Bill Klaproth (Host): This is Today in Nursing Leadership, a podcast from the American Organization for Nursing Leadership. I'm Bill Klaproth.

With me is Christina Llanez director of Nursing Professional Development at Nicklaus Children's Hospital. And we have Yamile Reyes, director of Critical Care Services, pediatric Intensive Care Unit at Nicklaus Children's Hospital. As we discuss, WeLEAD building nurse Leaders voice and influence in health policy.

Christina and Yamile welcome.

Christina Llanez, MSN, RN, NPD-BC, CNML: Thank you, bill, for having us.

Yamile Viera Reyes, MSN, RN, CNML: Thank you Bill so much. Uh, we're really excited and honored to be here today.

Host: Yes, well, excited to have you both here. So let's talk about this great program of yours. Christina, let me start with you. So what gap did you identify that led to the creation of your nurse leader advocacy program?

Christina Llanez, MSN, RN, NPD-BC, CNML: So at Nicklaus Children's Hospital, we actually host a learning needs assessment for all of our nursing leaders. And that actually is aligned to the AONL's Nurse Leader Competency Assessment tool. And when we disseminated it in January of 2025, we actually identified that there was an opportunity where our nurse leaders wanted to strengthen advocacy skills related specifically to healthcare economics and policy.

And so that's kind of where this. Stemmed from and Yami and I decided, you know, wouldn't it be a really cool idea if we can leverage the framework of AONL and develop something very similar in our organization? And we just collaborated with our government and community affairs director And we kind of ran with the idea, and that's how it was born.

Host: It's important to have nurse leaders at the table advocating. For the profession, that's for sure. So this sounds really interesting and glad you did this. So Yamile how did you design the program to feel safe and accessible for nurse leaders who had never engaged in advocacy before?

Yamile Viera Reyes, MSN, RN, CNML: Right. So we wanted to ensure that the program covered that psychological safety piece And we understood right, that the confidence level was not there Again, from that learning needs assessment.

And a lot of the pretest, uh, surveys that we had completed. And so we really wanted that first day of the program to collaborate with those who were experts at policy. So we engaged with our director of government affairs as well as, um, engaging with Stacy Chapel, who's our senior director, uh, at AONL For advocacy and external communications. And when we brought up the idea to them, they, number one, they were really excited to partner with us, and number two, they were the ones that brought that expertise on policy, crafting your message, and even what were the congressional ask that we were going to review.

For the program, right? And which Congressional ask not only aligned with our organization and our nursing department, but also with AONL

Host: So this collaboration and engagement sounds really, really. Important. So then can you talk a little bit more about the partnerships that you created with government affairs, interprofessional teams?

How did all of those different organizations come about and play a role in the program's success?

Yamile Viera Reyes, MSN, RN, CNML: Yeah, so when Christy and I had this first idea, the first person that we contacted was Stacy Chapel from AONL And she really, uh, recommended to partner and reach out to our government affairs team. And so that was our second step.

And then from there it was, we needed to get our leadership buy-in. So we contacted our chief nursing officer and our assistant chief nursing officer who really were head on with our idea on, This is a huge need, a huge gap in our organization And in nursing. Uh, so they gave us a green light to, to do that.

So that was key early on, uh, for this program. And it's a huge. Tip that we give for anyone that really wants to do this, uh, program as well in their organizations.

Host: So leadership backing, really important and nice to hear that they were with you, as you said.

Yamile Viera Reyes, MSN, RN, CNML: Yeah. Yes.

Host: Yeah. They were on board right away.

Mm-hmm. So that really helps, right?

Christina Llanez, MSN, RN, NPD-BC, CNML: Yes, definitely. I agree with Yami. You know, just to add on the importance of the collaboration with government affairs, You know, our, our director of government affairs really helped us execute the whole program from securing legislative officials to helping us review the congressional ask, ensuring that the congressional has ask, had alignment.

To our organizational priorities and our strategic priorities. Um, he was just instrumental and I think that that was the best tip that Stacey could have given us in really executing this program effectively.

Yamile Viera Reyes, MSN, RN, CNML: Yeah, And in addition to, Christina, we really wanted to make this interprofessional. So we also reached out to, uh, those that are part of the wellbeing, uh, council.

