Feature
From Bedside to the Capitol
Why nurses belong in advocacy
I am an emergency nurse. I like controlled chaos, trauma activations, and finding creative places to chart when every computer is occupied. Public policy was never on my radar.
Then, an email landed in my inbox asking for volunteers to testify in Sacramento in support of AB 2260, a bill to require trauma kits (emergency kits for treating severe bleeding after a mass casualty event) in public gathering spaces.
“Just a Nurse”
Honestly, I am still not entirely sure what compelled me to volunteer. But whatever the reason, I took time off work and used my own flight points to book a same-day trip to Sacramento. The entire flight felt like one long internal panic attack. I kept thinking, “Why me? I am not a policymaker. I am not a lawyer. I am just a nurse.”
Somewhere between walking into the Capitol building and delivering my testimony to the Assembly Health Committee, I realized something important: “Just a nurse” was exactly who the assemblymembers needed to hear from.
Most legislators are not nurses. (There have been a few.) They hear all the time from analysts, administrators, and lobbyists, but they often don’t hear from the people who are actually standing at the bedside.
With AB 2260, the trauma kit bill, legislators needed to hear from people who’ve seen tragedy unfold in real time and understand what happens in those critical minutes before EMS can arrive.
I spoke about hemorrhage control, survivability, and the importance of immediate access to bleeding control kits. I spoke about prevention and preparedness, and stressed the reality that in a mass casualty incident, bystanders often become first responders.
Despite all the anxiety leading up to that moment, that single experience completely changed how I viewed advocacy. Nurses don’t need to be political experts to make a difference. We simply need to be willing to share what we see.
What Is Advocacy, Anyway?
When nurses hear the word “advocacy,” many of us think about bedside care. We advocate when a patient’s condition changes. We advocate when pain is not controlled. We advocate when something simply does not feel right.
However, advocacy can extend far beyond the bedside. In public policy, advocacy means using our experience and expertise to help shape laws, regulations, and systems that affect patients, nurses, and healthcare at large.
Nurses see firsthand where the gaps exist. We know where systems succeed and where they struggle. Legislators need that perspective because most of them have never worked in healthcare. They have never managed a full waiting room, watched boarding delays pile up, or tried to explain to a family why resources are stretched thin.
We have, and that’s why our voices matter.
Why Nurses Should Care About Public Policy
Every nurse has experienced frustration with a systemic issue at some point: unsafe staffing, workplace violence, lack of mental health resources, delays in care, injury prevention gaps, limited healthcare access.
Many of those problems are influenced by public policy decisions. That means nurses have an opportunity to help create change before patients ever arrive at the hospital.
Here are some of my recent advocacy efforts.
• TYLER’S LAW
Especially meaningful to me is SB 864, also known as Tyler’s Law. This 2022 California law now requires acute care hospitals to include synthetic opioids like fentanyl in urine drug screens.
The bill was inspired by a heartbreaking story.
A 19-year-old boy named Tyler was brought to the ED unresponsive. A drug screen was negative, so he was treated and discharged. The following day, he returned to the ED, and this time did not survive. Later, his family learned that he’d had fentanyl in his system. Tyler’s providers hadn’t made a mistake — routine drug screens just didn’t test for synthetic opioids.
With support from the Emergency Nurses Association California Council, Tyler’s mother worked to raise awareness and push for legislative change. Tyler’s Law took effect in California in 2023, and Sen. Alex Padilla has introduced a nationwide version, S.921.
That is advocacy: Not politics for the sake of politics, but real patient impact.
• E-BIKE INJURIES
Some of my recent advocacy efforts have focused on e-bike injury prevention. At our trauma center, we’ve been seeing more and more patients injured on e-bikes. Some were kids with serious head injuries. Some were adults who underestimated how fast these bikes can go. Some had no idea the rules for e-bikes were different than for traditional bicycles. Every shift seemed to have another crash story.
