Every nurse who has stepped on a unit knows that nursing has its problems. Unfortunately, when confronted with these problems, many nurses feel as helpless as some of the patients they care for. Management is nonresponsive, there are no unions to support the common good, and one nurse can’t seem to make a difference. However, with the advent of social media, that primary assumption is changing. Nurses can affect change in the profession, and this is primarily through grassroots efforts.

What is a grassroots effort? It is an organization of nurses that come together of their own accord to affect change from the bottom up. They are usually not supported by larger, more established groups, but sometimes they are.

“Nurses need to understand that they have a voice and a powerful one when they all act together,” says Doris H. Carroll, BSN, RN-BC, CCRC, vice president of the Illinois Nurses Association (INA). “There is no way a single person can do it, but a group can. It is important to not be complacent, to stand up for patients and stand up for yourself. Standing up for you ultimately means standing up for your patients.”

Nurses can get involved in grassroots efforts in many ways. First, large, nationwide efforts exist that are fighting for the betterment of nurses across the boards. One notable example of this type is Show Me Your Stethoscope (SMYS), a group initiated completely through a Facebook group. Unions are another engine of change in the nursing landscape, though they aren’t present in every state. Finally, patient advocacy groups can allow nurses to become part of the stories of patients who have experienced medical errors.

The important part of the equation is for individual nurses to get involved in any way they can to become part of the conversation that will change nursing. “With today’s online availability, look for a cause you are interested in,” states Catherine Stokes, RN, BSN, executive chair of NursesTakeDC with SMYS. “Use Google and look for groups that you are advocating for. Ask to join; make friends; offer your participation.”

It really can be as easy as that to be part of the solution to change the landscape of nursing.

Large Scale Movements for Nurses

Large scale grassroots movements sound like they would be obvious, high profile groups, but they often are not. In fact, not many nurses know that grassroots movements exist, particularly if they are not on the internet or connected with social media.

One of the most popular groups large scale groups is SMYS, which was started after the insensitive comments made about nurses on The View. Why get involved with a group this large? What possible difference can one voice make?

“It is a place where any nurse can bring their idea to the table,” explains Jalil Johnson, BSN, MS, ANP-BC, the national director of SMYS. “There are other nurses that have the same interests, and the group helps to actualize that. We help with the empowerment in what individual nurses think is important. Our method is different in that we don’t direct nurses in what they should be involved in. It is driven by the nurses.”

SMYS is a grassroots efforts that seeks to be all-inclusive for nurses, but you don’t have to be a national director to affect change on the national level or even around your neighborhood. The group suggests talking to your local legislators, sending letters and emails, and corresponding with those who are in positions of influence to create the changes you want to see. Essentially, your level of involvement in large scale groups such as SMYS is completely determined by your comfort level.

Johnson adds: “We want to empower nurses to have voice and talk about the struggles publicly. We are not sure if legislators are aware of the problems nurses are facing. We want to connect to them and to let them know. We want to unite around issues to move conversation forward without getting bogged down in the specific issues to make change happen. Our goal is to move the conversation forward.”

Large scale grassroots movements need many nurses working together to move the conversations forward for better staffing ratios, attention to medical errors, and nurse bullying, but they are not the only ways that nurses can get involved. There are many other ways nurses can get involved in organizations that aren’t “official” and still get their voices heard.

Joining Nurse Unions

Unions have a bad rap in nursing and across the nation. Nurses have lost their jobs by attempting to form or join unions in their states, and that is a blow to the grassroots movement. National Nurses United is one of the largest unions in the nation, and it is worth getting involved with it. Like the American Nurses Association, it is not essentially grassroots. These organizations are really driven more by boards than by nurses who are interested in creating change on their own.

However, smaller unions are often more powerful with grassroots efforts, and this is where nurses can make a difference in the profession. “Joining a union is an opportunity to join an organization that has an infrastructure in place to assist in getting change,” explains INA Vice President Carroll. “It is easier than doing it on your own. Joining the union is one of the best ways to do it.”