So, the manager. From the wellbeing department in really leading the teams throughout the advocacy program on those congressional ask that have to do with, um, safety of the workplace. so that was really neat that they were also, really engaging and, and really wanted to collaborate with us.

Host: Absolutely. So then how did you measure the readiness of this Uh, Christina—changes in confidence, efficacy, or readiness to advocate? How did, how did you know that? Okay, we're ready.

Christina Llanez, MSN, RN, NPD-BC, CNML: So we actually utilize different tools to just measure the effectiveness of the program in its entirety. Um, first off, we utilized the AONL's Nurse Leader Competency Assessment Tool, as I mentioned, specifically looking at that economics and sub, um, economics and healthcare policy, subscale or leadership domain.

And we saw that the majority of our nurses at the beginning were novice or advanced beginners. Our goal was really to see if the majority of our nurses, 50% or more, would be. Either proficient, competent, proficient, or expert. So, um, we actually exceeded that at 66% at post-completion of our event. We also looked at self-efficacy.

We utilized valid and reliable tools to see post-completion of our event. Would those increase? And all of them did, you know, through those three additional tools that we utilized, really measured, you know, our participants' attitudes towards legislative advocacy. It also, me, me, um, measured self-efficacy.

Um, and I think the consensus was that our participants felt like the policy makers were actually making a difference. They're using our skills and everything that they learned, our legislative priorities that we, our pitches and actually. Having actionable follow-up. Um, there was urge letters, there was a commitment to, um, do proclamations and different things to take it to, to, you know, Congress and make a difference.

So I think we did see an increase in all of our skills and we're continuing to build upon that. Moving forward.

Host: Christina, thank you for that answer. Obviously you knew, and

Bill Klaproth (Host): uh,

Host: it's great that you were able to measure this and see the impact right away, so That is really cool.

Christina Llanez, MSN, RN, NPD-BC, CNML: Thank you

Host: So, Yamile let me ask you, what kind of surprises did you see

Christina Llanez, MSN, RN, NPD-BC, CNML: and, and,

Host: And what surprised you most about how nurse leaders responded to the experience?

Yamile Viera Reyes, MSN, RN, CNML: It was really that confidence and excitement, uh, post-completion of this program. So prior to the program starting, all of those who were going to attend their an anxiety level were extremely high. Um, And we knew that, right? Um, I am a 2024 AONL nurse leader, uh, fellowship. Alumni and I have participated at AONL advocacy, so I understood the anxiety heading to Capitol Hill.

And then once I was already in the program and talking with those legislative officials, my confidence shot up and my anxiety came right back down. And That is exactly what this program, um, did really for all, all of those who attended. And then in addition. To that, it was the last day. And that feedback, everyone asking us, are we going to do this on a yearly event?

And it wasn't just them, but it was also the legislative officials, right, asking us, you better invite us for that next, you know, that next program next year or I will tell other colleagues to also join. And so that excitement, not just from the attendees from, but from legislative officials. Within our community, uh, the different districts in Miami as well as, You know, in, in Florida.

That excitement was really what really surprised us. Um, I mean, we knew it was going to be a successful program. Christina and I worked really, really hard, uh, You know, with our, partners. But just that. That sense of, okay, you know, we got to do this on a yearly event. That excitement really helped, you know, it, it excited us.

Christina Llanez, MSN, RN, NPD-BC, CNML: Definitely.

Host: Yeah. It sounds like a great day you had there. Yeah. And interesting to hear the legislators were like, Hey, are we doing this again?

Yamile Viera Reyes, MSN, RN, CNML: Yeah, yeah. Yeah. So we actually had four, uh, to start off. Mm-hmm. Uh, four legislative officials to start off the program with. And up on that week, we ended up increasing it to eight.

right. It was eight

Christina Llanez, MSN, RN, NPD-BC, CNML: nine,

Yamile Viera Reyes, MSN, RN, CNML: sorry, nine legislative officials that ended up attending. We even had one that only gave us 30 minutes that he can be there. He ended up staying the entire program because he was mm-hmm. Absolutely floored by this and really excited about it. So again, that was just a testament to this program and, and that excitement that it brings.

Yeah, and just to add, you know, a lot of our participants were just so excited just in advocacy in general, the fact that they could get involved. How do I get involved outside of just advocacy day? What organizations would you recommend? Is there more education? So just building that momentum because as Yami mentioned, it was such anxiety prior to like.

