If They Learn Early, They Lead Early: Teaching Advocacy at the Baccalaureate Level Through Experiential Legislative Engagement
Tressa Pedroff, PhD, RN, CNE
June Bryant DNP, APRN, CPNP-PC
Abstract
Introduction: Nursing practice is directly shaped by healthcare policy, yet many nurses enter the profession with limited understanding of the legislative processes that influence their scope of practice, workplace conditions, and patient outcomes. Preparing future nurses to engage in policy advocacy is an essential component of professional nursing education.
Background: Advocacy is recognized as a fundamental component of professional nursing responsibility; however, structured advocacy education at the baccalaureate level is often limited. The purpose of this manuscript is to describe the impact and educational significance of experiential legislative advocacy exposure among baccalaureate nursing students participating in a state capitol advocacy event through the Student Nurses Association.
Program description: Undergraduate nursing students participated in a legislative immersion experience that included attending a state capitol advocacy event, meeting with state legislators, and engaging in discussions regarding healthcare policies affecting nursing practice, workforce issues, and patient care. Faculty mentors prepared students before the event and facilitated reflection following the experience.
Program outcomes: Students demonstrated increased awareness of the relationship between healthcare policy and clinical practice and gained greater appreciation for the nurse’s role in influencing legislation. Participation fostered growth in confidence, communication skills, and engagement with policymakers as students evolved from observers to active participants in the legislative process.
Conclusion: Experiential advocacy opportunities provide transformative learning experiences that support the development of professional identity and leadership competencies in undergraduate nursing students. Integrating legislative advocacy into baccalaureate education prepares graduates to become informed advocates who can influence healthcare policy and improve patient outcomes throughout their professional careers.
Introduction
Nursing practice is directly shaped by healthcare policy, yet many nurses enter the profession with limited understanding of the legislative processes that influence their scope of practice, workplace conditions, and patient outcomes. Advocacy is recognized as a fundamental component of professional nursing responsibility; however, structured advocacy education at the baccalaureate level is often limited. Early exposure to legislative advocacy may play a critical role in fostering professional identity formation and preparing future nurses to engage in systems-level leadership. This article presents an innovative, experiential learning activity created in a nursing program at a university located in Tampa, Florida. This initiative has occurred consecutively over the last three years which has allowed a total of 12 novice nursing student leaders the opportunity to engage with state lawmakers regarding healthcare policy advocacy. This experiential activity can be reproduced in both undergraduate and graduate programs in other geographic areas to expose students to healthcare advocacy initiatives.
Background
Health policy knowledge and advocacy skills are recognized as core competencies for nursing education in the United States (AACN, 2026; ANA, 2015; ANA, 2021). Although most nursing programs include some health policy content in their curriculum, most nursing graduates have limited or no experience with health systems advocacy required to become safe, novice clinicians (Kaeser, et al. 2023). According to Laari (2026), advocacy is not uniformly practiced due to the obstacles experienced at the individual, interpersonal and systemic levels. Furthermore, a conceptual review by Cropley, et al. (2022), found gaps in nursing education related to nursing graduates’ preparation for leadership engagement at the policy level. This indicates the immediate need for effective teaching strategies to be employed consistently in nursing education programs to foster competency in nursing advocacy. Evidence from the literature suggests that experiential learning is an effective strategy for improving nurses’ understanding of policymaking and fostering long-term involvement in policy-related activities (Gandra & DaSilva, 2023; Han, et al., 2025; Hawkins & Tremblay, 2021;). Gandelman and Moran (2020), suggest the creation of political activism exercises in nursing programs to ensure treatment quality and the preservation of patient rights. The purpose of this article is to describe the impact and educational significance of experiential legislative advocacy exposure among baccalaureate nursing students participating in a state capitol advocacy event through the Student Nurses Association (SNA).
Program description
This paper describes the implementation and impact of a legislative immersion experience in which undergraduate nursing students attended a state capitol advocacy event, engaged with legislators, and participated in discussions regarding healthcare policies affecting nursing practice and patient care. The experience is examined through the lens of professional identity formation and experiential learning theory.
