Two Nurses Serving in Congress Discuss Nurse Leadership

For National Nurses Week, two nurses who serve in the U.S. House of Representatives share their views on nurse leadership with the Robert Wood Johnson Foundation (RWJF) Human Capital Blog. Lois Capps, D-Calif., has served in the House since 1998; and Diane Black, R-Tenn., since 2011.

Capps: We Must Increase Our Nursing Workforce

Human Capital Blog: Prior to running for Congress, you worked as a nurse and a nursing instructor. How does your background as a nurse help shape your agenda on Capitol Hill?

Rep. Lois Capps: When I began my career as a nurse, I never imagined I would become a member of Congress. But when my husband passed away shortly into his first term in Congress, I was encouraged by my friends and neighbors to run, and I won the seat in a special election. Despite the fact that nurses and other health care professionals often never think about engaging in policy-making careers, I knew my experience as a nurse would make me a great advocate for the health community in Congress. Just as nurses are the best advocates on behalf of our patients, we are naturally inclined to be the best advocates on behalf of our patients in the Capitol.

HCB: You have made addressing the nursing shortage a priority. What has Congress done so far to address past shortages, and what needs to be done to curb future ones?

Rep. Capps: As a nurse in Congress, I know and understand the impact the nursing shortage can have on my constituents, but it is not a problem we can fix overnight. It takes many years to move a student through the nursing pipeline, so we cannot let up.

Now, more than ever, our nation must prepare to increase our nursing workforce. America’s health care system is already stressed due to the aging Baby Boomer population, the growing incidence of chronic diseases, and a shortage of providers in all specialties, particularly primary care providers. Nurses are integral to addressing these health care demands as they work in all health care fields and are linked to lowered health care costs, improved health care quality, and increased health care access.

One of my proudest accomplishments is the inclusion of provisions to improve our health care workforce, with a specific emphasis on nurses. As a senior member of the Energy & Commerce Committee’s Health Subcommittee, I successfully sought inclusion of provisions to increase funding for nursing students, improve opportunities for nurse faculty, and ensure that advanced-practice nurses could serve as coordinators for patient care in innovative new models of health care delivery.

I authored the Nurse Reinvestment Act, which established programs aimed at both increasing the number of qualified nurses, including advanced practice nurses and nursing school faculty, and improving the quality of nursing services in the United States through the Title VIII Nursing workforce programs. But it is not enough just to pass a law, we need it funded. That is why I always lead a bipartisan effort to keep this program strong. I also introduced the Registered Nurse Safe Staffing Act, which empowers registered nurses to drive staffing decisions in hospitals and, as a result, protect patients and improve the quality of care. This is important to keep our nurses, once trained, in the field, taking care of patients.

HCB: You founded the Congressional Nursing Caucus and are serving as its co-chair. Why did you found it and what are your legislative priorities?

Rep. Capps: I founded the Congressional Nursing Caucus in 2003 and continue to serve as its co-chair because it allows me to work closely with my colleagues to address some of the most pressing health concerns facing Americans. Support for nurses and their patients is a bipartisan effort, and I have been privileged to work with some great Republican members on this issue over the years, as well. This caucus has given me the opportunity to educate other members of Congress about issues important to the nursing community, as well as to educate new members about the importance of nurses to our evolving health care landscape. In addition to the Congressional Nursing Caucus, I also serve as co-chair of the House Cancer Caucus and the Congressional Heart and Stroke coalition, as well as the Congressional Caucus for Women's Issues’ Health Task Force. 

HCB: There are a lot more physicians than nurses in Congress. Why do you think that is, and would Congress, and the country, benefit if more nurses held public office?

Rep. Capps: As I mentioned earlier, in Congress, I have become known to my colleagues as an authority on health issues because of my nursing background. The compassion and dedication nurses are known for can carry over into the political arena as well. Members of Congress specifically, and public officials generally, need to be dedicated to the task at hand. They need to feel the connection and compassion to the people and issues they are fighting for.

And not just that. Most everyone will come into contact with nurses at some point in their lives. Nurses can have a tremendous impact on a person’s well-being. So for all the hard work, dedication, and compassion a nurse shows to others, they also need someone looking out for them. In order to help them face the challenges they face, they need representatives in Congress to help address such challenges from a legislative perspective.

