ANNA Member Rhuena Bautista Reflects on 2017 Nurse In Washington Internship Program

ANNA member Rhuena Bautista participated in the Nurse in Washington Internship (NIWI) program in Washington, DC, March 12-14, 2017. Sponsored by the Nursing Organizations Alliance, the NIWI program provides nurses the opportunity to learn how to influence health care through the legislative and regulatory processes. Participants learn from health policy experts and government officials, network with other nurses, and visit members of Congress. Read below to learn more about her NIWI experience.


The Nurse in Washington Internship (NIWI) has been a beacon of light for me to understand what health policy advocacy is all about. I learned a lot from this experience, and it gave me voice to speak up and advocate for my patients, for health, and for the nursing profession. The NIWI presenters brought attendees to a new level of thinking, which enabled me to view things from a different perspective. ESRD is a chronic condition afflicting thousands of patients and costing millions of healthcare dollars. There is a void that needs to be filled, which is to raise awareness of ESRD, not only at work but also in the community. We need to make connections and get everyone involved; to empower patients, their family, and the healthcare team; and to take action and promote health for all.

NIWI connected me with people who have the same goal. They were the ones who guided me and mentored me throughout the process, giving me strength in my role as health policy advocate. It was a life-changing experience!

I have been active in health policy advocacy since attending NIWI. After interacting with Congressman Ami Bera while in Washington, DC, I discovered that we can make a difference. We do not have to be a public official; all we have to do is speak up and make things known. If we do not raise the issues, who will? As constituents, we have responsibilities, too. We have the power to influence the law-making body. We cannot sit in the dark anymore and wait for things to happen. I have to take action if I want results. Somebody has to speak up, and now I feel I have the voice.

We need to take action. I felt empowered with the knowledge learned and the experience I had in Washington, DC. The “Asks” we learned at NIWI were ingrained in my mind so that each time I have an opportunity to discuss Title VIII (Nursing Workforce Development Programs), I try to include it in the conversation. I had the privilege to talk to members of the American Nurses Association in California in the State Capitol during their legislative day. I mentioned why I oppose SB 349 (Chronic Dialysis Clinics: Staffing Requirements), but we have to support Title VIII. Various activities followed that gave me opportunities to be an advocate. One such activity was a Town Hall Meeting on the staffing ratio. I shared information about how it sounds great to have a staffing ratio because who doesn’t want to have more nurses? We can ask for more nurses, but how can we produce enough nurses to meet the proposed standard? The demand for nurses is outpacing the supply. If we do not act now, there will be a nursing shortage crisis that is worse than during the introduction of Medicare in 1960. We must push for Title VIII to address the imminent nursing shortage that can affect clinics, hospitals, skilled nursing facilities, etc.

I went to the Judiciary Hearing for SB 349. We had a lobby day in the Capitol where we discussed why the bill is important. I took this opportunity to stay connected and be involved with what is important and how we can make a difference. Overall, I feel empowered to be part of the greater goal. We spoke with the representatives’ chiefs of staff, and I tried to make a point that we have to support nursing workforce development.

I want to thank ANNA for sponsoring me to participate in NIWI. I highly recommend this conference. I hope more nurses attend and get involved.

Rhuena Bautista, MSN, RN, CNN
NIWI Grant Recipient
Health Policy Representative

Sacramento Valley Chapter #509