Nurse of the Week: Rep Underwood Goes to Washington
Some nurses could easily be Nurse of the Week 52 weeks a year, and Lauren Underwood is one of them.
In 2018, Lauren Underwood, BSN, MSN, MPH inspired nurses and women of color everywhere when she became the youngest Black woman to be elected to Congress. Illinois’ 14th District Congressperson had accomplished a great deal prior to her election and has been busy blazing new trails since her swearing-in. Underwood is still a nurse as well, so it was clear from the start that she was not going to be the kind of representative who spends their time vying for social media “Likes.”
The dean of New York University’s Rory Meyers College of Nursing, Eileen Sullivan-Marx, Ph.D., MS, BSN, conducted a lengthy interview with Underwood in August and has generously allowed DailyNurse to share some choice excerpts. Let’s check in with Illinois’ MSN on the Hill…
What Made/Makes Rep Underwood Run?
Underwood first was drawn to public policy as a teen, and in 2009 earned both her MPH and MSN at Johns Hopkins. Already a vocal advocate of the ACA, in 2014 the Obama administration tapped her to join their team as a policy advisor, and she quickly became an MVP in the push to obtain passage of the ACA. After Obama left office, she found a position as Senior Director of Strategy and Regulatory Affairs at Next Level Health and served as an adjunct instructor at the Georgetown University School of Nursing & Health Studies.
But what prompted her to take on the enormous challenge of running for office? As a promising candidate back in 2018, she told Janice Phillips at Minority Nurse that she had been bitterly disappointed by her predecessor during the ACA repeal frenzy after the end of Obama’s term. At a local League of Women Voters meeting, her own representative “said that he was only going to support a version of Obamacare repeal that allowed people with preexisting conditions to keep their coverage.” As Underwood herself has a heart condition – AND had worked hard to get the ACA passed – she felt invested both professionally and personally in the rep’s promise.
“When I walked into a room, even with people who didn’t share my political point of view, they knew that I was very clear on what was going on in our health care system.”
However, “A week to ten days later he went and voted for the American Health Care Act, which is a version of repeal that did the opposite. It made it cost-prohibitive for people like me to get coverage. But, she stressed, “I was upset not at the vote itself, but because he did not have the integrity to be honest the one time he stood before our community…. A representative is supposed to be transparent, accessible, and honest. And we deserve better. I said, ‘you know what, it’s on! I’m running.’”
Early this summer, Sullivan-Marx asked Underwood, “What was one of the drivers as to why you kept leaping forward beyond the usual kind of candidate?”
“Two things,” Underwood responded: “The number one issue in the election was health care and I brought expertise as a nurse. Someone who worked on the ACA. I was working for a provider—a private company. I’ve been a patient and I understood the law as it was, and I had a greater understanding of the ACA than my opponent, the Congressman, and then all my primary opponents— these six guys –they’re great guys—they just did not have the expertise.
When I walked into a room, even with people who didn’t share my political point of view, they knew that I was very clear on what was going on in our health care system. I had many solutions. They knew that I understood the problem and I understood what was going on with their families and that I had been fighting for years to try to solve it… That enabled us to walk into every room and be taken seriously, even if we didn’t agree on anything. People knew that on this issue, which was important to them, that I had credibility. The second thing is that we were willing to show up everywhere in person to engage people and build connections.
The Most Trusted Profession Meets the Most Mistrusted Profession
Sullivan-Marx also asked Underwood to describe her typical day on Capitol Hill:
Underwood: “In this Congress, I am assigned to two committees—the House Committee on Veterans’ Affairs (VA). I’m on the Health Subcommittee. The VA is an incredible health care system that has its challenges. I focus pretty exclusively on suicide prevention, mental health, and women’s health care. The VA has this unbelievable responsibility for caring for women veterans across the lifespan. I think folks forget that there are still cadet nurse corps members from World War II that are alive and they’re active and they’re getting care in the VA that has been inconsistent at best.
“I think that nurses take for granted that every elected official knows a nurse or has interacted with nurses. We assume that they know about the work that we do.
In my experience that is completely false. They have no clue what happens at schools of nursing. They have no idea the level of expertise that a BSN graduate brings.”
I also serve on a House Committee on Appropriations. The Congress has three core functions: we create programs and we call that authorizing to solve problems. We fund the federal government appropriations, including funding those programs, and then we do Congressional oversight over the executive branch. Within the appropriations committee, I am assigned to the Agriculture Subcommittee, which also has jurisdiction over the Food and Drug Administration. That’s how we fund COVID and tobacco. Trying to make sure that we are curbing the tobacco usage epidemic. And then I serve on the Homeland Security Subcommittee. There we have ICE [U.S. Custom and Immigration Enforcement], immigration, Federal Emergency Management Agency (FEMA), cyber security, and the US–Mexico border and the Canadian border. It’s fascinating and then obviously I still do health care work, too.”
Calling all Nurses…
Toward the end of the interview, Sullivan-Marx asked, “What kind of assistance would be great for nursing to give you? How can we be helpful to you?”
The Congresswoman said, “Nurses have been so helpful for us in terms of gathering and presenting evidence. Many of these problems have a local focus and for us in Congress it is very difficult to get that kind of local data. Evaluation type data demonstrating that an intervention is effective. We can build relationships with nurses, either in our communities or folks who’ve been impacted by these problems. Site visits and testimonial stories are very powerful.
“We [nurses] have got to do better about inviting them [members of Congress] in.”
I think that nurses take for granted that every elected official knows a nurse or has interacted with nurses. We assume that they know about the work that we do. In my experience that is completely false. They have no clue what happens at schools of nursing. They have no idea the level of expertise that a BSN graduate brings. They have no idea what APRNs do. They have no idea what practicing to the full extent of our education and training means. We [nurses] have got to do better about inviting them [members of Congress] in. My colleagues are very familiar with physician education. Their whole advocacy strategy is completely different than how nursing engages members of Congress and we’ve got to step it up.”
Yes, let’s step it up! The full interview with Underwood is a great read. If you have an opportunity, check out Policy, Politics, and Nursing Practice, “Eileen Sullivan-Marx Interview of Representative Lauren Underwood (Democrat-Illinois 14th District)” here.
Thanks to Eileen Sullivan-Marx for graciously sharing her interview with DailyNurse.