I often work with my physician colleagues to raise awareness on a host of health issues. Together we bring a unique perspective to the policy debates of the day.

HCB: How do nurses’ training and experience position them to be strong leaders?

Rep. Capps: A leader can function in different roles. They excel at relationships and inspire others to do their best working toward a shared goal. A leader is an advocate, but also needs to be able to look at all the perspectives on a particular issue. Leaders use their position to empower others and challenge the status quo. Leaders must be decisive in the face of questions, and resilient in the face of challenges. I believe nurses, through their training and experience, must be all of these things and more. They thrive under pressure, and that translates well here on the Hill as well as in our communities.

HCB: What role would you like to see nurses playing in leading health policy in the future?

Rep. Capps: We have seen, and I hope we will continue to see, an increased recognition of the important and unique role nurses can play in a high quality-affordable health care system. With the implementation of the Affordable Care Act, the need for nurses, especially advanced practice nurses, to provide care will hopefully lead to increasing options for nurses to serve to the top extent of our training and licensure combining. Similarly, nurses will likely continue to lead in providing care in new settings, helping all Americans get better access to care. The Institute of Medicine’s landmark report on the future of nursing gives us the roadmap for where as a profession we need to advocate at all levels of our government. The document challenges us to engage.

When I began my career as a nurse, nurses were never asked nor expected to be involved in federal policy-making, but now we have to be. You do not need to run for Congress to have an impact on policy—there are many ways to be involved in advocacy with local and national organizations. But no matter how you get involved, nurses are the backbone of our health care system and your input is essential as elected officials legislate on related issues.

Black: We Need More Health Professionals in Congress

Human Capital Blog: Prior to running for Congress, you worked for more than 40 years in the health care field as a nurse and in other positions. At what point in your career did you decide to run for Congress, and why?

Rep. Diane Black: I have always felt drawn to public service where I feel that I can help. As a nurse in Tennessee, I had a firsthand look at the state-level pilot program for the Hillary Clinton health care overhaul known as TennCare. This program had disastrous effects on our state’s health care system and budget, which led me to run successfully for office in the Tennessee state Legislature. Then after watching a version of Tennessee’s failed health care experiment pass at the national level, in 2010 I ran for Congress to fight against Obamacare, which I knew would be equally disastrous.

HCB: Does your background as a nurse help shape your agenda on Capitol Hill?

Rep. Black: Absolutely. With health care at the forefront of national debate right now, understanding the issue from the perspective of patients as well as health care providers gives me great insight into how policies will affect everyone involved in our health care system.

HCB: You are a member of the Congressional Nursing Caucus. What are the caucus’ priorities?

Rep. Black: The Congressional Nursing Caucus is a bipartisan group of members whose backgrounds help them provide a voice for the needs of the nursing community in Congress.

HCB: There are only a few members of Congress who have also worked as nurses. Do you think Congress, and the country, would benefit from more nurses in public office? Why or why not?

Rep. Black: Our nation’s health care system will be at the forefront of national debate for years to come, and having more medical professionals in Congress would certainly help lawmakers understand the ramifications of the policy decisions that are made in Washington. I believe we should have more lawmakers with private-sector backgrounds to better address the issues that affect the American people.

HCB: How do nurses’ training and experience position them to be strong leaders?

Rep. Black: Nurses undergo significant training so that they can perform their jobs under long, often off-peak hours, and under some of the most stressful and time-sensitive conditions. They must be decisive and exercise the strongest judgment when doing their jobs. There is a reason that nurses are consistently rated as among the most well-respected professions, and that is certainly a quality we would like to see more of in Congress!

HCB: Why is it important to have nurse leaders in positions of leadership and what role would you like to see nurses playing in leading health policy in the future?

Rep. Black: I believe the insight nurses have into our health care system is invaluable and should be at the table whenever health care reforms are being negotiated. Our health care system is undergoing many changes right now, and in order to preserve the nation’s greatest health care system, I believe it is essential that nurses play a key role in advancing the policy debate.

This commentary originally appeared on the RWJF Human Capital Blog. The views and opinions expressed here are those of the authors.