This experiential learning initiative was piloted in the spring of 2024. It stemmed from the connection to a nursing classroom topic/assignment regarding advocacy in nursing. Faculty teaching the required Contemporary Issues course was looking for a way to foster both understanding and participation in nursing advocacy at the student level. After attaining financial support from The University of Tampa Department of Nursing leadership, it was decided that the executive board of the Student Nursing Association (SNA) would be invited to participate in Advocacy Days with the Florida Nurses Association (FNA) at the capital in Tallahassee, Florida. FNA’s Advocacy Days is a flagship event designed to empower nurses and student nurses, giving them a voice in the legislative process on issues that impact their profession and the patients they serve. This platform allows nurses to unite to learn about key legislative bills and meet face-to-face with lawmakers to advocate for healthcare policy. Faculty and students alike have the unique opportunity to engage with policymakers and gain firsthand experience in advocacy and healthcare legislation.
This two-day event occurs annually during the spring legislative session. For the past three years, the SNA executive board, consisting of 4-5 members, have accompanied their faculty advisors to the capital to advocate on topics important to nursing. Prior to the conference, students prepared for the experience by watching the Advocacy Days 101 Webinar, developed and presented by the Florida Nurses Association (FNA) as a primer for all nurses attending Advocacy Days. Additionally, each student downloaded the conference guidebook and app, to review the legislative platform and talking points, developed and published by the FNA.
All attendees participated in the two-day FNA sponsored Advocacy Days conference which included opportunities to learn about grassroots advocacy, the current FNA legislative agenda, how to be an effective advocate, and current workforce strategies. Additionally, role playing was performed by experienced attendees to assist with the effective execution of legislative visits to representatives. Next, group networking and planning took place, allocated by county districts prior to the walk to the capital for meetings with the legislators. Pre-arranged appointments took place with multiple representatives, senators, and legislative aids in which faculty, students and other practicing nurses advocated for specific causes important to nurses in the state of Florida. (see Table 1). In addition, students were able to observe testimony provided by nurses and other healthcare professionals in support of the legislative initiatives during subcommittee public hearings, as well as remarks from the sponsoring legislators on the floors of their respective chambers.
Table 1: FNA Advocacy Days Legislative Talking Points 2024
| Initiative | Motivation |
|---|---|
| Abolishing surgical smoke in operating rooms | Protecting surgeons, nurses, staff, and patients from inhaling harmful byproducts that increase respiratory issues, cancer risks, and viral transmission. |
| Ensuring strong oversight of nursing education | The Board of Nursing should regulate programs to prevent another Operation Nightingale and maintain high educational standards. |
| Patient-Directed Medical Orders (PDMOs) | Expanding beyond a DNR, these orders ensure end-of-life care aligns with patients’ wishes through legally binding provider-issued directives. |
| Supporting APRN full practice authority | Expanding access to quality healthcare by allowing APRNs to practice at their full scope. |
Following the legislative visits, conference attendees had the opportunity to interact with colleagues and lawmakers in a more relaxing environment at the legislative reception. Events on the second day of the conference included a debriefing session where attendees reflected on their legislative visits and shared their experiences with the entire assembly. Students participated in the assembly debriefing with guidance from their faculty mentors. The conference concluded after final educational sessions consisting of additional current topics related to leadership, advocacy and nursing. During the advocacy days experience, all FNA participants were treated to a welcome reception hosted by Dr. Barbara Sharief, the only nurse serving in the Florida Senate. This created opportunities for meaningful group discussions and personalized interactions that enhanced student engagement and learning.
After the advocacy days legislative experience, students sent follow-up emails to each of the legislators to thank them for their time, attention and to offer future assistance with future healthcare related legislation. Additionally, upon returning to campus, the SNA student attendees presented the advocacy days experience with their student peers during the general SNA meeting as well as the entire nursing faculty at the full faculty meeting.
Program outcomes
Participation in legislative advocacy experiences fostered increased student awareness of the relationship between healthcare policy and clinical practice, enhanced understanding of the nurse’s role beyond direct patient care and promoted confidence in engaging with policymakers. This was demonstrated by the reflective communication carried out in both formal and informal settings by 4 SNA students annually, for 3 consecutive years, involving a total of 12 students.
Students demonstrated increased recognition of their responsibility to advocate not only for individual patients, but also for the nursing profession and broader healthcare systems. Student interactions with the legislative meetings have advanced from mere observation, in year one, to student led dialogues, in year three.
