Public Advocacy Writing

Public Advocacy Writing

Thomas Long

nurse author & Editor, 2014, 24(3), 4

The nursing profession is justly proud that, for the past two decades of Gallup polling, Americans have identified nurses as the most ethical professionals (with physicians further down the list). However, does Americans’ trust in ethical nursing also mean that they think of nurses as health authorities? Unfortunately, popular culture resorts to easy stereotypes and the news media to convenient Rolodex contacts in which physicians, rather than nurses, are the default experts.

This reality was driven home to me in 2013 when a Connecticut woman was observed in Washington, DC, driving erratically near the U.S. Capitol. Thinking that the woman posed a threat, federal security police shot and killed her. Her family later revealed that she had suffered from postpartum mood disorder, which can include postpartum psychosis. Despite the fact that my UConn nursing colleague Cheryl Beck is an internationally renowned expert on postpartum mood disorders and creator of the Beck Postpartum Depression Screening Scale, local Connecticut news coverage of the case and its significance invariably interviewed physicians for expert commentary.

This discrepancy is well documented. Examining nurses’ voices in news media, Buresh, Gordon, and Bell (1991) found a substantial gap between physicians’ and nurses’ representations, which Buresh and Gordon (2000) saw persisting a decade later.  The title of their book suggests an important agenda for nursing leaders: From Silence to Voice: What Nurses Know and Must Communicate to the Public. Public advocacy writing, like letters to the editor, editorials and op-ed (opposite the editorial page) essays, is one means for nurses to assert their professional expertise and authority.

Although many professional journals in nursing and other health sciences, as well as peer-reviewed science journals, publish editorials whose audience is fellow professionals (see Copp, 1997; Singh & Singh, 2006; Fontanarosa, 2014), my emphasis here is writing opinion pieces for general non-expert audiences. Admittedly, making the effort to craft a written response to a current issue in a timely fashion may seem a daunting task for which the rewards may be elusive. Clinical nurses and administrators may be pressed for time, and they may feel under some scrutiny by their employers when appearing in public debates about controversial issues. Nursing professors may find that public advocacy writing does not count toward tenure or promotion. Further, the sheer number of opinion pieces that an editor receives means that the probability of yours being published might be small. However, you need to ensure that your expertise, professional role, and clear expression of a viewpoint will earn you publication.

First, keep in mind that your response must be timely. Newspapers and other media may impose a time limit on responses, so make sure that you understand what that deadline might be. Second, even if your letter, editorial, or op-ed essay is not published, it serves an important function: it educates the editorial page editor. Third, if you are responding to the work of a reporter or journalist, send a copy of your response to that person as well. The journalist, like the editor, also needs to be educated about nursing. Journalists often do not understand what nurses do or what is the unique perspective of nursing on issues related to health. Finally, follow the instructions provided by the news outlet (e.g., length [usually limits on the number of words], how to submit the piece [usually electronically]).

Letters to the editor, editorials, and op-ed essays follow well established structures. A letter to the editor, for example, typically begins by establishing the context for your letter (identifying the controversy, the previously published article, news report, editorial, or op-ed essay that you are responding to), then asserting your credibility (your professional role, credentials or experience). You can make your argument in one or two points by offering an assertion and supporting it with relevant facts. Finally, you conclude your letter with a call to action or a summary of your main idea.

Longer editorials or op-ed essays expand on this structure. Because an essay is longer than a letter to the editor, you can devote more space to the introductory paragraph and develop your points in greater detail. An editorial or op-ed essay may be less time sensitive, though it still focuses on issues in the news. First, you establish the context for your op-ed essay with an attention grabbing first paragraph by using: a) a striking statistic, unusual fact, or vivid example or anecdote, b) a paradoxical statement, c) a quotation, d) a question, or e) an analogy. You can also make your argument in two or three points by offering assertions supported by facts or examples. Finally, you conclude your essay with a call to action or a summary of your main idea, keeping in mind that people are persuaded by stories more often than by facts.

Publishing an op-ed essay can be a collaborative effort. For example, when at the beginning of the 2014 Connecticut legislative session Governor Dannel Malloy proposed expansion of nurse practitioners’ scope of practice, the dean and other APRNs in the UConn School of Nursing saw an opportunity to engage in the public debate. Because proponents and opponents of the legislation spoke out in editorials, letters to the editor, and online commentaries, we had the opportunity to discern the grounds of the debate while individual faculty members posted comments on news websites. It was particularly helpful to see what objections physician opponents were raising in order to respond to them specifically. Some faculty members, initially posting preliminary letters to the editor and comments, later pooled their rhetorical resources in order to draft a longer co-authored op-ed essay. In the meantime, I worked with the opinion editor of the Hartford Courant, Connecticut’s newspaper of record, to secure his receptive consideration of the essay, and I edited the finished draft of the essay, submitting the essay to the newspaper and working with its editor on some minor revisions, which appeared as “Take Reins Off Advanced Practice Nurses.”

In the digital age, such op-ed essays are often replicated on other websites, which was the case with this essay. Thus the essay’s reach extended even beyond the borders of Connecticut. Featured in print on a Sunday (the optimal reading day, which indicated the editorial page’s support of the legislation), the op-ed essay educated not only the general citizenry of Connecticut but also the editors and reporters of the newspaper.

And the best news is that the legislation was passed successfully.

Entering into public discussions, nurses can bring their experiences, education, and values to public debates. As I have written elsewhere:

[N]ursing leaders, educators, scholars and professionals should consider why nursing seems under-represented in . . . the larger cultural forum . . . , at least when compared to its medical colleagues, many of whom are well established in the literary canon. They might start by supporting mentors for nurses’ writing and publishing and providing incentives for nurses to encourage their writing. Remedying that imbalance would be a worthy project because the stories and insights of nursing practice are indispensable to advancing human health and to our understanding of wellness and illness, of health and disease, and of the gendered dimensions of work. (Long, 2013)

Already highly regarded as ethical health professionals, nurses need to avail themselves of public debates in order to demonstrate themselves as health care experts and authorities.


  • Buresh, B., & Gordon, S. (2000). From silence to voice: What nurses know and must communicate to the public. Ottawa, Canada: Canadian Nurses Association.
  • Buresh, B., Gordon, S., & Bell, N. (1991). Who counts in news coverage of health care?Nursing Outlook, 39(5), 204–208.
  • Copp, L. A. (1997). Reading and writing editorials. Journal of Professional Nursing, 113(3), 137-138.
  • Fontanarosa, P. B. (2014, June). Editorial matters: Guidelines for writing effective editorials. Journal of the American Medical Association, 311(21), 2179-2180.
  • Long, T. L. (2013). Nurses and nursing in literary and cultural studies. In P. D’Antonio, J. A. Fairman, & J. C. Whelan (Eds.), Routledge handbook on the global history of nursing (pp. 37-54). New York, NY: Routledge.
  • Singth, A., & Singth, S. (2006). What is a good editorial? Mens Sana Monographs, 4(1), 14-17.

about the author

Thomas Lawrence Long, PhD, UConn Associate Professor-in-Residence, is a professor of English providing writing support services to the UConn School of Nursing, Storrs, CT, USA. Email:

NAE 2014 24 3 4 Long

Copyright 2014: The Author. May not be reproduced without permission.
Journal Complication Copyright 2014: John Wiley and Sons Ltd