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Influence through advocacy: Raising awareness, advancing change

Anne Hofmeyer | 1/24/2020

Identify causes, issues, or needs where YOU can exert influence.

In her presidential call to action for the 2015-17 biennium, Cathy Catrambone has called on all members of the Honor Society of Nursing, Sigma Theta Tau International (STTI) to "Influence to Advance Global Health & Nursing" in four areas: 1) advocacy, 2) policy, 3) lifelong learning, and 4) philanthropy. This first of a six-part series on President Catrambone’s call addresses influence through advocacy.

The difference between what we do and what we are capable of doing would suffice to solve most of the world’s problems.  —Mahatma Gandhi

Hofmeyer_Anne_ID_embed_SFWReflect for a moment on your professional and personal interests. What causes, issues, or areas of need really matter to you? What positive outcomes in global health and the communities you serve do you want to help advance? For what do you want to advocate? What knowledge and expertise do you need to be effective in your advocacy?
Influence involves advocacy, and to be effective in advocating for change and better outcomes for individuals, communities, and society at large, we need to be engaged. Influence can be understood as the power to cause change, preferably change that positively affects others or advances an important issue. Credible leaders influence others to be the best they can be in whatever they are doing. In nursing, we “jump ship” to follow leaders who inspire and influence us to achieve the best outcomes for those we serve (Hofmeyer, Sheingold, Klopper, & Warland, 2015).
Advocacy is active support of a cause. Through effective use of strategies and methods that influence views, choices, and—most importantly—actions of individuals, communities, or organizations, we address areas of need. Advocacy can be understood as standing up and speaking out for a moral good, voicing concerns of disadvantaged people, and collaborating with individuals or groups who need support in exerting their rights and preferences.

Nursing has a long tradition of advocacy for the common good. Florence Nightingale advocated for better hospital conditions for patients in the Crimean War and better education for nurses. She sought to influence governments, policymakers, physicians, and philanthropists as she advocated for continuous improvement in health conditions and better care of the sick and vulnerable. She observed, “Were there none who were discontent with what they have, the world would never reach anything better.”
It is up to us, members of STTI, to identify the causes, issues, or areas of need that matter to us and discern how, through advocacy, we can effect influence that raises awareness and advances change.
What matters to me?
I advocate for a palliative care approach to become mainstream in global health systems. This means that any patient with a life-limiting illness (regardless of diagnosis) will have access to health care that is responsive to their holistic needs, promotes quality of life and hope, and is provided by interprofessional teams. No longer should access to palliative care be limited to patients with cancer or be available only to patients who are admitted to hospice and palliative care units.
Early in my nursing career, I became engaged in improving access to palliative care because I could not relate to—or promote—the values of a health system that ignored and marginalized patients who could not be cured. I saw neglect of patients who suffer with life-limiting illnesses (and their families) as unjust and indefensible. In 1967, Dame Cicely Saunders, OM, DBE, FRCS, FRCP, opened St. Christopher’s Hospice in London. Her approach to pain and symptom management became the foundation for hospice and palliative care practice. She explained the complexity of suffering and the need for emotional, psychological, and spiritual support for the terminally ill patient as well as his or her family.
The World Health Organization defines palliative care as “an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial, and spiritual.” Palliative care aims to comfort, not to cure; to relieve pain and distress; improve the quality of life for people with a life-limiting illness and their families; and support families in bereavement. Therefore, it is crucial to advocate for targeted education of nurses and interprofessional teams and palliative care access that is inclusive of patients with noncancer diagnoses, such as heart failure, dementia, chronic obstructive pulmonary disease, motor neurone disease, and multiple sclerosis.

What matters to you?
On 1 January 2016, the 17 Sustainable Development Goals (SDGs) of the United Nations’ 2030 Agenda for Sustainable Development were officially launched. Relevant for developing as well as developed countries, the goals are reflective of the view that health is socially determined, that it is influenced and experienced within a social context. For that reason, there is synergy between the diverse SDGs.
For example, achievement of Goal 3 (good health and well-being) is dependent on advancing goals to build just and inclusive civil societies and to develop sustainable social and environmental resources. As nurses seeking influence to advance global health and nursing, it is useful for each of us to decide, within the context of the SDGs, what causes, issues, or areas of need are the best “fit.” Finding a fit between one or more SDGs and our individual areas of advocacy will strengthen our influence, relevance, and achievements.
In addressing the area of advocacy you choose, what evidence do you need to consider in your decision-making? What actions have worked in similar communities to address similar causes or issues, and what, therefore, may be a sound course of action for you to adopt? Answers to questions such as these will help you decide how to engage in advocacy that leads to positive outcomes for those you serve.
Human capital can be understood as the values, knowledge, and expertise of individuals who, by working cohesively with others, can foster productive networks and relationships (social capital) to achieve common goals, such as quality healthcare (Hofmeyer, 2013). When we act to foster productive networks and relationships, evidence-based healthcare, and “good health and well-being for all” (SDG 3), we also promote “just, peaceful, and inclusive societies and institutions” (SDG 16) where people feel respected and hopeful, regardless of their diagnoses or social context.
Are you ready to influence in through advocacy?
To build capacity for influence through advocacy, President Catrambone suggests that we, as nurses, embrace three strategies to guide our actions: 1) Develop advocacy expertise, 2) engage in advocacy, and 3) foster advocacy partnerships.
To support members and help them understand how to plan and engage, she provides ideas and actions under each strategy in her “Presidential Call to Action” brochure. I hope you will read this document and prepare to lead conversations and plan relevant actions with other nurses in local contexts. By so doing, you will help ensure that the 2015-17 presidential call to action not only advances the profession through advocacy, policy, philanthropy, and lifelong learning, but also achieves positive outcomes for those we serve across the globe.
Anne Hofmeyer, PhD, RN, a tenured academic in the School of Nursing and Midwifery, Division of Health Sciences, University of South Australia, has an appointment as an honorary visiting fellow within the Faculty of Health, Social Care, and Education at Anglia Ruskin University, Cambridge, United Kingdom. In the current biennium, Hofmeyer is serving as chair of the Research and Scholarship Advisory Council of the Honor Society of Nursing, Sigma Theta Tau International.

Read the other installments in the "Answering the call" series:

Influence through policy: Nurses have a unique role
Influence through policy: Four steps YOU can take

Influence through lifelong learning: I developed leadership skills I didn’t think I’d ever have! 

Influence through philanthropy: What philanthropy looks like

Influence through philanthropy: Giving back to pay it forward

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