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In this file photo, Delaware Lt. Gov. Bethany Hall Long and School of Nursing professor participates in a bill signing on the Health Sciences Complex on UD’s STAR Campus.
In this file photo, Delaware Lt. Gov. Bethany Hall-Long and School of Nursing professor participates in a bill signing on the Health Sciences Complex on UD’s STAR Campus.

Advocacy matters

Photo by Evan Krape

From bedside to Legislative Hall, more nurse legislators needed

Delaware Lieutenant Governor and University of Delaware School of Nursing Professor Bethany Hall-Long’s interest in politics started with a fire in her belly when she was a graduate student at the Medical University of South Carolina, working with vulnerable populations.

“The people in the Black and Brown communities, particularly mentally ill veterans experiencing homelessness, did not have a voice,” she said. 

Through those experiences and equipped with guidance from strong mentors like Dr. Hazel Johnson-Brown, who became the first Black female general in the U.S. Army in 1979, Hall-Long saw a clear need for nurses in healthcare policy.  

“Without me writing letters and advocating to work with the League of Women Voters and other organizations, we were not going to get the resources necessary for shelter or therapeutics that mentally ill veterans experiencing homelessness needed,” Hall-Long said. 

While a doctoral candidate at George Mason University, Hall-Long interned in the Washington, D.C. offices of Senators Bob Dole, Thad Cochran, and Ted Kennedy, furthering her interest in public service.  

Speaking during a virtual panel discussion entitled Nurse State Legislators Monday, Feb. 13, sponsored by School of Nursing in the College of Health Sciences and the Biden Institute at UD as well as the Center for Health Policy at Columbia University, Hall-Long encouraged current graduate and doctoral students and nurses at the bedside to be engaged with elected officials and their local communities. 

“Don’t be shy. You’ve got a lot of courage,” she said. “If you’re a nurse, clinician, or administrator, you can be elected. You have all the skill sets and can be ready on day one. We need nurses at every level of government.”

She recounted her own political journey, first winning office to the Delaware House of Representatives in 2002, where she served until 2008 when she was elected to the Delaware Senate. She’s now serving her seventh year as lieutenant governor of Delaware. 

“If you run, you not only need to have that fire in the belly, but be willing to get your name out there, and be willing to lose and pull your pants back up the next day and move on,” Hall-Long said. “The first door I knocked on, somebody said, ‘How nice you’re here helping your husband.’ There were still some of those gender biases 20 years ago, but 98% of people are super supportive. I lost the first time I ran for elected office and worked very hard door-to-door campaigning and raising money, but the very next day I went right back to my community meetings, and the next time around I won.

“But you must have that passion. Healthcare is health in all policies whether it’s environmental, infrastructure, social justice, or criminal justice. It’s not always directly healthcare at the bedside but other social determinant health policies.” 

The panel discussion also included Darlene J. Curley, a former Maine state legislator and adviser for the Center for Health Policy at Columbia University who presented data from the American Nurses Association that showed there are 68 nurse legislators in 34 states. That’s down 30% from 2013. Delaware currently has Hall-Long as lieutenant governor and one nurse legislator, Majority Whip Rep. Melissa Minor-Brown, who’s also the clinical coordinator for graduate services at the UD School of Nursing. Three nurses are currently in Congress on the federal level. 

Nursing was ranked the number one most trusted profession for the 21st year in a row, according to a Gallup poll, and Hall-Long said nurses should use that to their advantage. 

“I saw that trust mattered more than ever during COVID when I administered 4,000 COVID vaccines in 2022 door-to-door or in the community with the UD SON Medical Reserve Corps. People know we’re respectful, full of integrity and put aside personal interest for the public good,” she said. “We’re also quick decision makers. At the bedside, nurses make life and death decisions in seconds; people know that makes for a good provider and clinician.”

While good policy can take years, Hall-Long said nurse leaders are needed to build bridges along the way by focusing on nonpartisan problems and providing bipartisan solutions.

“Working across the aisle during divisive times is important,” Hall-Long said. “Nurses build consensus every day by the bedside, in their scholarship or their academic setting, or wherever they’re working.”  

Over her legislative career, Hall-Long has sponsored or co-sponsored more than 1,000 bills, and 60% of the measures touched on healthcare. She stressed timing and strong relationships as she recalled both wins and losses.

“Failure is the best lesson,” Hall-Long said. “To me, it wasn’t measured by how many bills were passed but really it was more about the quality of the measures.”  

Hall-Long stressed the need for more diversity in healthcare. 

“Equity is so important. Our Black and Brown communities across America are increasing, and we want to make sure that they’re represented,” she said. “We want to be laser-focused and intentional to ensure that we have more male and Black and Brown nurse leaders to lower that gap. This is why having nurse leaders such as Rep. Minor-Brown is critical.” 

She also called for a cohesive approach to academics, healthcare at the bedside and scholarship. 

“Part of the nursing curricula, both undergraduate and graduate, should encourage and give credit to students who go to community and association meetings,” Hall-Long said. “Faculty are rated on service. Instead of just scholarship and teaching, let’s really up the ante and show that service does matter and that service in policy matters.”

Elizabeth Speakman, senior associate dean of the School of Nursing, said nursing and advocacy have always been intertwined.

“The nursing profession has been part of most, if not all, societal, political and economic movements from women's right to vote to climate change initiatives,” Speakman said. “This webinar highlighted the value and need for nurses to not only be part of the advocacy movement but also serve as legislators crafting and implementing policies that impact patients and the many communities they serve.”

Policy impacts everything that a nurse does from taking care of patients to reimbursement levels and the ongoing, at times, crippling nurse shortage fueled by burnout during the COVID-19 pandemic. 

“We’re in the midst of a ‘twindemic’ — the COVID pandemic and the opioid epidemic — and never has it been more important that nurses at the bedside, at the levels of research and scholarship and at the administrative level have a place at the policy table,” Hall-Long said. “If we’re not at the table, we’re on the menu. Nurses are the fabric; we are the glue of the healthcare system. The health system will crumble without nurses, and who better to make policy for themselves than nurses.” 

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