Advocacy and lobbying are familiar concepts for nurses, who may engage in either of those activities daily. However, while they share many similarities, there is a fundamental difference in advocacy and lobbying.
Regardless, both professions require similar skills, which include deft interpersonal communication and relationship-building, as well as intricate knowledge of policy.
To understand what separates advocating for the safety of patients and actual lobbying for better regulations to improve patient safety, let’s look at the definitions and examine real-world examples of each.
What is Lobbying
Lobbying refers to attempts to influence the decisions, actions, or policies of legislators or members of regulatory agencies. Moreover, lobbying may involve directly contacting or getting the public to contract the policymakers in order to support or oppose certain legislation. It may also involve advocating the adoption or rejection of certain legislation. Therefore, we can describe lobbying as a type of advocacy.
What are advocacy and lobbying?
While similar concepts, the actual definitions of advocacy and lobbying help outline a fundamental difference. According to Merriam-Webster, advocacy is “the act or process of supporting a cause or proposal.” On the other hand, to lobby is defined as “to promote (something, such as a project) or secure the passage of (legislation) by influencing public officials.” So although advocacy and lobbying are related at the core — a nurse advocates or lobbies to raise awareness of an issue — the actual intent of the act is different.
To advocate is to bring up and publicize an issue within a community, like making health care a part of the national discussion and a focus in the media. To lobby is to direct that effort at those in positions of power, namely public officials, politicians, governmental bodies and regulatory agencies. For example, when the Affordable Care Act was being crafted, nurses and professional associations were key voices in ensuring nurses had input on provisions and were involved in the process of creating the final legislation.
Advocacy vs Lobbying: Key Differences
Advocacy:
- Promoting a cause or issue to influence public opinion or policy.
- Educating and raising awareness about a specific issue.
- Supporting or representing a particular group or community.
- Encouraging others to take action or support a cause.
- Can be done by individuals, organizations, or coalitions.
Lobbying:
- Directly influencing government decisions or policies.
- Attempting to sway legislators or policymakers.
- Focus on specific legislation or regulations.
- Typically involves face-to-face meetings, phone calls, or written communications.
- Often requires registration and disclosure.
Key differences:
- Purpose: Advocacy focuses on raising awareness, while lobbying aims to influence specific policy decisions.
- Scope: Advocacy can target broader audiences, while lobbying targets government officials.
- Tactics: Advocacy may involve public campaigns, while lobbying involves direct communication with policymakers.
- Regulation: Lobbying is subject to stricter regulations and disclosure requirements.
| Attribute | Advocacy | Lobbying |
|---|---|---|
| Definition | Act of supporting or promoting a cause or idea | Act of influencing or persuading government officials or organizations |
| Focus | Wide range of issues, including social, environmental, and political | Primarily political and legislative issues |
| Methods | Public speaking, writing, organizing events, grassroots campaigns | Direct lobbying, campaign contributions, forming coalitions |
| Target Audience | General public, policymakers, media | Government officials, legislators, regulatory bodies |
| Legal Regulations | Less regulated, often protected under freedom of speech | Subject to specific lobbying laws and disclosure requirements |
| Transparency | May or may not disclose funding sources and affiliations | Required to disclose lobbying activities, expenditures, and clients |
| Representation | Represents the interests of a particular cause or group | Represents the interests of a specific organization or industry |
| Scope | Can be undertaken by individuals, organizations, or grassroots movements | Primarily conducted by professional lobbyists or lobbying firms |
Examples:
Advocacy:
- American Cancer Society promoting cancer research funding
- American Heart Association advocating for healthier food options in schools
Lobbying:
- Pharmaceutical company representatives meeting with lawmakers to influence medication pricing legislation
- Trade association pushing for tax reform beneficial to their industry
Nursing Implications:
- Nurses can engage in advocacy through professional organizations (e.g., ANA) or community groups.
- Nursing advocacy can focus on healthcare policy, patient rights, or workforce issues.
- Lobbying efforts can target specific legislation, such as safe staffing ratios or scope of practice laws.
What is advocacy in nursing?
- Now that a more clear line has been made between advocacy and lobbying, let’s examine examples of patient advocacy in nursing. The scope of advocacy in nursing is immense. Nurses advocate for their patients, coworkers, employees and themselves. It’s common to encounter nurse advocacy throughout the workplace, like appealing for improvements that increase the quality of care or advocating for the adoption of technology to better serve patients.
- Nurse leaders and nurse executives have an essential duty to advocate for their nurses and patients, conveying concerns or communicating staffing needs. Nurses may also champion causes, like awareness campaigns for diseases or health issues relevant to their specialty. Advocacy can also occur outside the organization, like speaking on behalf of patients’ rights as consumers in light of overall industry trends.
- Advocates need to be vocal on a number of issues. And nurse advocates have many platforms from which to speak. Not only can they advocate to decision-makers in their organizations; they can also utilize forums like social media or professional conferences to publicize issues and gain support.
- However, there is some overlap between advocacy and lobbying. Sometimes, advocates will come in contact with public officials and elected representatives. They may meet with a local politician about a particular issue, or write a representative in Congress about the effects of a law. This is not technically lobbying, as it is a general effort to raise awareness or start a conversation.
What do nurse lobbyists do?
Nurse lobbyists can be differentiated through their express intent to drive those conversations toward a clear objective: influencing public policy or the creation of legislation. While advocacy may be the spark to the grassroots movement, lobbying is the means to the end of effecting that desired change. Nurse lobbyists are active across local, state and federal levels, and may work for all kinds of organizations in health care, or interested in it. For instance, nurse lobbyists may be employed by:
- Health care organizations, including hospital systems and independent practices
- Pharmaceutical companies and insurance groups
- Professional associations like the American Nurses Association or the American College of Nurse-Midwives
- Groups that focus on advancing public health or patient rights
- Health care technology firms developing telehealth solutions or implantable devices
- Governmental bodies like the Department of Veterans Affairs or nurse unions
Professional nurse lobbyists are the conduit for advocacy campaigns to reach those in positions of power. While a U.S. senator may receive hundreds of letters on an issue, the nurse lobbyist is the person who can directly lay out concerns or opportunities and work with the politician’s office to ensure those sentiments are addressed in legislation.
How to become a nurse lobbyist
Lobbyists, and advocates in general, need particular skills to be successful. Not only does that include a strong mastery of basic nursing concepts, but also insight into policy creation and interprofessional relationships. Policy knowledge is crucial because, in order to make an impact, lobbyists need to understand what goes on behind the scenes.
Advocates can also gain by knowing how to translate causes into policy appeals. Interprofessional communication is key, such as that between nurse lobbyists and politicians, or between nurse leaders and other patient-safety stakeholders. Advocates and lobbyists must collaborate and work on shared missions.
REFERENCES
- “All Lobbying Is Advocacy, but Not All Advocacy Is Lobbying!” Amplifi, 7 Feb. 2017
- Best Practices and Tips for Advocacy and Lobbying, NLIHC’s Legislative Action Center, 02-15_Best-Practices-Tips-for-Advocacy-and-Lobbying.pdf
- Hasa, Pediaa.com, What is the Difference Between Advocacy and Lobbying, April 8, 2021, https://pediaa.com/what-is-the-difference-between-advocacy-and-lobbying/
- American Nurses Association (ANA) – Advocacy and Policy
- National Association of Social Workers (NASW) – Advocacy and Lobbying
- Centers for Disease Control and Prevention (CDC) – Advocacy and Partnerships
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