GNSA Bulletin: March 2026

This Month's Highlight: Advocacy as Professional Identity

Advocacy has long been a key tenet in the professional identity of nursing practice, yet in today’s rapidly evolving healthcare climate, the role of graduate nursing students and advanced practice nurses as advocates has never been more critical. As healthcare systems encounter mounting challenges, such as workforce shortages, expanding health inequities, increases in moral distress among clinicians, and shifting policy landscapes, nurses are progressively called upon to serve not only as expert clinicians, but also as change agents who translate lived clinical experience into meaningful action (American Association of Colleges of Nursing, 2021; Mason et al., 2021). From protecting patients’ voices at the bedside to driving organizational culture and shaping health policy at the state and national levels, nurses are uniquely positioned to bridge clinical realities with systems-level change. Graduate nursing education plays a pivotal role in refining this functionality by better preparing nurses to think critically, lead ethically, and advocate with intention across diverse spheres of influence.

At the bedside, advocacy remains the moral and ethical focus of nursing practice and often represents the most discernible form of professional action. Graduate-prepared nurses routinely encounter situations in which patients’ needs, preferences, or safety may be impacted by systemic barriers, communication failures, or implicit bias. A graduate nursing student caring for a critically ill patient may advocate for shared decision-making when treatment plans conflict with the patient’s expressed goals, ensuring that informed consent and patient autonomy are defended. Similarly, graduate-prepared nurses frequently identify disparities in pain management, language access, or discharge planning and intervene by coordinating interdisciplinary collaboration, engaging ethics consultations, or adjusting care plans to promote equitable outcomes (Haddad & Geiger, 2018).

Advocacy at the bedside encompasses the identification and prevention of care that has inherent risk, such as questioning unsafe medication orders, escalating concerns about staffing ratios that threaten patient safety, or challenging clinical practices that disproportionately harm vulnerable populations. These actions require moral courage, clinical expertise, and confidence, all of which are fostered through graduate nursing education. In these moments, advocacy is not abstract; it is personal, experiential, and deeply rooted in the nurse–patient relationship, reinforcing nursing’s foundational commitment to patient dignity, justice, and safety.

Beyond individual patient interactions, the need for advocacy extends into healthcare organizations, where graduate nursing students are playing an increasingly significant role. Organizational advocacy may take the form of participation in shared governance councils, quality improvement committees, or interprofessional task forces focused on patient safety, health equity, and workforce sustainability. Examples of this are endless. A graduate-prepared nurse might contribute to a quality initiative addressing hospital-acquired infections by analyzing data, proposing evidence-based interventions, and advocating for practice changes based on current research. Advanced practice nurses may lead efforts to revise clinical protocols, implement trauma-informed care models, or promote inclusive policies that support diverse patients and staff (Mensik, 2022). Organizational advocacy includes championing the well-being of the nursing workforce itself. Graduate nurses recurrently advocate for safe staffing models, appropriate operational and clinical policy revisions, and professional development opportunities. By influencing institutional policies and organizational culture, graduate-prepared nurses help create environments where ethical practice is supported and sustainable, thereby improving both patient outcomes and nursing satisfaction. These efforts demonstrate that advocacy is inseparable from leadership and that systemic change often begins within one’s own organization or clinical environment.

Equally vital is advocacy beyond the walls of healthcare institutions, but at the state and national levels, where policies shape the conditions under which care is delivered. Nurses are repeatedly ranked among the most trusted professionals in the United States, a distinction that confers both influence and responsibility (Gallup, 2023). Graduate nursing students and nursing professionals can and should leverage this trust through engagement in professional organizations, legislative advocacy, and direct communication with policymakers at all levels. Grassroots advocacy campaigns, such as participating in voter education initiatives, contributing to policy briefs, or collaborating with community organizations to address public health priorities, are great places to begin one’s advocacy journey. At the national level, nurse advocates influence federal health policy through involvement with organizations such as AACN, specialty nursing associations, and interdisciplinary coalitions. These efforts ensure that health policy decisions reflect clinical realities and are informed by those who understand the lived experiences of patients, communities, and the nursing workforce.

This month’s bulletin calls graduate nursing students and professionals to embrace advocacy as a core component of their scholarly, clinical, and leadership identities. Advocacy is not reserved for a select few, nor is it something to be deferred until graduation. It begins now, in classrooms where students critically examine health systems and policy, in clinical settings where nurses protect patient voices, in organizational spaces where quality and equity initiatives are formed, and in public forums where healthcare decisions are made. Graduate nursing students are not merely preparing for future leadership; they are actively shaping the present and future of the profession through informed action and a collective voice.

By leveraging advanced education, evidence-based practice, and professional credibility, graduate nurses have the power to greatly influence systems, advance health equity, and strengthen healthcare delivery at every level. As articulated in the AACN Essentials, advocacy is a fundamental expectation of professional nursing practice and leadership, calling nurses to act with integrity, courage, and purpose often in the face of opposition and change (AACN, 2021). The challenges facing healthcare demand engaged, informed, and persistent nurse advocates. The moment is now, the responsibility is shared, and the call to lead has never been clearer.

References

American Association of Colleges of Nursing. (2021). The essentials: Core competencies for professional nursing education. https://www.aacnnursing.org

Gallup. (2023). Honesty and ethics ratings of professions. https://www.gallup.com

Haddad, L. M., & Geiger, R. A. (2018). Nursing ethical considerations. In StatPearls. StatPearls Publishing.

Mason, D. J., Perez, G. A., McLemore, M. R., & Dickson, E. (2021). Policy & politics in nursing and health care (8th ed.). Elsevier.

Mensik, J. S. (2022). Nursing leadership from the outside in. Sigma Theta Tau International.

Gordon M. Gartrell, MSN, RN, NEA-BC, CENP, CCRN, CEN, CPEN, TCRN
Doctoral Candidate – PhD in Nursing
School of Nursing
School of Graduate Studies in Health Sciences
University of Mississippi Medical Center