Energy, Excitement and Enthusiasm: Advocating at the Capitol

By Elizabeth Clark, MSN, APRN, FNP-BC

The request came in on typical crazy Monday afternoon. As I wrapped up a full day seeing patients in the Neurology Clinic at Parkland Hospital, I opened an email from Cindy Zolnierek, PhD, RN, CAE, chief executive officer of Texas Nurses Association. Her emails always get my attention, but this time, she surprised me by asking if I could testify at a hearing of the House Public Health Committee later that week.

I study nursing policy, leadership and advocacy at the Yale School of Nursing, where I’m working on my Doctorate of Nursing Practice degree, and Cindy knew about my passion (or obsession?) for health care policy and advocacy, particularly here in Texas. So yes: I was not going to say no to this request! The committee was considering H.B. 2409, which would permanently lift fees and needless application delays when nurses who are inactive for less than four years want to jump back into action during a public health emergency like COVID-19.

I had two days to prepare to testify.

Learning the Ropes

Prior to college, I had little experience in — or even exposure to — politics or policy. My family barely remembered to vote in local and national elections. The Student Nurses Association at UT Tyler was my first taste of policy; but after attending “Capitol Day” in Austin during my master’s work, my involvement dwindled due to job and family responsibilities. In 2019, when I applied to the DNP program at Yale, I began considering topics for my three-year DNP project.

I saw that nurses needed to become more involved in the policymaking process, both for the profession and our patients. I began researching and learning, meeting as many nurse policy experts and political leaders as I could find and becoming more involved in the Texas Nurses Association.

For the past few years, Cindy and TNA have let me volunteer and pick their brains about policy challenges facing the profession. Under Cindy’s guidance and mentorship, I’ve helped author policy briefs for TNA on a variety of topics, including on medication for opioid use disorder, telehealth during the COVID-19 pandemic and full practice authority for APRNs. This work sensitized me to the importance of legislation and policymaking to our profession.

Now I was being asked to help directly influence it.

Over two days, I was fortunate to be prepped by two experts, Cindy and Kevin Stewart, J.D., TNA’s lobbyist. Not only was I preparing to put my policy training to the test, I was also hoping to use this testimony to overcome my fears of public speaking. I was filled with excitement and nervous energy. Do I speak too fast? Can they understand me? Is my tone and pace appropriate for the occasion? Is this testimony helpful? It’s amazing how many times you can rehearse a short 3-minute speech.

Speaking my Piece

On the morning of testifying at the Capitol, I woke up early and nervous. To avoid traffic, I stayed in a hotel close to the Capitol. Around 7:30 a.m., I met Cindy outside of the Capitol, and she reviewed a few more topics with me. We walked to the building where the hearing was taking place and met up with Kevin. I observed as the two of them conversed and joked with other lobbyists. Then, we were ushered into a large room with theater seats. In the front was a large platform where the representatives sat. Before the platform was a podium with a microphone.

The day of my testimony dragged on, but my time practicing helped calm me. The hearing continued into the afternoon, and the longer I waited, the more anxious I began. Finally, around 3 p.m., the bill was called, and they called my name as a witness. I rushed up to the podium (almost stumbling — don’t do that when it’s your turn), took a deep breath, took off my mask and began.

I had my testimony written down, but did my best to not just read the words, but tell the story to the committee. I would read a little, then look around to each member. If I could do it over again, I would have memorized the 3-minute testimony, but I believe I got my point across. While the bill did pass the House, it eventually languished in the Senate Health and Human Services committee.

Regardless of the outcome, one of several bright spots was meeting State Representative and Chair of the Public Health Committee Stephanie Klick, a fellow nurse. I’m sure I blabbered and fan-girled during our conversation, but at least Stephanie knows I’m enthusiastic about policy. Another bright spot was spending the entire day with my mentor, Cindy. She has supported me in pursuing a DNP, developing policy skills and creating lasting relationships in our profession. I hope to inspire at least one person to get involved like Cindy has inspired me.

Taking the Next Step 

My advice to nurses interested in becoming involved in politics and policy: Anyone can do it! Having little background or knowledge in politics should not be a barrier. Sign up for opportunities and meetings hosted by nursing organizations. Volunteer to be on (or start) policy committees at your workplace. Find a nursing mentor. Get connected with your local nursing chapter to meet others passionate about policy who will support and encourage you. There are not enough of us interested, which means opportunities abound!

Ultimately, policy change for nurses in Texas requires a critical mass of nurses in office. We are getting there, but there is much more to do. To further this effort, I will be conducting a pilot project this Fall, sponsored by TNA and related to my work at Yale, that will prepare nurses interested in politics and policy. The one-hour, self-paced online course will review policymaking processes, ways to become involved within the nursing profession, current “hot topics” in nursing policy, as well as a resource guide. I hope you will consider participating! I encourage each one of you to step out of your comfort zone and fight for nurses in your own way. I was proud to testify before Rep. Klick, a fellow nurse, with my amazing nurse mentor by my side to advocate for all nurses in Texas. We need you!

Left: TNA CEO PHD, RN, CAE and Clark before the capitol; Right: An Austin view!