As I saw those injuries pile up and heard families say, “We didn’t know,” I realized that complaining in the breakroom was not going to fix the problem. So, I headed to Sacramento for another advocacy day, anxiously rehearsing what I wanted to say about 700 times in the car. E-bike safety legislation is currently moving through the legislature.
What to Do Next
Advocacy can sound intimidating, especially if you’re picturing some dramatic movie scene with microphones and cameras flashing everywhere. Let me reassure you that most advocacy starts much smaller, and involves skills nurses already use every day. Here are some ideas.
• JOIN NURSING ORGANIZATIONS
One of the easiest ways to get started is through our professional nursing organizations. Visit the ANA website for federal initiatives (RNaction.org) or the ANA\C site for updates on state policy campaigns (anacalifornia.org/legislation).
Many nursing associations host legislative days where nurses can meet elected officials and discuss issues affecting healthcare. There are regular events like these in both Sacramento and Washington, D.C.
The great thing is that you don’t have to figure everything out alone. The organization provides talking points and training, and they schedule group meetings with legislators. I’ve participated in several of these events.
• CONTACT A LEGISLATIVE OFFICE
If there’s an issue you specifically care about, call your state representative, congressperson or senator.
This sounds scarier than it is. Legislators’ official websites list their phone numbers and office hours. When you call, you’ll speak with a staff member, not directly with the legislator. Just say that you’re a constituent and would like to leave a comment on an issue.
The staff members who answer the phones won’t try to debate you, they’ll just note down your comment and probably ask for your ZIP Code. You can leave a message on voicemail if you call after hours.
If you want to share more detailed thoughts, ask if there’s a staff member focusing on that particular issue who can call you back. You can also use the email form on the legislator’s website to send a written message, but calling is more effective.
Be sure to mention that you’re a registered nurse. Explain what you see in practice, and why the issue matters. Communication that is short, direct, and personal is best.
• SUBMIT A PUBLIC COMMENT
State regulatory agencies like the BRN or CDPH have public comment periods for proposed new or revised regulations. The agency website (or regulations.gov for federal agencies) will have information on how you can submit a comment. Most agencies take public comments seriously, and nurses’ credibility and frontline experience can have a big influence.
Attending a public meeting of the city council, school board, or other boards or agencies is also an effective way for nurses to shape the conversation on an issue.
What I’ve Learned Along the Way
One of the biggest surprises for me was realizing how much legislators genuinely want to hear nurses’ perspectives. Elected officials often have to make decisions about healthcare without ever having seen the behind-the-scenes reality of modern hospitals, and nurses provide a vital reality check.
Another surprise is that successful advocacy is not about being the loudest person in the room. It’s about being credible, informed, and authentic. Honestly, nurses are already exceptionally good at this. Every day, we educate patients, de-escalate stressful situations, coordinate care teams, and speak up during difficult conversations. Advocacy simply applies those same skills in a different setting.
Data matters, but stories stick.
When I spoke to elected officials about workplace violence in emergency departments, statistics helped to frame the issue, but sharing real experiences from nurses is what changed the tone of the conversation. Suddenly, it was no longer an abstract problem — it became personal and urgent.
Advocating for Millions
As nurses, we’re far more prepared for advocacy than we might think. Nurses advocate every single day. We question unsafe orders. We push for better pain control. We notice subtle patient changes before anyone else. We call the attending at 2 a.m. because something does not feel right. That takes courage, experience, and persistence. Speaking to elected officials really isn’t any different.
So, attend the legislative day. Send the email. Make the phone call. Share the story. Your voice carries more weight than you realize.
A nurse who can advocate for one patient at the bedside can also help to advocate for millions beyond the bedside.
TYLER MCCULLOCH, RN, MSN, MICN, is an emergency department nurse and trauma analyst. He serves as the president of the Inland Empire chapter of the ENA.
In this Article: ANA, ANA\C, Legislation and Public Policy
