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What to Expect - Your Introduction to the Advocacy Institute Guide

Nursing advocacy in California has its benefits and challenges - this guide will give you the knowledge, skills, and confidence to advocate for the change you want to see.

What you'll learn in this section:

  • Why nurses are the right people to influence health policy

  • Perceived barriers to nurses' influence

  • What you'll learn in the Advocacy Institute Guide

  • Actionable tips for nurse advocates


Whether you are a new nurse or a registered nurse with 30 years of experience, there are times in your career when you will feel a change needs to be made - that you or ‘the system’ could do or be better.

You may want to provide higher-quality care for your patients and communities.

Or, perhaps, advocate for the advancement of your profession, grow nurse leaders and careers, or simply stand up for what is right.

But often, the road to creating change takes more than a single phone call, meeting, or social media post.

While nursing advocacy can be daunting, it can also lead to new opportunities. We are here to help you navigate your journey as a nurse advocate in California and support your advocacy efforts along the way.

In this introduction, we will demonstrate why nurses are agents of change and cover three main barriers nurses currently face to creating change.

We will also outline what you can expect from the Advocacy Institute Guide, Digital Courses, and the Fellowship programs. Our goal is to help you finish this series with a basic understanding of nursing advocacy in California as well as help you gain the confidence to create the change you want to see in nursing, healthcare, and life.

Why Nurses are the Right People to Influence Health Policy

There are four million registered nurses in the United States and over 450,000 in California, making nurses the largest group of healthcare workers in the nation and the state.

Nurses are not only trained to provide direct care to persons and families, but they also directly influence the advancement of their clinical practice environments.

Here are nine (9) reasons why nurses are the right people to influence health policy:

  1. Nurses are simultaneously exposed to a spectrum of real-time experiences of patients and systemic healthcare problems that require government agencies to intervene.

  2. Nurses constantly develop theories to explain and predict what they encounter at the bedside.

  3. While they practice, nurses incorporate various theories from psychology, education, biomedical science, information technology, and biology.

  4. Nurses interact with more diverse and interdisciplinary individuals on a daily basis than other healthcare professionals, allowing them to pick up on interpersonal patterns.

  5. Nurses are durable from experiencing life to death to everything in between.

  6. Nurses are durable as members of all healthcare professionals who experience the highest incidents of workplace violence.

  7. Nursing education is more formalized with its approach to communication - a skill vital to speaking to lawmakers and the public.

  8. Nurses are the most trusted profession.

  9. Nurses care and value partnerships over competition for the common goal.

All of these characteristics make nurses great resources for developing policies and understanding the intricacies of health care.

Perceived Barriers to Nurses Influencing Health Policy

So, if nurses are the right people to influence health policy and change, then why are there not more nurses doing so?

We identified several barriers nurses face when trying to create change:

  • Lack of education on how to formally advocate

  • Perceived lack of impact

  • Perceived lack of self-confidence in advocacy skills

  • Perceived lack of incentives to advocate

  • Perceived lack of time

  • Fear of retaliation by employers

These barriers are real barriers but not insurmountable. By creating educational content that actively engages nurses in skill-building exercises, we can create additional opportunities and incentives to have the impact we want to see.

What You'll Learn in the Advocacy Institute

The idea for the Advocacy Institute was born out of a realization by Dr. Marketa Houskova (ANA\California Executive Director 2017 - present) that there was no nursing-specific, step-by-step advocacy toolkit for registered nurses.

So we transformed her toolkit into this guide so we can empower nurses to confidently advocate both at the bedside and away.

The Advocacy Institute Guide is the first part of the Advocacy Institute's three programs. Each section is designed to increase your knowledge, skills, and awareness of nursing advocacy in California.

The Guide starts by teaching you the basics of nursing advocacy in California, giving you an overview of systems, timelines, and processes before moving on to actionable information and downloadable templates.

The series will cover the following concepts:

  • An understanding of legislative, regulatory, and policy change

  • What a nursing campaign is and how to start one from scratch

  • What ‘political will’ means and how to influence stakeholders

  • How to effectively communicate your message to policymakers and news media

  • Examples of nursing advocacy success stories

  • Using advocacy message templates

Recommendation: We recommend finishing the Advocacy Institute Guide before moving on to the Advocacy Institute: Digital Courses or submitting your application for the Advocacy Institute Fellowship.