Knowing as a lot of our nurse managers and nurse leaders were novice in this and just building that momentum and really growing and fine tuning their, advocacy skills. It was just really exciting to see.

Host: Yeah. We were talking about in a previous podcast how nurse leaders are natural at advocating because they're used to advocating for their department.

Right. So when you get in that position, I'm sure you felt comfortable like, oh, I got this

Christina Llanez, MSN, RN, NPD-BC, CNML: right.

Host: Yeah. And then like you said, that anxiety came down.

Yamile Viera Reyes, MSN, RN, CNML: Yeah. And. And it was really explaining to those nurse leaders or those who attended you are all the storytellers. You are all the ones that can bridge that gap between what is happening at the bedside to the lawmakers,

Host: and that's really important.

Yamile Viera Reyes, MSN, RN, CNML: Mm-hmm. Right. It's not, you know, this isn't an obligation to advocate. It's really our professional mandate. Advocacy is a competency under the AONL nurse leadership competency. So. We just wanted to make sure that we elevated that to all of our leaders at Nicklaus Children's.

Host: Yeah. And who better to advocate than somebody that's right there than nurses, right.

So great that you're doing this for sure. So Christina does, uh, hospital size at all matter. Can organizations with limited resources begin this work?

Christina Llanez, MSN, RN, NPD-BC, CNML: Definitely, I don't think size matters at all, honestly. This was a low-cost model for us all. We really did. Um, And the cost associated was, you know, food on day two, um, for our, our participants and legislative officials.

But everything was leveraging internal resources, right? Um, our director of government and community affairs are tapping into our nurse leaders that have already had. Experience in advocating at the state and federal level that could serve as mentors and provide that support. it's, you know, getting your, the buy-in from our executive team that helped sponsor and really helped support the event.

you know, Stacy agreed to be our keynote speaker, but since she presented virtually, that was at no cost. So I think size really doesn't matter. It's really more about initiative and wanting to make that change. And even if you're. You don't have to have a whole event. You can start small in your local organizations and still have a meaningful impact.

Host: So, it sounds like it's good for nurse leaders wherever they are, to get to know their legislators and start advocating for the profession. Is that right?

Yamile Viera Reyes, MSN, RN, CNML: Yeah,

Christina Llanez, MSN, RN, NPD-BC, CNML: definitely.

Yamile Viera Reyes, MSN, RN, CNML: Yeah. And I agree with Christina. Um, and just to add on, it's how do you partner up with local hospitals? So one of the ideas that we had for year two is how do we reach out to local South Florida hospitals because their really congressional, ask that affects nursing, uh, whether it's pediatrics or adults.

So how can we expand that impact, again, with, with different organizations? Yeah. So, it can be a small local hospital that partners with a, a larger health system.

Host: Yeah. So, where do you see this going in the future for nurse leaders in advocacy? Where do you see this heading?

Yamile Viera Reyes, MSN, RN, CNML: So This is definitely needs to be a priority.

You know, I, uh, just from the surveys and, and seeing that low confidence, I, I really think that This is definitely a skill that many nurse leaders need to hone in on. If, you know, I did state that it is a competency for our AONL uh, nurse leadership competencies. So definitely mimicking this program, right.

And leveraging with AONL You know, sending nurses to advocacy day, uh, or partnering with different organizations that have advocacy programs or contacting Christie and I, uh, so we can share, You know, how we, we did this program is, would be key. For that future.

Host: Yeah. Well, this has been great. Thank you both for stopping by.

I appreciate it.

Yamile Viera Reyes, MSN, RN, CNML: Thank you Thank you

so much

Christina Llanez, MSN, RN, NPD-BC, CNML: for having us. It's been a pleasure.

Host: Yeah, thank

Yamile Viera Reyes, MSN, RN, CNML: you, bill. Thank you.

Host: Yeah, you're doing great work. Keep it up. It's good to bring this type of awareness that we need more nurse leaders. Advocating for the profession. So thank you again. I appreciate it.

Christina Llanez, MSN, RN, NPD-BC, CNML: Thank you. Thank you, bill.

Bill Klaproth (Host): Yeah, once again, That is Christina and Yamile and if you found this podcast helpful, please share it on your social channels and check out the full podcast library for topics of interest to you at aonl.org/nursing-leadership-podcast This is today in nursing leadership. Thanks for listening.