Nurse Activism: 15 Ways Nurses Can Affect Real Change

Nurses advocate for their patients every shift. That same advocacy can reach past the bedside to influence policy in your institution, community, and state. You have a perspective on healthcare that legislators and administrators do not, and you can use it.

"Nursing is not only on the front lines of a global pandemic, they are also on the front lines of systemic wounds affecting the health of patients each and every day," says Kelsey Noah, BSN, RN, CCRN, an adult intensive care unit nurse in Saint Paul, Minnesota.

Why Activism Matters in Nursing

Nurses see the consequences of a broken system firsthand: patients who cannot afford care or medications, and the inequities that follow. One study found that nurses are more likely to vote than the general public but far less likely to take other political action. That gap matters, because nurses are the largest healthcare profession and are positioned to drive change if they engage.

"It is imperative that nurses band together to advocate for our patients' healthcare needs, and that includes the reforms needed to improve our healthcare system," Noah says.

Most nursing programs offer little formal training in policy and advocacy, so many nurses simply do not know where to start. The 15 steps below are where to start. You will not do all of them. Pick one or two that fit your interests and time.

1. Get informed first

You cannot advocate effectively for something you do not understand. Healthcare issues are complicated, even for the people who work in them, and most have several legitimate sides. Read up before you act, and seek out perspectives other than your own.

"Gaining multiple perspectives is important to having more conversations regarding healthcare reform and fosters interdisciplinary collaboration," Noah says. Reform takes an all-hands approach across disciplines, and conversations with colleagues can spark activism in others.

2. Join state and local nursing organizations

National, state, and local nursing organizations often have sections devoted to advocacy, with lobbyists who educate legislators on healthcare issues. Getting involved rarely takes much time. You might be asked your opinion on a bedside-nursing matter or to contact a legislator. When nurses stay out of the organizations that shape policy, non-nurses make those decisions for them.

3. Get involved in the policy process

Once you understand how the system works, you can influence it. That can be as simple as an email or a phone call, or as involved as testifying before committees, serving on policy boards, or running for office. Evidence-based data carries weight, but so does a personal story. Noah encourages nurses to write their representatives about lowering healthcare costs or widening NP scope of practice, both of which expand patient access to care.

4. Intern with elected officials

Relationships drive policy, and an internship is a direct way to build one. In Congress, interns serve temporarily in the House or Senate, usually unpaid, and individual offices set their own rules. Most states run internship programs through the legislature or secretary of state. Contact your federal, state, or local officials about an internship or volunteer position.

5. Donate to healthcare reform causes

Small donations add up when many nurses give. Most nursing organizations have an advocacy arm working at the state or federal level to make sure nurses are heard on healthcare policy. "Start small and recognize the ability to improve healthcare in this country is a marathon, not a sprint," Noah says.

6. Use the influence you already have

You likely have more standing in your workplace and community than you think. Influence grows through networking with nurses and other professionals. Whether on a nurse-led advisory board or on social media, professionals inside healthcare organizations and nursing schools can advocate for change.

7. Focus on key issues

It is easy to get overwhelmed by everything that needs fixing. Concentrate on issues with downstream effects. Better staffing ratios, for example, also improve patient outcomes, reduce workplace violence, and lower burnout. Higher pay and smaller class sizes for nurse educators improve the quality of nursing graduates.

8. Start a business that fixes a gap

Nurses see where healthcare delivery falls short, and they tend to be independent thinkers. Gail Trauco, an oncology nurse and pharmaceutical trials expert with four decades of experience, founded The PharmaKon LLC, a nationwide mobile nursing service that brings clinical trials to participants. Patients complete assessments at home and meet a nurse by telehealth while a courier handles lab samples, so they no longer miss work, scramble for childcare, or skip visits over transportation. That reaches rural and marginalized communities that trials usually miss. "It's an entirely new era of hybrid mobile nurses to support clinical trials," Trauco says.

9. Become a nurse educator

Experienced RNs make strong teachers and mentors, and the profession needs them. Nurse educators face a faculty shortage made worse by pay. Nurse educators average about $87,000 a year, well below the roughly $137,000 mean wage for nurse practitioners, even though most educators hold a doctoral degree. "We need to encourage nurses with master's and doctoral degrees to consider becoming adjunct faculty or full-time faculty," says Anne Dabrow Woods, DNP, RN, chief nurse at Wolters Kluwer Health.

10. Bring technology into the classroom

Technology lets programs teach more students and produce practice-ready nurses. Expanding educational capacity eases staff-to-patient ratios, which in turn affects outcomes, stress, and burnout.

11. Push for adjunct faculty training programs

Adjuncts make up the majority of college instructors and are usually paid less than full-time faculty. Dabrow Woods recommends that healthcare systems partner with academic centers to train adjunct faculty. These partnerships address the faculty shortage, bring more experienced clinicians into teaching, and let programs admit more students while holding favorable faculty-to-student ratios.

12. Fund scholarships that increase diversity

Nursing lacks representation, which limits mentorship and leadership and affects patient care. A diverse staff brings more creative thinking to the policies that drive change. Nursing administrators and executives can back local organizations and foundations that fund financial aid for marginalized students.

13. Support nursing programs at community colleges

Community colleges sit at the center of their communities and open the door to students who might not otherwise attend college. Nurses and healthcare organizations can support program funding and administration, run outreach to local high schools, and lobby legislators for more community college funding and higher educator pay.

14. Expand LPN/LVN and ADN programs

Representation among providers saves lives. One widely cited 2020 study found that Black newborns had lower in-hospital mortality when cared for by Black physicians, narrowing the racial mortality gap, though a 2024 reanalysis found the effect weakened substantially after adjusting for very low birth weight. The broader point holds: a more diverse workforce matters. LPN/LVN and ADN programs are more racially and ethnically diverse than BSN programs, so expanding them widens entry into nursing. From there, nurses can advance through LPN-to-RN and RN-to-BSN bridge programs.

15. Speak up on news outlets, podcasts, and social media

You are an expert whenever you know more than your audience, and at the bedside you usually do. Advocate through interviews with local stations and podcasts, your own social media, or campaigns run with your nursing organization. Public-facing nurses help close the gap between healthcare workers and the public.

No one person carries all 15. But if every nurse took on one, through a donation, an email, a phone call, or a conversation with a colleague, the change would add up.