This experiential legislative engagement initiative was recognized at both the state and local level. As depicted by Megan Maroney, FNA’s West Regional Director, “Showing strong unity and purpose, West Central Region members and nursing students from the University of Tampa met at the Florida State Capitol for FNA’s annual Advocacy Days. Our efforts bore fruit as HB63, sponsored by Representative Woodson, passed the House of Representatives with a vote of 115/1” (Maroney, 2024, p 6). Additionally, this initiative prompted networking which enabled The University of Tampa SNA to host an engaging evening with the FNA’s West Regional Director who denoted “Such gatherings reminder us of our shared responsibilities.” (Maroney, 2024, p 6). Moreover, the College of Natural and Health Sciences (CNHS) April 2024 newsletter featured this endeavor in the story Empowering Nurses: Reflecting on Advocacy Days in Tallahassee. “The feedback from our student nurses about this experience has been exceptionally positive, underscoring the importance and impact of such advocacy work.” Dr. Botwinski, the Director of Nursing, has recognized the value of this initiative and has pledged ongoing support for this annual participation (Botwinski, 2024, p 7).
Feedback from students who participated in this experience over the past three years indicated a greater understanding of nursing advocacy and increased confidence in their ability to contribute to policy change. Specifically, a reflective response from senior nursing student Caitlyn Whelen indicated that “being able to attend Advocacy Days and represent both the UT Nursing Department and the Florida Nurses Association was an experience I will never forget. I learned how much of a voice I have when it comes to policy changes and advocating for bills that will benefit the medical field which in turn, benefits the patients.” Many students reflected on the significant influence of their interactions with Barbara Sharief, noting that her role as the only nurse serving in the Florida Senate provided a compelling example of nursing leadership and policy engagement.
Discussion
This educational innovation resulted in the following scholarly reflection. Experiential advocacy opportunities provide transformative learning experiences that support the development of professional identity, leadership, and civic responsibility in undergraduate nursing students. While classroom-based policy content introduces students to the structure and purpose of healthcare legislation, direct participation in a state capitol advocacy event allows students to observe how nursing voices influence policy in real time. This type of immersion helps students connect bedside concerns, workforce issues, patient safety, and access to care with broader legislative decision-making.
A notable outcome of this initiative was the progression of student engagement over time. In the first year, students primarily observed faculty and practicing nurses during legislative meetings. By the third year, students were more actively participating in and leading portions of advocacy conversations. This progression suggests that repeated exposure, intentional preparation, and faculty mentorship may increase student confidence and willingness to engage in policy dialogue.
This experience also reinforces the role of nurses as advocates beyond individual patient encounters. Students were able to see that advocacy includes speaking on behalf of patients, protecting the nursing workforce, supporting safe educational standards, and advancing policies that improve healthcare delivery. These experiences align with professional nursing expectations and help students begin to view advocacy as an essential part of nursing identity rather than an optional leadership activity.
Although this initiative involved a small group of student leaders, the impact extended beyond the students who attended the event. Student presentations to peers and faculty created opportunities for broader discussion about health policy, professional responsibility, and nursing leadership. Future iterations could strengthen evaluation by including pre- and post-experience surveys, guided reflection assignments, or advocacy confidence measures to better capture changes in student learning and professional identity formation.
Conclusion
Integrating legislative advocacy experiences into baccalaureate nursing education is an important strategy for preparing future nurses as informed advocates, leaders, and participants in healthcare policy. Early exposure to policymaking environments helps students recognize that nursing practice is shaped not only at the bedside, but also through legislation, regulation, and professional advocacy. Through structured preparation, direct engagement with lawmakers, and post-event reflection, students gain confidence in using their voices to influence issues affecting patients, nurses, and healthcare systems.
This initiative demonstrates that even a small, faculty-supported advocacy experience can have meaningful educational value. By connecting professional identity formation with experiential learning, legislative immersion activities can help students move from viewing advocacy as an abstract concept to understanding it as a core nursing responsibility. Nursing programs should consider incorporating similar advocacy experiences to strengthen student confidence, civic engagement, and readiness to contribute to the future of the profession.
Dr. Pedroff is Assistant Professor/Assistant Director of Nursing, Department of Nursing, The University of Tampa, Tampa, Florida.
Dr. Bryant is Assistant Teaching Professor, College of Nursing, University of Colorado Anschutz Medical Campus, Aurora, Colorado.
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