional connections, even for career nurse advocates. Journalists and reporters offer a unique opportunity to reach other nurses and local representatives, as well as inform voters in California.
But the Woodhall Study - conducted twice, once in 1997 and again in 2017 - found nurses were cited as sources in only 2% of health news stories, a surprising decrease from 4% in the previous study.
This is due to a multitude of factors:
Journalists don't fully understand the range of nurses' roles, work, and education
Journalists often don't know how to find nurses to interview and have limited time to track them down.
Editorial biases, policies, and processes can impede using nurses as sources.
Communications staff of healthcare organizations aren't offering nurses as sources unless journalists specifically ask for them.
Associations aren't implementing the latest tools and strategies to engage journalists.
While we understand advocating can be uncomfortable at first and may even seem terrifying at times, with the right knowledge and training, communicating confidently to legislators and the media will help nurses' voices be heard.
This subsection will demonstrate:
how to identify the best media source(s),
steps to take before contacting the media,
basics on how to frame your message, and
best practices for speaking to the media.
Note: It is incredibly important that you become familiar with your employer's organizational media policies and consult directly with the department that oversees external media opportunities.
HOW TO IDENTIFY MEDIA CONTACTS
A media list - also known as a press list or media contact list - is a document containing contact information for a list of journalists, reporters, social media influencers, bloggers, and more.
Media lists allow you to quickly send your messages to relevant people who are potentially interested in amplifying your message.
To start building your media list, follow these steps:
Step 1: Figure out who is talking about nursing topics
Step 2: Decide which contact information you’ll add to your media list
Step 3: Choose where you’ll keep your media contacts
Step 4: Find media contacts and add them to your list
Where to find local and regional news reporters:
For print coverage
A good starting point is the U.S. Newspaper List (USNPL), which lists newspapers by state and city. Consider N2 Publishing group for local city newspapers, city, ZIP code, and neighborhood-based magazines, and Chamber of Commerce and other business directories for educational publications and community-centric publications.
For radio stations
Discover radio stations in your area using a free radio locator tool. They link to each station’s website where you can find contact information.
For television stations
News stations need local-interest stories for their programming. Every major network has a local affiliate with its own website and contact information.
Local websites include blogs, digital news sites, and even Facebook groups dedicated to posting news and announcements relative to specific locations. One of the biggest online networks for local news stories is Patch Network, with individual websites for several hundred neighborhoods and cities.
Where to find national syndication media contacts:
Fairness & Accuracy in Reporting's (FAIR) media watch list contains a list of many of the major news stations in the United States.
Nursing industry blogs:
Nurse.org - nurse.org/articles
Working Nurse - https://www.workingnurse.com/
Nursetopia - nursetopia.net
The Nursing Site - thenursingsite.com
Confident Voices in Healthcare - confidentvoices.com
Diversity Nursing - blog.diversitynursing.com/blog
Digital Doorway - digitaldoorway.blogspot.com
Nurse Gail - nursegail.com
RegisteredNurseRN - registerednursern.com
Nurse Code - nursecode.com
The Nerdy Nurse - thenerdynurse.com
Nursing Times - nursingtimes.net/opinion
Nurse Buff - nursebuff.com
Ask Nurse Alice - asknursealice.com/blog
Dear Nurses - dearnurses.blogspot.com
The Bossy Nurse - thebossynurse.com
Reality RN - realityrn.com
FreshRN - freshrn.com
AJN Off the Charts - ajnoffthecharts.com
ANS: Advances in Nursing Science Blog - ansjournalblog.com
Lippincott NursingCenter - nursingcenter.com/blog
BMJ Evidence-Based Nursing - blogs.bmj.com/ebn
Correctional Nurse - correctionalnurse.net
Healthy Workforce Institute - healthyworkforceinstitute.com
Nursing Stories - nursingstories.org
NP Business - npbusiness.org
*Interested in being mentioned in the list above? Contact us: email@example.com.
STEPS BEFORE MESSAGING THE MEDIA
Spokespersons and PR practitioners who provide behind-the-scene counsel and support know that successful communications skills are honed through media training and practice.
The following five-step process will help you develop strategic messages and prepare for interviews with news media:
1. Set your agenda
Before embarking on any policy initiative, it is important to set a clear agenda that outlines the goals, objectives, and timelines. This involves identifying the problem or issue that the policy aims to address, as well as the desired outcomes and unintended consequences the policy is expected to have.
