Politics with a small p: if you engage, you can lead change

Political leadership and engagement isn’t just about party politics – it’s about being at the centre of decision-making

Political leadership and engagement isn’t just about party politics – it’s about being at the centre of decision-making

Political awareness equips nurses to take control of the profession’s destiny, says Anne Corrin. Image: iStock

While many nurses may have chosen to avoid the political arena, believing it has little to do with their working lives, engagement with political issues is increasingly viewed as a responsibility, rather than an option.

‘Some nurses have not seen it as relevant for them and they don’t believe they have the power to become agents of change,’ says Anne Corrin, the RCN’s head of professional learning and development. ‘It’s to the detriment of them as individuals and to nursing. This is about nurses controlling the destiny of the profession – and not allowing others to shape where it’s going.’ 

There can be confusion about what political engagement means in practice, about the difference between politics with a capital P – government, administration – and politics with a small p – the politics of everyday life, getting or using power with an organisation, the haves and have-nots. ‘Most nurses think of it as party politics,’ explains Dr Corrin. ‘They don’t understand the politics of a small p. It disadvantages a profession if you don’t understand how important it is – and that you can bring about change and make things better.’ 

‘Embed leadership in education from day one’

Another difficulty has been the omission of political decision-making from preregistration training, although that is going to change (see box: Nurses creating change: the wider context). ‘There wasn’t much taught about nurses becoming future leaders and while some have come to it later on, it’s been very hit and miss,’ says Dr Corrin. ‘We really need to embed it with student nurses from day one, teaching them that this is part of being a nurse. It’s not ‘something others do’, but you do it. If we want really good quality care, nurses have to be at the centre of making strategic decisions.’

To that end, the RCN has been running a political leadership programme, now known as system leadership, since 2015. Targeted at band 8 healthcare professionals, the two-day course looks at working at board level; building readiness for political leadership; understanding local context; and practising political influencing skills, using personalised case studies.

‘We’re trying to give people confidence,’ says Dr Corrin. ‘Going into a boardroom for the first time can be quite a daunting experience. You’re facing powerful people and trying to put your case can be scary.’

Legacy of a predominantly female profession

Nursing is an overwhelmingly female profession, and she believes it’s hard to ignore the effect of gender. ‘Historically we haven’t been strong politically as a profession,’ Dr Corrin admits. ‘But we seem to be going through a sea change now in the wider world, with campaigns such as #MeToo, which will hopefully filter through. Being a hierarchical profession has also not helped in the past, but the new curriculum is much more about building leadership skills.’

Political leadership is also a huge issue for black and minority ethnic (BME) nursing staff, she believes, while there are large numbers of BME people at lower bands. ‘Look up, and the numbers are frighteningly small,’ says Dr Corrin. ‘It’s clear that something is just not working. It’s a big issue in retention, because people need to see that whatever their background, they can go all the way to the top. Political leadership can help to change this and it’s very necessary.’

The RCN in Northern Ireland has been running an annual political leadership programme for the past four years, with around ten participants on each course. ‘The aim is to encourage members to get involved in the political process, influencing on behalf of nurses and nursing,’ explains John Knape, the RCN’s head of communications, policy and marketing in Northern Ireland. ‘It’s really about giving people the skills and helping them realise they have a valuable contribution to make.’

‘I can’t stress enough how much politicians value meeting nurses on the front line’

John Knape

Confidence is key. ‘In my experience, nurses have great expertise and ability to talk to politicians, decision-makers and opinion-formers, helping to shape policy, but what they initially lack is confidence,’ says Dr Knape. ‘I can’t stress enough how much politicians value engaging directly with nurses. It’s one thing for them to talk to people like me, but another thing entirely for them to meet someone they regard as a real nurse, particularly someone on the front line.’

‘Nurses have a powerful voice’

He believes there has been a reluctance in the past for nurses to become involved politically. ‘But I would say it’s an issue that goes beyond gender,’ says Mr Knape. ‘Initially many nurses say, why would anyone listen to me? Our aim is to help them understand they have a very powerful voice. They are also surprised at how normal politicians are and that what they want is for people to explain the issues and challenges they face, and what help they need.’  

