As we respond to the ill-conceived VA Nursing Handbook, state legislatures continue to struggle with legislation and regulation affecting our practice and the environment in which we provide care. Professionalism, citizenship and our Hippocratic Oath require us to speak up when elected officials and health policy experts make decisions that impact patient safety and access to care. In addition to our federal advocacy effort, our state components lead a parallel effort in state legislatures, where legislation and regulatory changes have an even greater impact on our practice. The pressure to remove critical patient safety protections will intensify in the wake of the proposed federal changes.

The new pressure in state legislatures will demand an intensified advocacy footprint. A successful state advocacy effort includes grassroots engagement, lobbyist support and political action committee (PAC) fundraising. Some states have had a more tumultuous history and have state advocacy programs that evolved to become...

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