So, how exactly do unions help nurses? “We fight for labor issues on all of our units on a daily basis,” Carroll states. “It is not just about wages. We negotiate for self-scheduling and floating. We impact ratios. Illinois is one of first states that has a law that all hospitals have staffing committees to address staffing issues based on acuity.” Unions can fight for these issues in the profession that need to be addressed, and the infrastructure of unions makes it likely they will get accomplished. The downside is the difficulty of getting unions in place, but once they are, they are a powerful grassroots effort for nursing change.

For example, the Illinois State Union worked with SMYS to organize the 2016 rally in Washington, DC. Not only did the group donate a great deal of funds to the cause, they also arranged for important legislators, such as Representative Jan Schakowsky, to appear at the rally. Without the joint effort of unions and large scale grassroots nursing efforts joining in on the conversation about nursing, the changes would be less likely to come to pass.

Getting Involved with Patient Advocacy Groups

Patient advocacy groups may seem like an odd area for a nurse to affect change in the profession. They are essentially groups started by laypeople after they encounter life-changing issues when interacting with medical institutions. “The majority of advocacy groups are started by patients,” says Deena Sowa McCollum, BSN, RN, a patient advocate. “They can focus on topics such as medical error transparency. For instance, the mother of a victim of medical errors can speak out. Many hurt families are starting groups.”

How does this help nurses to change their profession specifically? “Groups are influencing nurses whether we are involved or not,” McCollum continues. “When nurses advocate for themselves, they sound to [the] layperson like they don’t want to work too hard. Patient advocate groups have stories. Nurses have stories about these problems but don’t share them. There are errors every day, but we don’t use stories about real people. Advocates are sharing war stories, and that makes a difference to the public perception.”

When patients are injured, their loved ones speak out. They are sharing their stories, going on talk shows, and drawing attention to themselves. Nurses, on the other hand, are not doing this. If nurses could get involved in these groups and make themselves part of the solution to the problems, they could affect changes for nurses as well as patients. Some patient advocacy groups tend to reject nurses as part of the problem, but many realize that nurses are caught up in the same medical machinery their loved one was. By coming together, patient and nurse, more change can happen.

This makes patient advocacy groups a very powerful tool for the grassroots effort. It is important to find a group and get involved. “Start by Googling advocacy groups that you believe in,” suggests McCollum. “Get on Facebook. Put in a search for advocacy groups. Nurses need to find the right group. Advocacy groups want to know how can you help us for our end. How can we all stand up on our end for safety? Don’t be defensive or try to defend the nurses. There are nurses and other people that desperately want what is better for the patient.”

Strategies for the Individual Nurse

All of this boils down to the individual nurse. How can you, the nurse reading this, get involved in grassroots efforts? How can you make a positive change in the profession that you love?

“Nurses can start their own movements,” says Stokes. “Using social media, start a movement for your cause, find like-minded people, and ask them to participate.” It really can be that easy, but it isn’t necessarily the only way.

It is much more likely that individual nurses can get involved in pre-existing groups. “Nurses must get involved,” Stokes states. “As a profession, we should not sit back and let things continue. We can’t continue the habit of ‘this is the way it’s always been done.’ It’s not really hard to type a search into Facebook, say hello, and start putting ideas out there. See where it goes. Find out who is in charge and find out what you can do.”

Carroll agrees: “Working together is essential with grassroots campaigns. Everyone comes with different experiences. It isn’t easy to organize online because many nurses are not online. We need to do this together.” The way we do this together is for individual nurses to get involved with grassroots campaigns on some level. Even if it is as simple as writing a letter or as complex as volunteering to be a national director, nurses need to come together if change is ever going to happen.

Johnson sums it up: “Change is what nurses are interested in. They aren’t interested in the methodology, or the back and forth. They want to move this forward. We believe that professional organizations are contributing. They have a seat at the table, but the conversation hasn’t moved very far since the first nurse march on Washington in 1995.”

The question is and always has been, do you want a seat at that table, too? What will be your contribution to the conversation about change in nursing?

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Lynda Lampert

Lynda Lampert, RN, has worked medical-surgical, telemetry, and intensive care units in her career. She has been freelancing for five years and lives in western Pennsylvania with her family and pets.
Lynda Lampert

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