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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

  • Who created the Advocacy Institute Guide


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 you (nurses) are agents of change, as well as cover three barriers nurses currently face to creating change.

We will also outline what you can expect from ANA\California's 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 over four million registered nurses in the United States and nearly 500,000 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.

9 Reasons Why Nurses Can Influence Health Policy

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.

But often nurses face unforeseen barriers in their journey to creating sustainable change within policy and politics.

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 Guide

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

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

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

The next sections of the Guide start 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 does ‘political will’ mean and how to influence stakeholders

  • How to effectively communicate your message to policymakers and media

  • Examples of nursing advocacy success stories

  • Using advocacy message templates

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.


  • 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, and Instagram 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 preparing to be a nurse leader, expert, or entrepreneur one day, 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.


Meet the Authors and Creators of the Advocacy Institute Guide

Dr. Marketa Houskova Professional Photo Round

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

ANA\California CEO

Dr. Houskova is ANA\California's CEO (2017 - present). Previously, Dr. Houskova served as Secretary at ‘Hands for Global Health’, a non-profit organization administering and coordinating global health missions by connecting inter-professional healthcare students with other medical providers in remote parts of Panama.

Dr. Houksova, a Certified Pediatric Nurse with High Honors, initially graduated from a nursing school in the Czech Republic. She subsequently embarked on a career as a Nurse Anesthetist in a regional trauma hospital. Pursuing her dreams of working in America, Dr. Houksova obtained RN licenses through experiences in England and Canada.

Her academic journey included graduating Magna Cum Laude with honors from both CSUSM, where she earned a B.A. in Political Science and Women’s Studies, and the University of Miami, where she achieved a dual-track Masters in International Administration in Global Health Administration and Regional Development. Dr. Houksova's educational pursuits culminated with her recent graduation (2019) from the University of San Francisco, where she earned her Executive Leadership DNP. During this program, she created a Public Policy Toolkit aimed at enhancing nurses' understanding of the significance of advocacy.

Dahlia Maldonado Professional Photo Round

Dahlia Maldonado BSN, RN-BC

ANA\California Advocacy Institute Fellow 2024

Dahlia is currently the Nursing Practice Outcomes and Magnet® Program Coordinator for UCLA Medical Center, Santa Monica. She is recognized throughout the UCLA Health System as an influential leader and passionate supporter of the voice of nursing.

Since becoming a nurse in 2017, she has been extensively involved in Professional Governance, held various leadership roles, and participated in advocacy at a local and national level.

Dahlia graduated from Mount Saint Mary’s University with a Bachelor of Science in Nursing and Healthcare Policy and is pursuing an MSN in Nursing Leadership and Management from Western Governors University.

Rachel Viale Professional Photo Round

Rachael Viale, MSN, RN, CCRN

ANA\California Advocacy Institute Fellow 2023

Rachael is 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 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 Byrne Professional Photo Round

Melissa Sablik (Byrne), MS, RN, CPN

ANA\California Member

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 has been 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 Professional Photo Round

Jared Fesler

ANA\California Communications and Programs Manager

Jared 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.

Jared Fesler Professional Photo Round

Make'da Traynum, MSN, RN

ANA\California Policy Aide

Make’da Traynum, a South Carolina native, discovered her passion for healthcare early on, inspired by her nurse parents. Beginning as a Certified Nursing Assistant, Make'da earned her BSN from the University of South Carolina Upstate and her Master’s in Nursing Executive Leadership at Purdue University Global, focusing on legislation’s effect on nursing.

During her role as a travel nurse, Make’da delved into healthcare policies across diverse settings, gaining insights into nationwide healthcare concerns observed in free clinics and during the COVID-19 pandemic. In her position in the health insurance sector, she focused on addressing racial and income disparities in coverage and establishing educational forums to promote informed choices in insurance options.

Selected as a 2022 ANA\California Advocacy Institute Fellow, Make’da now serves as Policy Aide for ANA\California, dedicated to healthcare reform and advocating for nurses and the community through policy engagement.


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