Influence through advocacy, policy, lifelong learning, and philanthropy

Catherine “Cathy” D. Catrambone | 04/18/2016

President Catrambone reviews her call to action.​​

Dear STTI members,

The tremendous member excitement and commitment that I witnessed at the biennial convention of the Honor Society of Nursing, Sigma Theta Tau International (STTI) this past November filled me with joy and a deep sense of pride. This exceptional group of nurses from across the globe is a dynamic, international community of nurse scholars with a wide array of practice, education, leadership, research, and social experiences. It is a body in motion, its energy fueled by its global health mission. 

Cathy CatramboneAt the convention’s House of Delegates, the incoming president presents the call to action. Based on the mission, vision, values, guiding principles, and strategic plan of the honor society, this call serves as the organization’s energizing vision for the next biennium. Mobilization of members and chapters is essential for our continued growth, and the call to action provides direction for those members and chapters to engage in and advance the organization’s goals. As Robert M. Gates emphasizes in A Passion for Leadership, “People, not systems, implement an agenda for change.”
My presidential call to action for the 2015-17 biennium is “Influence to advance global health and nursing.” Numbering more than 19.3 million, nurses and midwives are the largest group of health care professionals in the world. Globally, nursing is woven into every element of healthcare. Given the challenges we face in healthcare, now is the time for the profession to leverage its influence and power. In any sphere of human activity, influence is an essential force, and it is at the core of my call to action. In that call, I’ve identified four themes to focus on in the coming biennium:

  • Influence through advocacy
  • Influence through policy
  • Influence through lifelong learning
  • Influence through philanthropy

