Rep. Linda Upmeyer, NP

I recently completed my first session as a representative in the Iowa Legislature and am eager to share what I learned to better prepare NPs to shape public policy. As the former chairwoman of the Iowa Nurses Association's political action committee, I once thought getting the attention of legislators was best done with a check - good contributions from citizens and associations. As legislator, I learned that is partly true, but only partly.

Campaigns are expensive, and legislators appreciate financial support. Associations may give donations based on a legislator's ability to be helpful by serving on certain committees or acting in leadership roles. Lawmakers also appreciate personal checks because, in most cases, personal contributions convey personal support (i.e. votes). Yet, when I think of the people who influenced me most during the past legislative session, it wasn't based on contributions; it was based on the people and the stories they told me.

Get to Know Your Legislators
The most effective way to influence policy is to meet with your legislators before the session begins. Tell them who you are - both personally and professionally. If I speak with someone face to face, I am more likely to understand an issue, ask questions and discuss the best course of action to take. You have an advantage over professional lobbyists: You can personalize issues. If a legislator knows that a constituent is a mother, part-time NP student and nurse, she can better understand the ramifications of mandatory overtime. Even if your legislative agenda has yet to be set, take the opportunity to get to know your legislators. Then, when you do need to discuss a bill, your legislators have a frame of reference for who you are and what you care about. Remember: All politics is local. Get to know your representatives.

Share Stories and Solutions
Legislators may respond to your message in a variety of ways. They may disagree and, at times, even act hostile. They may seem indifferent. Or, they may strongly agree and become your advocate. I worked very hard on several pieces of health care legislation last year. Often, I got involved because someone took the time to approach me with a problem and offered an idea about how to improve the situation. This tactic induced my passion. When constituents convinced me, I poured my heart into advocating change to my colleagues.

Last session I successfully championed legislation to allow NPs to serve as primary care managers for patients covered by Medicaid. Such legislation had been introduced in the past but failed. It had never been fully understood, so no one wanted to sponsor it and most viewed it as a dead issue. But I cared deeply about the matter, and last year I was able to help my fellow legislators understand why it was a positive change.

As a health care provider, your personal stories can convince a legislator to advance your cause. A woman whose daughter was born with undiagnosed retinoblastoma recently approached me. As a result, I am now working with her to gather information on whether to propose a bill to mandate dilated eye exams for newborns. If we decide to proceed, I will be able to easily support the issue because she explained it to me personally. Meanwhile, I will take the same personal approach with my fellow legislators.

Speak Clearly and Completely
When discussing an issue, use terms legislators understand. Cut to the chase by offering the clearest, simplest explanation possible. Many issues compete for legislators' attention, and their eyes may glaze over if a topic becomes too laborious. While many legislators are good talkers, not all are good listeners. Be sensitive to their attention span. If you sense it is not a good time to receive their full attention, reschedule the appointment.

Never lie or mislead, and always provide sound information. Present both sides of an issue. If you present only the positive aspects of your cause, your opposition will be free to fill in the holes with all kinds of gloom-and-doom details. Instead, diffuse the negatives yourself. Let legislators know who might oppose the issue and why. If you build a relationship based on trust, you will be heard. If legislators don't consider you trustworthy, they will avoid you like the plague. For example, on the Medicaid legislation mentioned earlier, a lobbyist opposing the bill was not honest about the bill's implications. Her skewed information greatly concerned the legislators. I took the opportunity to explain the bill further, solidify my point and get the legislation passed. The association she once represented no longer employs her.

Offer Your Expertise
Over the last year, I've come to the startling realization that many legislators do not know a nurse practitioner from a registered nurse, licensed practical nurse or physician assistant. We need to continue educating on that topic so lawmakers know they can come to us for advice on health care issues. As a nurse practitioner, I was surrounded by other legislators every time we worked on a health care bill. Most lawmakers will appreciate your offer to help.

Lobbying is advocating, educating and caring. It shouldn't seem unnatural; it's what nurse practitioners do.

Linda Upmeyer is a nurse practitioner who serves in the Iowa House of Representatives. When the Legislature is not in session, Upmeyer practices at Mercy Heart Center in Garner.

NursingWorld     ANA Marketplace