While some may view it as a futile exercise, Dr Knape argues the opposite is true. ‘It’s how the world changes and moves forward,’ he says. ‘I can point to instances where certain things that nurses have said have changed policies and sometimes even the law. It’s vital that nurses understand their capacity to make that kind of difference. It’s not just about having a good conversation with a politician – you have the ability to change the world.’

‘Politicians are genuinely concerned about nursing’

For Caroline McGeary discovering the human side of politicians has been a revelation. ‘The big thing for me is that they are so different off-screen,’ says Ms McGeary, who is a senior infection prevention and control nurse at the Public Health Agency in Northern Ireland.

‘What I’ve seen on television is completely different to the people I’ve talked to, who are very human and genuinely concerned about the issues and pressures, particularly facing front-line staff.’

She readily admits that before she embarked on the RCN’s political leadership course in Northern Ireland, stepping in for a colleague who had booked a place but was unable to attend, she had very little interest in politics. ‘It’s not something I was exercised about,’ says Ms McGeary, who took up her current post in 2010. ‘I think that’s probably because of the way the situation was here in Northern Ireland for a long time.’

Part of the course involves undertaking an influencing activity, and she chose to attend three party conferences, meeting politicians from the Ulster Unionist Party (UUP), Democratic Unionist Party (DUP) and Sinn Fein on the RCN’s stands. She enjoyed the experience so much she has since volunteered to attend the conferences of other parties too.

‘After doing the first one, I felt comfortable talking to the politicians and my confidence grew,’ says Ms McGeary. ‘At first, I thought nurses would be the last people they would want to talk to, as we’re just one small group of people in such a big world for them.

But all of them had personal experience of health services in Northern Ireland, whether for themselves or a family member. They recognise what’s happening on the ground.’

Historically, she believes nurses have been unwilling to become engaged in political lobbying. ‘Even through the recent pay campaign, you would overhear nurses saying that they couldn’t make a difference,’ says Ms McGeary. ‘But now I think raising the issues definitely helps.

The course has completely changed everything for me. I’ve gone from thinking, I’m not sure about this, to becoming much more involved, both in the political side and with the RCN’s work.’

Nurses creating change: the wider context

Understanding how to influence policy and prompt change in healthcare organisations is part of the Nursing and Midwifery Council’s new standards of proficiency for registered nurses, which reflect what is required from a newly registered nurse ‘at the very beginning of their career’. The standards say that nurses should be able to demonstrate development of political awareness and skills.

On the world stage, the International Council of Nurses (ICN) launched its Nursing Now campaign in February. It will run for three years and seeks ‘to empower nurses to take their place at the heart of 21st century health challenges’, helping to enhance their influence and maximise their contributions to ensure everyone has access to healthcare. Another ICN campaign, Nurses: A Voice to Lead, began last year and focuses on the need for nurses to become more active and vocal in policy development and implementation.

Top tips

  • Don’t be afraid to take a risk, advises Anne Corrin. ‘Have a go. Say yes to things. Be brave – and if it goes wrong, you can learn from it’
  • Remember you’re the expert, advises John Knape. ‘You may feel nervous meeting a politician for the first time, but if you’re talking about your area of practice or an issue in your workplace, you know a lot more than they do’
  • ‘Just do it,’ says Caroline McGeary. ‘It’s so interesting and you can make a difference. Politicians are genuinely interested in what nurses have to say’
  • Find a mentor you trust who can offer you support. ‘Training can help too,’ says Dr Corrin 

How to get involved

The RCN system leadership programme takes place at RCN Scotland headquarters in Edinburgh, on 19-20 April, with another course running in London later in the year. It costs £899 and is organised in small cohorts of around 15 people.

An introduction to political influencing in Northern Ireland runs annually. There are four sessions run over different afternoons and participants are also expected to undertake an external activity of their choice, where they put policy into practice. Call 028 90 384 600 or email ni.board@rcn.org.uk

Further reading

Lynne Pearce is a freelance health journalist



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