Influence through advocacy
The first theme of my call to action is “influence through advocacy.” The need has never been greater for the voice of the nurse to be heard. Through their use of knowledge, expertise, and relationships, nurses advocate for and lead change to improve global health. Across all settings, professional practice roles, and cultures, nurses are uniquely positioned to apply current evidence to advocate for the rights, health, and safety of the populations they serve; to redesign health systems to meet society’s rapidly changing needs; and to advance the profession worldwide.
Both the International Council of Nurses (ICN) and the American Nurses Association (ANA) address advocacy. The ANA Code of Ethics (2015) defines advocacy as “the act or process of pleading for, supporting, or recommending a cause of action” (p. 37). As nurses, we advocate for individuals, communities, and populations. We “give voice” to what is needed to promote quality care, safety, and the well-being of those entrusted to our care.
In the United States, nurses continue to be recognized as the most trusted profession.Nurses have earned this trust and, because society is experiencing major challenges in health care, now is the time for nurses to truly embrace and engage in advocacy, to amplify our voice and exert influence that brings stakeholders together and creates the changes needed in health care and nursing.
The Honor Society of Nursing, Sigma Theta Tau International supports nurses in their roles as advocates in many ways. For example, the STTI leadership academies prepare and position nurses for leadership roles in academic and health care settings. The academies provide environments and resources for nurses to combine their knowledge and advocate for evidence-based programs and practices that positively influence health outcomes.
To position members as strong advocates, STTI will launch the Institute for Global Health Care Leadership in September 2016. This institute will leverage interprofessional collaboration as a strategy for creating better health care systems and will prepare health professionals from a spectrum of disciplines to assume key health care leadership positions.
With more than 135,000 members across the globe, STTI is a powerful voice in the world. The challenge for each of us is to make a conscious choice about where to focus our advocacy efforts. Where do you want to exert influence? What is your passion? What changes do you want to make personally or professionally? I urge you to focus on these three strategies: 1) Develop advocacy expertise, 2) engage in advocacy, and 3) foster advocacy partnerships. Now is the time to influence through advocacy. Seize the moment and embrace the role.
Influence through policy
The second theme of my call to action is “influence through policy.” Nurses in every setting must embrace their responsibility to engage in shaping policy. Health policy impacts how decisions are made and resources are allocated. STTI calls on its members in 91 countries to contribute their leadership, scholarship, and research expertise to advance health policy.
Many STTI members have accomplished significant work in shaping policy. Participating in policy is a specific way of being an advocate. While advocacy can be accomplished by presenting important health information to community organizations or to other health care professionals, engaging in policy shaping is intentionally working within the structure of established entities, such as a government department or a hospital policy committee, to advance policies that create standards for performance. For example, nurses advocate for patient safety by influencing policies to assure appropriate nurse-patient ratios.
Nurses are uniquely qualified to engage in policy activity as our profession is based on the relationship we hold with the public and our commitment to their welfare. Our work in policy influences decisions that will impact quality of life and universal access to health care for all.
As nurses, we possess skills for engaging with the community and interfacing with key stakeholders about the need for and implications of policy change. Partnering with not-for-profit organizations that work with local or national government agencies to address health-focused issues can provide a great opportunity for influencing policy.
Many organizations seek nursing participation in policy development. Nurses bring evidence-based knowledge that serves to inform policy development and can influence policy decision-makers. Collaborating with decision-makers and government officials places us where we can influence audiences necessary to achieve policy change.
For the nursing profession, key policy issues include practicing to the full extent of our license, migration of nurses and faculty to high-demand areas, and providing healthy work environments. Major areas of focus for global health policy include universal access to health care, universal health coverage, needs of our aging population, treatment of noncommunicable diseases, and increased demand for human resources for health.
Sigma Theta Tau International is expanding its policy agenda and will continue to collaborate and partner with nursing, governmental, and nongovernmental organizations to advance pressing health care issues. We seek our members’ clinical and research expertise to inform and shape policy.
STTI’s Global Advisory Panel on the Future of Nursing and Midwifery (GAPFON) has gained great momentum by convening extraordinary global nurse and midwifery leaders around the world to identify and prioritize global issues that are key to strengthening the delivery of healthcare with the goal of helping to achieve global health. Combining the voices of these visionary leaders is key to achieving positive outcomes. In 2016, to establish priorities in health and nursing, the honor society is convening the remaining regional GAPFON meetings in Europe, the Middle East, North America, and South Africa.
Once these meetings are completed, summative global and regional reports will be generated that will inform the implementation phase of GAPFON. Multisectoral and interdisciplinary stakeholders will be then be assembled to establish action plans with outcomes and metrics that address identified priority areas for policy, leadership, workforce, and education to improve health at the global and regional levels (GAPFON, 2016). Click here to follow GAPFON developments.
Through STTI’s association as a nongovernmental organization with the United Nations with Economic and Social Council (ECOSOC) special consultative status, the honor society will continue to have a significant presence and provide support to influence issues related to health and nursing STTI has also appointed a liaison and two youth representatives, all of whom are STTI nurse members, who will represent STTI at the United Nations. In addition to attending events related to health and nursing, they will plan and speak at STTI-sponsored activities that are held parallel to United Nations events. Click here to learn more about them and their work.
STTI members’ engagement in policy is crucial. We are ideally positioned to address policy in the areas where we live and practice. Our challenge is to actively engage in shaping policy through actions that include creating, influencing, evaluating, and changing health policy, as well as in seeking opportunities that strengthen policy impact.
Another priority area for policy influence is advancing the 17 Sustainable Development Goals, or SDGs (UN, 2016), launched by the United Nations in January 2016. Each SDG goal has specific targets that focus on developed and developing countries. Goal No. 3 relates directly to health: Ensure healthy lives and promote well-being for all at all ages. Although the other SDGs do not specifically mention health, the goals they cite—such as zero hunger, clean water, sanitation, climate change, and life on land—have significant health-related implications. The primary purpose of the SDGs is to end poverty, protect the planet, and ensure prosperity for all people within the next 15 years.
The policy implications for advancing the SDGs represent a powerful forum for nursing action. I challenge each of us to make time to review the SDGs and strategize within our chapters and regions to take effective action. We can inform and inspire each other via communication in The Circle and other social media. Commit to sharing your stories and achievements to educate one another and the general public.