The Digital Courses and Fellowship are advanced levels for those who wish to continue their advocacy journey and have familiarized themselves with the basics.

Advice & What to Do Next

  • Keep a short list of issues you care about and why they matter to you. It is easy to get lost in the variety and complexity of nursing legislation, regulation, or policy at any given moment. Remembering the core change you're setting out to advocate for will set you up for success further along the advocacy journey.

  • Connect with nurse leaders, experts, educators, and entrepreneurs to learn more. You can also connect with ANA\California on LinkedIn, Twitter, Instagram, and Facebook as we post news, events, data, personal stories, expert testimonials, and more about our nursing campaigns and legislative efforts.

  • Certain experiences often make you more interesting and influential. Nurses advocating for the betterment of themselves, their profession, their patients, and their communities very often correlate with the experience needed to succeed in leadership roles. If you’re properly preparing to one day be a nurse leader, expert, or entrepreneur, advocating will be a core part of your job.

This is just the beginning of your journey as a nurse advocate and we're here to help you create the change you want to see.

Now, take the next step and begin familiarizing yourself with the processes of changes behind legislation, regulations, and policies.



Dr. Marketa Houskova, DNP, MAIA, BA, RN

Dr. Houskova is ANA\California's Executive Director (2017 - present).

During her Doctor of Nursing Practice project at University, San Francisco, Dr. Houskova found that no central sources of information could be found on nursing advocacy. So, she created a Public Policy Toolkit to better inform nurses about the importance of advocacy.

Today, that toolkit has been transformed into the Advocacy Institute Guide today.

More about Dr. Houskova:

Due to her global health expertise, Marketa served as Secretary at ‘Hands for Global Health’, a non-profit organization administering global health missions/clinics by bringing together inter-professional healthcare students along with other medical providers to remote parts of Panama where she mentors American nursing students.

Marketa graduated Certified Pediatric Nurse with High Honors from a nursing school in the Czech Republic. Later, she pursued a career as a Nurse Anesthetist in a regional trauma hospital. Her dreams of America led her through England and Canada where she obtained RN licenses. She graduated Magna Cum Laude with academic awards from both the CSUSM with B.A. in Political Science and Women’s Studies, and from the University of Miami with dual-track Masters in International Administration in Global Health Administration and Regional Development. Marketa most recently graduated from the University of San Francisco with her Executive Leadership DNP.

Rachael Viale, MSN, RN, CCRN

Rachael is a 2023 ANA\California Advocacy Institute Fellow and a Critical Care Resource Team Nurse at the University of California, San Francisco Medical Center.

Rachael graduated from Loyola Marymount University with honors in Philosophy and minors in Biology and Economics. She then served as an AmeriCorps VISTA at the Health Justice Project in Chicago, Illinois which inspired her to pursue nursing in an effort to get the hands-on experience needed to create change. Rachael graduated from the Johns Hopkins University School of Nursing Master Entry to Nursing Program in 2019. She is passionate about increasing access to quality care, and improving symptom management and palliative care.

Melissa Sablik, MS, RN, CPN

Melissa is an ANA\California Joanne Powell Award Winner and a pediatric ICU nurse at UCSF Benioff Children's Hospital in Mission Bay.

Melissa has been featured on human trafficking nursing interventions with the online publication Nursing Management.

Melissa Sablik graduated from CSU Sacramento with a BSN in December 2015, and graduated from UCSF School of Nursing with an MS in Nursing Health Policy in 2022. Melissa has had a strong interest in nursing policy since being introduced to ANA\California in 2014 during my undergraduate degree. Melissa is a member of the Medical Reserve Corps in Sonoma County since 2017. Her collective experiences are what make her proud to be a registered nurse and are why she believes nurses are essential and unique voices in nursing policy.

Jared Fesler

Jared Fesler is the Communications and Programs Manager at the American Nurses Association\California.

He brings a wealth of experience to his role with a proven track record of success in developing and executing strategic communications plans and implementing programs that support the organization's mission. His business and marketing skills have made him a valuable asset to the ANA\California team, where he has been instrumental in increasing engagement and awareness of the organization's campaigns and developing new value propositions for its members.

Before ANA\California, Jared co-founded media startup in 2016 and graduated with a Bachelor's degree in Business and Marketing from CSU, Chico in 2013.

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