There's an old saying that if you don't have a seat at the table, you'll end up on the menu, and this could not be more true of nurses and the nursing profession.

When nurses are busy looking the other way, others can fill the void and make decisions for them. But when nurses demand a seat at the table, they are making a bold statement that their voices are crucial components of the conversation.

Legislating the nursing profession

Throughout the United States, legislative bodies frequently make decisions that directly impact nurses' ability to practice on their own terms. In state legislatures and governors' offices, the scope of practice for nurses and nurse practitioners is often hotly debated, and when nurses don't chime in, others end up deciding what's best for them and the patients they serve.

The Nurse Practice Act in each state must be revisited from time to time, and nurses and nursing organizations would be wise to sit up and pay attention when such debates are being held. In terms of the expanding role and scope of practice of nurse practitioners, there can be powerful pushback from physician advocacy groups that seek to limit the role and power of NPs.

Likewise for registered nurses, decisions related to scope of practice or membership in the multistate nursing licensure compact must occasionally be debated by state representatives. When nurses successfully insert themselves into the conversation and provide expert testimony, legislators can be duly educated and have their relative ignorance addressed.

Nurses and the media

When the media discuss nursing and healthcare, nurses' voices could be significant sources of professional opinion and analysis. If only physicians are asked for comment on salient stories of the day, the public is deprived of the nursing perspective on important topics.

Nurses can choose to make themselves available to local, regional, national and international news outlets as expert commentators who have something to add to newsworthy discussions.

From the opioid crisis to healthcare reform, nurses are on the front lines as witnesses to the struggles of patients and the challenges faced by healthcare institutions and the professionals who staff those facilities. As the largest segment of the overall healthcare workforce, nurses are in a perfect position to leverage their expertise for the benefit of the media and the public who consume media content.

Gallup says it all

According to the annual Gallup poll, nurses have been deemed the most trustworthy and honest professionals in the United States for 16 out of the last 17 years.

If members of Congress are seen by only 11 percent of the American public as trustworthy as compared to 82 percent viewing nurses thus, this underscores the notion that nurses deserve a seat at the table. And with physicians clocking in at 65 percent, we can see that nurses maintain a healthy lead in terms of the public's overall trust.

The most trusted professionals in the country have a right to self-determination and agency, to the expression of an educated opinion, and to having a say in changes to their own scope of practice. Similarly, nurses' points of view regarding timely issues of public health and healthcare policy also deserve attention.

In these days of threats to healthcare reform, an aging population and a healthcare system in jeopardy, nurses' opinions matter more than ever. And if nurses won't be asked to sit at the table, it's time for them to demand a seat and an opportunity to decide what should be on the proverbial menu.