Journalists will be asking you questions to understand more about how the issue will impact their viewership and being prepared will allow you to hit key messages throughout the interview.
2. Frame your key messages
In policymaking, framing is important because it can influence how stakeholders perceive the issue and the proposed policy solutions. The same is true for framing your messages for news media.
To frame key messages effectively, you should consider the values, beliefs, and priorities of the media outlet's or journalist's audience and tailor your messaging accordingly.
3. Prove your points
Gathering relevant evidence, research, and data will not only help you support your arguments but also show why your proposed policy solutions are necessary and effective. By backing up your claims, you will build trust with media experts as a credible and prepared healthcare provider and increase the likelihood that you are invited back.
4. Prepare for FAQs
Anticipating and addressing frequently asked questions (FAQs) is an important part of effective communication with journalists. You should be prepared to answer questions about the policy proposal, including its rationale, potential impacts, and details about how it would be implemented. By addressing FAQs proactively, you can reduce confusion and uncertainty among key stakeholders.
Here are some FAQs journalists may ask you during a media interview:
Who is involved in the story? Who is affected by the events in question?
What happened? What are the details of the story?
When did the events occur? When will things happen in the future?
Where did the events occur? Where are the people involved located?
Why did the events occur? Why are the people involved in the story taking certain actions?
How did the events occur? How are people responding to the events?
What are the potential consequences? What will happen if the situation is not resolved?
What are the different perspectives on the issue? What do different people think about the events in question?
What are the facts and evidence to support the story?
Are there any conflicting information or discrepancies that need to be addressed?
5. Identify media contacts
In today's media landscape, the media can play a powerful role in shaping public opinion and influencing policy decisions. You can ensure that your messages are amplified effectively by identifying key media contacts who cover the relevant policy issues and building relationships with them over time. By cultivating relationships with journalists and other media professionals, you can help ensure health information is accurately conveyed to the public.
FRAMING YOUR MESSAGE
Simply, messaging is telling your story through researched and prepared advocacy.
Effective messaging includes careful consideration of your campaign's purpose, goals, and audience while balancing the interests of your members, colleagues, and parallel health organizations.
To aid in message development, we recommend an easy-to-remember list of guidelines:
The Five C’s of Messaging
Make – at most – 3 to 4 easily understandable points. Ask yourself: Do they address the problem, the responsible party or institution, and the solution? If you're having trouble reducing it down to a few points, then you might need to revisit the scope of your message.
Make sure your message connects not just with your mission or core values, but also with the values of your audience. For example, if your policy issue focuses on a social justice issue, then you might frame the message in a way that emphasizes the value of fairness and equal treatment.
Ask, “Why should their audience care about this? How can I make them care?” By putting oneself in the shoes of the audience, you can ensure that your message is relevant, timely, and meaningful to its intended audience.
In media communication, the use of sound bites can be an effective way to convey information quickly and succinctly. They typically range from 7-12 seconds in length and are designed to be easily digestible and memorable for the audience. They are particularly important in today's fast-paced media environment, where attention spans are short and the competition for audience attention is high.
Repetition and reinforcement of your key messages is an essential strategy for ensuring your message resonates with the intended audience. By keeping the message consistent you will increase the likelihood that the audience will remember.
6 BEST PRACTICES FOR DELIVERING YOUR MESSAGE TO NEWS MEDIA
Here are five best practices for delivering your message to news media:
Frame your message
Be friendly, concise, and honest in your outreach
Anticipate tough questions and prepare answers
Use simple language and short sentences
Avoid no-comment answers because it makes it seem like you’re hiding something
Review your organization's media policies
Connect with your employer's external communications department
Summary and Next Steps
When nurses speak, people listen.
Learning to effectively communicate your needs and recommendations to both policymakers and news media is crucial in creating sustainable change. By doing so, you ensure that your voice is heard, and your concerns are addressed by those who have the power to make a difference.
It allows you to build support for your cause and garner the attention needed to make meaningful progress. Without it, our efforts risk being overlooked or dismissed, leaving us unable to achieve the long-term and lasting impact we strive for.
The next section of the Advocacy Institute, Success Stories, will share real-life examples of nurse advocates, associations, and coalitions whose work can be seen today. Watch their recorded interviews!