Nurses are measured by many quantifiable factors—our clinical skills, years of experience, degree level, and certifications, to name a few. But there is one skill that takes time to develop, and that’s being an advocate. Learning to speak  up for our patients, our co-workers—and most important of all, ourselves—is an integral part of stepping into your own as a nurse. To be a true nurse is to take an active role in all that we do! Let’s explore some of the ways this skill can be cultivated. 

Advocate for Safety

First and foremost, issues of safety are essential for you to speak up about. This goes beyond self-confidence as a nurse to maintaining the integrity of your license. Often in nursing, we’re told to document like crazy in order to CYA. While that is true, if you repeatedly experience situations that put you between a rock and a hard place, your MUST speak up. One way to find your voice here is to join forces with other nurses experiencing the same issue. 

Take inadequate staffing, for example, one of the biggest examples of safety failures that nurses deal with. Each hospital is different, but many times staffing is determined electronically, and is based on census and acuity. What a lot of nurses don’t know is that acuity is sometimes based on your documentation. Nursing interventions—and completed orders—get quantified, which helps to determine staffing. That means that making time to document, and likewise, helping out your co-workers to get their documentation done in a timely manner can really impact the shift ratios to come. Communication with your unit leaders is also key here—use your voice to make sure that complicated patients are not overlooked, even if their acuity is not reflected in the documentation.

Advocate for Professionalism

No one is coming to save us—we are the ones we've been waiting for! If there are situations on the job that trouble you, than there’s no better person than YOU to help solve them! One great way to become involved is through nursing organizations. Your hospital may have committees that you can join and practice flexing your voice in. Nursing associations in particular can be a great way to connect with other like-minded nurses and effect change on a broader scale. Nursing unions are another way to amass influence and advocate for certain issues, (although  some nurses find unions to be too politicized). 

Nursing associations will have the most up-to-date information on specific issues and ways to empower interested nurses in using their voices to see changes in real time. Sometimes as nurses, we are made to feel as if we are more ancillary members of the health care team—that we’re there to carry out the orders that other practitioners prescribe. That’s just not true anymore! Nurses spend more face time with patients than almost any other member the healthcare team. Our assessment skills are an invaluable asset. We need to be proud of our role! By joining forces with other nurses, we can advance our causes simply by collaborating with one another.

Advocate for Ourselves

One of the most important words in a nurse’s vocabulary should be “no.” We work in settings where we are chronically short-staffed, yet we are expected to go above and beyond to make “the patient experience” as good as it can be. This results in an impossible situation for nurses. When we’re continually asked to work overtime, with little to no breaks during shifts, and stretched as thin as possible during that time…well, that’s a pace no one can keep up for very long. Sometimes we get so focused on completing the next task in order to get through our shifts and clock out, that we forget to pause and check-in with ourselves. 

Is this safe?

Does this line up with my goals as a nurse?

Am I happy and fulfilled with my job?

These are all important questions we must take the time to ask—and answer! We cannot allow the fast pace of our jobs to derail our perspective on what matters most (or should matter most). Using our voices to ask for what we need is an important skill to develop, but it almost always starts with the courage to ask for what we don’t.

Here’s how it sounds:

‘No’ to that extra shift; ‘no’ to staying late; ‘no’ to taking on an additional patient; ‘no’ to reusing PPE…the list goes on. If saying ‘no’ feels like you’re not being a team-player, well, then it’s time to readjust your definition of the game. Because we owe it to our patients, each other, and ourselves to speak up.