Influence through lifelong learning
The third theme of my call to action is “influence through lifelong learning.” Dynamic lifelong learning will lead to advances in nursing practice. As we build upon our capabilities as professional nurses, we will positively influence transformation of global health. Conducting a positive inventory of strengths and opportunities for continued development and advancement enhances our scholarship, leadership, and service. STTI supports every member’s lifelong learning by offering resources and engagement with honor society initiatives.
Mahatma Ghandi spoke eloquently to the practice of lifelong learning: “Live as if you were to die tomorrow, learn as if you were to live forever.” Lifelong learning is essential to survive in a world characterized by an explosion of knowledge. Within the STTI community and the nursing profession at large, intentional and value-based learning enhances our worth and expands our ability to positively influence global health. Through lifelong learning, we grow personally and professionally, and we enhance our capacity to serve society. In pursuing lifelong learning for ourselves, we also model lifelong learning for the next generation.
The concept of transformational change known as appreciative inquiry offers a unique approach to learning. One begins the process by deeply acknowledging and affirming, through positive inventory, learning that has already occurred. After expressing appreciation of existing knowledge and abilities, the next step is to identify opportunities for continued development. This process energizes us to advance to the next level in our personal and professional goals.
STTI’s mission—to advance world health and celebrate nursing excellence in scholarship, leadership, and service—speaks to the organization’s commitment to the lifelong learning of its members. Knowledge products and services are continually being developed to respond to the dynamic and challenging environment in which we live and practice.
In the near future, STTI will launch the International Institute of Nursing Scholarship (IINS). This initiative will include the creation of three centers: Center for Excellence in Research, Center for Excellence in Evidence-Based Practice, and Center for Excellence in Knowledge Dissemination. The overall goals of IINS are 1) building global scholarship capacity, 2) enhancing nursing research and knowledge dissemination, and 3) promoting use of evidence-based nursing practice locally, regionally, and globally, with the ultimate mission of enhancing global health.
The challenge for each of us is to take action. Intentionally engage in lifelong learning. Use a strength-based approach to learning, such as appreciative inquiry, to assess what learning you have achieved and opportunities for further development. Consider pursuing advanced education and certifications to optimize your value and contributions to global health. Finally, integrate personal wellness into your life balance and professional endeavors.
Influence through philanthropy
The fourth theme of my call to action is “influence through philanthropy.” Philanthropy originates from a Greek word that means love of mankind,” and it refers to action taken for the betterment of humanity. STTI’s sustainability and continued growth depend upon philanthropy. Its advancement is dependent upon us, as members, giving our time, expertise, and charitable contributions. Influencing others through philanthropy is realized when we contribute our time and other resources. For example, serving as a volunteer or supporting events that result in others achieving their potential or improving their lives can have a profound impact on the lives of others.
STTI recognizes that individual philanthropic contributions depend upon a person’s unique circumstances and that, for a member to experience the true joy of giving, it is important to be realistic about his or her level of philanthropy. Each contribution expands resources that enable STTI to sustain and expand its ability to develop members’ leadership capacities, provide research grants, and engage in many important initiatives that positively influence the future of health care across the globe.
In the next two years, STTI’s work on key global initiatives will continue to move forward. In addition to South Africa, infrastructure in regions outside North America will be phased in, beginning with Asia and Europe. In addition to achieving a greater presence in influencing global health, STTI will also continue to increase its service to and resources for members.
There are many ways to exert influence through philanthropy. Consider participating in the annual celebration of STTI Founders Day on 5 October with 90 minutes of volunteer service in communities and organizations that align with your passion. There are also a host of charitable-contribution opportunities to consider. No matter which fund you select—Research, Leadership, Future, or Undesignated—your contribution makes it possible to expand resources available to nurses around the world.
Now is our time to stand and act together as the Honor Society of Nursing, Sigma Theta Tau International. By sustaining and advancing our profession, we can significantly influence and advance global health. During this biennium, I am calling for us to achieve influence through the practices of advocacy, policy, lifelong learning, and philanthropy. Being influential requires that you believe in who you are as a person and as a nurse and that you recognize the profound impact you have to influence the health and lives of others.
The four themes of my presidential call to action are dynamic and interrelated. For example, continual learning supports our ability to expand the influence we have in advocacy, policy, and philanthropy. Nurses have expertise in evidence-based health care. We are experts in approaching care from a holistic and patient-centered perspective and motivated to create significant positive changes for the betterment of humanity.
This synergism is powerful. Celebrate the value nursing has and celebrate the opportunities that lie ahead as we, together, exert influence to advance global health and nursing. I urge you to share your individual and collective contributions in responding to this call by connecting via The Circle and Twitter #NursesInfluence and @STTI.
Cathy Catrambone signature
Cathy Catrambone, PhD, RN, FAAN
President, Sigma Theta Tau International, 2015-17
American Nurses Association. (2015). Code of ethics for nurses with interpretive statements. Silver Springs, MD: Author.

Sullivan, E.J. (2013). Becoming influential, a guide for nurses (2nd ed.). Upper Saddle, NJ: Prentice Hall.


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