In the early morning hours Friday, the Senate narrowly rejected the Republican plan to repeal parts of the Affordable Care Act.

While the country's leaders stayed up late to debate one of the most impactful pieces of legislature in U.S. history, thousands of healthcare workers continued their work caring for their patients through the night. Despite the dramatic vote, care continued and nurses went about their routines, just as they do 24 hours a day.

In hospitals and long-term care centers, community centers and homes, nurses continue to be the front-line workers in healthcare. They see the effects of laws drafted and passed. They hold the hand of the homeless woman just diagnosed with cancer who sees no hope. They try to come up with ways to get life-saving medicine for the unskilled worker who needs to get back to work or he can't feed his family.

No matter which laws get passed, it's the nurses and other healthcare workers who continue to do the work of caring for patients. They are the ultimate masters of the "workaround."

But with so much intimate knowledge, why are their voices not being heard at the table? It would seem in the largest discussion of healthcare, the voice that should be listened to are those on the front line living the experiences and seeing the consequences of these legislative decisions.

Strangely, the American Nurses Association (ANA) has been quiet considering they are the recognized voice for nursing. The last congressional testimony by the ANA regarding healthcare reform was in 2009.

So where are all the nurses?

Although nurses are the backbone, heart and soul of healthcare, they are often not perceived as leaders. There are many factors that contribute to this situation — nurses being perceived as subservient to physicians, nurses historically not being called on for solutions, the problem seeming too big to change or even just the issue of being female-dominated group. Whatever the reason, now is the time to change.

If ever there was a time for nurses to engage in the legislative process, it is now. Key issues that are facing the healthcare industry currently need nursing's input staffing, violence against healthcare workers, the opioid crisis, and the list goes on and on. All of these issues impact most nurses' daily work life, but nurses often do not harness their knowledge of the impact to educate key decision-makers.

Well, now is the time. If healthcare truly wants effective change that will positively impact our patients and communities we live and serve, then nurses need to step out of the shadows and into the leader spotlight where they belong.

I challenge you. Educate yourself on a key issue you are passionate about, and then act upon it. Whether is means calling a member of Congress or writing a letter, do something.

As always, our patients and the public are depending on us.