“So never lose an opportunity of urging a practical beginning, however small, for it is wonderful how often in such matters the mustard-seed germinates and roots itself.”

Florence Nightingale

A shining light to guide a burgeoning field—often referred to as “the lady with the lamp”—Florence Nightingale was a revolutionary figure in nursing, transforming care by simple but radical actions. Through scientific research she showed that sanitation and healthy diets improved patient outcomes, and through advocacy she fought for access to those conditions for all of her patients. She modeled the way for nurse advocates throughout history and into today.

Lillian Wald was a pioneer in public health, advocating for medical services and opening community centers for poor and immigrant families and children.

Mary Breckinridge was an early pioneer in rural healthcare, bringing nurse midwives to assist with maternal care in underserved populations in the Kentucky Appalachian mountains. She was also instrumental in founding national nursing organizations.

As superintendent of the Union Army Nursing Corp, Dorothea Dix championed mental health issues. Taking her research to state legislatures, she convinced elected officials to invest in psychiatric hospitals, introducing holistic care to the health system.

Walt Whitman wasn’t only an American poet—he was also a male nurse during the Civil War, transferring soldiers from the battlefield to hospitals. He wrote letters for the wounded to their families, demonstrating patient advocacy.

Clara Barton spearheaded a campaign to address medical supply shortages at field hospitals during the Civil War. After working with the International Red Cross, she founded the American Red Cross and later the National First Aid Association of America.

Nurses like these set a standard for advocacy that organizations and individuals—including ONS and its member advocates—continue today.

Nurses Are Advocates by Personality as Well as Profession

Gallup public opinion poll results have affirmed for two decades that Americans see nurses as the most ethical and trustworthy profession. National nursing organizations like ONS call on that clout to promote a variety of public policy changes that have transformed care. Advocacy has long been one of ONS’s core values, with national leadership and individual members taking the organizational legislative agenda to decision-makers at all levels of government. When nurses speak, policymakers listen.

“Political activism has opened up an avenue to support patients and oncology nurses in a powerful way I had never thought of with our elected officials,” ONS member Colleen O’Brien, RN, CBCN®, CBPN-IC, who belongs to the Long Island-Queens ONS Chapter, said. “Our congressional members look to and listen for nurses as the experts. At first advocacy was a curiosity; now it’s a passion. It’s empowering!”

ONS’s formal advocacy programs raise awareness for nurses’ role in health care. Politics and policy are often divisive and intimidating. ONS takes a different approach, focusing on the nurse and the impact that the legislative environment has on patients. Motivation and mobilization are how nurses become engaged activists.

If You’re Not at the Table, You’re on the Menu

Oncology nurses must literally and figurately have a seat at the political table. Through coalitions like One Voice Against Cancer, Nursing Community Coalition, and Campaign for Tobacco Free Kids, ONS adds a vital voice representing oncology nurses’ perspectives in cancer, nursing, and public health to support mutual goals of quality care, evidence-based practice, and nurse leadership. Because of their visibility through coalitions, oncology nurses are sought after when patient-centered care issues are sponsored in federal and state public policy proposals.

ONS also increases the Society’s commitment and visibility with congressional offices and regulatory agencies by submitting formal comments on specific pieces of legislation, such as:

  • Palliative Care and Hospice Education and Training Act: Palliative care is integral to oncology and should be offered at the time of a cancer diagnosis, regardless of whether cure is an option.
  • Oral Parity for Cancer Drugs: Cost should not be not a factor in physician and patient decisions.
  • Title VIII Funding for Nursing Education: Programs bolster nursing education, from entry-level preparation through graduate study, and provide support for institutions that educate nurses to practice in rural and medically underserved communities.
  • Lymphedema Treatment: Two million Medicare beneficiaries do not have equal access to compression supplies. 

Finally, grassroots programming in ONS chapters introduces local oncology nurses to their U.S. congressional district offices. In 2020, almost 50 ONS chapters met virtually with their members of Congress to discuss the impact of the COVID-19 cornonavirus and access to affordable cancer care.

“Capitol Hill Days gave me the confidence to invite our local congressman to a chapter meeting. It’s exciting to be a compelling and convincing voice for patients and their families,” ONS member Denise Brigham, RN, MPH, OCN®, health policy liaison for the Coastal North Carolina ONS Chapter, said.

Because of those meetings, members of the U.S. House of Representatives joined the House Nursing Caucus, helping to solidify the bipartisan commitment to nursing legislative priorities.

It’s a Marathon, Not a Sprint

ONS’s annual Capitol Hill Advocacy Days bring more than 100 ONS members from around the country to Washington, DC, to train as activists on the most important policy issues of the congressional session. Meeting with their representatives in the House and Senate, oncology nurses inform them about scope of practice, pain management, and federal investment and ask for their support.

Through Democratic and Republican administrations, ONS is a reliable resource. Our members testified before U.S. Congress about access to opioids for patients with cancer. Our leaders frequently meet with the U.S. Food and Drug Administration, National Institutes of Health, Centers for Disease Control and Prevention, and Centers for Medicare and Medicaid Services. And ONS members served as representatives on the Cancer Moonshot Initiative.

Nurse leadership takes many forms, and nurse find themselves seeking opportunities that previously were thought outside of their scope—including taking their expertise to the highest levels of the federal government. “ONS has always been out front in preparing its members to be leaders in the policy arena. The skill sets I developed through ONS were a critical factor in my selection as a Robert Wood Johnson Foundation Health Policy Fellow,” ONS member Peggy Wilmoth, PhD, MSS, RN, FAAN, U.S. Army major general (retired), said.

Nurse advocacy has come a long way since the days of Florence Nightingale. Change is difficult and it requires the willing to persevere, but that is exactly what nurses do and how ONS and its members make a real difference. Celebrate Oncology Nursing Month in May by becoming a conduit for a stronger healthcare system. Join the fight at ons.org/make-difference/ons-center-advocacy-and-health-policy.