Title:From the Hilltop to the Hill

At Georgetown’s Berkley School of Nursing, policy education and engagement are fundamental to the mission.

In the early 2020s, syphilis cases began increasing dramatically in the U.S., particularly among the Native American population. By 2024, the syphilis rate among Indigenous people in the Great Plains surpassed the highest point since 1941, when penicillin was first used to treat the disease. Cases of transmission in pregnant women also sky-rocketed, with 3% of Native American babies born in South Dakota in 2023 having congenital syphilis.

Working for the Indian Health Service between 2023 and 2025, midwife/nurse practitioner Anna Dykstra (G’21) served on the frontlines in combatting the spread of syphilis on the Pine Ridge Reservation in South Dakota’s Oglala Lakota County.

“Our county had one the highest rates of syphilis in the country,” says Dykstra. “We were working as hard as we could with testing, treatment, and public outreach. And we’ve really made great progress. Rates have gone down significantly.”

Dykstra decided to translate her clinical experience into advocacy. She was already involved in a project through South Dakota’s Avera Research Institute addressing maternal health outcomes in the state, so she approached the head researcher and another OB/GYN about initiating a study on syphilis.

“As unfortunate as it was to have this terrible outbreak in our community, it provided an excellent opportunity for research on effective treatment and prevention,” she says. The institute secured funding, and the project began earlier this year, with Dykstra providing her clinical observations on the specific challenges involved in treating a rural population with high poverty rates and low levels of health literacy.

Dykstra’s experience highlights the essential voice that nurses bring in advocating for better patient outcomes and, ultimately, more effective health care policy.

“Nurses are the Swiss Army knives of health care,” says Rebecca Shasanmi Ellis, assistant professor at Georgetown’s Berkley School of Nursing. “Because nurses operate in such a wide span of settings and spend the most time with patients and their families, we have a unique lens across the individual to the societal level. It allows us to amplify the voices of our patients and the communities we serve.”

Policy as liberation

Recognizing that policy is foundational to how care is delivered, financed, regulated, and experienced, the Berkley School of Nursing has taken on a leadership role in policy education and engagement.

“Nurses work in all different spheres, helping those who are sick, those who are close to death, those coming into the world, as well as providing preventative health care,” says Dean Roberta Waite. “So they really need to understand how policy impacts people across the lifespan.

“The core ethical tenets of nursing focus on social justice and health equity,” continues Waite. “If we say we’re about promoting social justice and supporting health equity, we need to be engaged in policy.”

She emphasizes the early leadership of the nurse-midwife program in bringing students to Capitol Hill during their on-campus intensives, a practice that has been adopted by other hybrid master’s programs.

Faculty need to be versed in policy as well, Waite says. She notes that just this year, four Berkley School of Nursing faculty members have been inducted as fellows of the American Academy of Nursing, a leading policy organization. The academy director, Suzanne Miyamoto, teaches a course on Health Care Policy & Advocacy at the school.

Because its mission is rooted in cura personalis, the Berkley School of Nursing is especially well positioned to “understand the whole person—their physical, emotional, spiritual, and financial needs—because all of those things impact their ability to thrive, operationalize, and lead fully productive lives,” says Waite.

“From my perspective, what good policy allows for is the pursuit of liberation, because it ensures that resources are aligned with policies that support optimal health for everyone.”

The school has recently introduced a number of new initiatives on the undergraduate and graduate level, capitalizing on Georgetown’s DC location. “What has deepened over the last three years is not only didactic education, but engagement on Capitol Hill as well as with national nursing organizations,” she says.

Unprecedented access

Waite points to the work of Associate Professor Stephan Davis (G’09), who joined the school’s faculty in 2024 and served for two years as the inaugural executive director of leadership, policy, and Doctor of Nursing Practice (DNP) education, and led innovations in the Executive DNP in Health Systems Leadership and Policy degree program.

Davis continues to teach in the Executive DNP program, which—along with the Berkley School of Nursing’s other doctoral programs—is located on Georgetown’s Capitol Campus, just blocks from Congress. “It’s an amazing environment,” says Davis. “We have unprecedented access to people involved in the legislative process.”

He also remarks that the downtown location of the school’s DNP and Ph.D. programs enhances opportunities for cross-disciplinary collaboration with the other schools and programs, including the Law Center and the McCourt School of Public Policy. Vicki Girard, professor and founding co-director of the Georgetown University Health Justice Alliance, recently presented to students on medical-legal issues, leading to the integration of that work into the their scholarly projects, he says.

In January 2025, Davis launched the Nurse Executives in Residence Program, which gives DNP students the opportunity to learn directly from national nursing leaders through focused mentoring and special lectures. Among the current program participants are Robyn Begley (N’77), CEO emerita of the American Organization for Nursing Leadership (AONL), and Deb Zimmermann, AONL’s immediate past president.

In a pilot program facilitated by Begley, Zimmermann, and AONL staff, two Executive DNP students and four DNP program faculty members participated in the AONL Advocacy Academy in Summer 2025. The academy provides education on the legislative process and hones advocacy skills in preparation for meetings with members of Congress. In Summer 2026, all executive DNP students will be able to participate. This June the Berkley School of Nursing co-hosted a reception with AONL for its board and Nurse Leaders in Advocacy members on Capitol Campus to kick off the Advocacy Academy.

“The fact that we’re able to build these types of programs shows the power of the connections we have,” says Davis. “Being the most trusted profession, nurses are such an important voice in advocacy, especially during this time of unprecedented distrust in government and institutions.

“We usually think about advocacy in the context of lawmakers, but I also think it’s important that nurse leaders and clinicians are prepared to engage in discourse that’s meaningful with patients and communities and to be able to have respectful dialogue across differences,” he says. “I believe Georgetown is uniquely positioned for that work.”

Undergraduates on the Hill

In the Berkley School of Nursing’s undergraduate BSN program, recent innovations include the integration of a policy intensive into the health care systems course, an initiative spearheaded by faculty member Rebecca Ellis, a longtime public health nurse and current chair of the Public Health Nursing Section of the American Public Health Association (APHA).

She notes that BSN Program Director Sarah Vittone wanted to connect with the Law Center to prepare nursing students for advocacy work. Ellis became the first nursing faculty member to teach in the Health Justice Alliance’s program that pairs medical students with law student mentors to prepare for meetings with Congressional members.

“With the program’s blessing, I translated materials to be nursing focused and integrated a policy intensive into the Berkley School of Nursing’s existing health care delivery systems course,” explains Ellis.

She piloted the course in Spring 2025, which culminated in nursing students’ traveling to Capitol Hill for meetings in the individual offices of their home-district legislators. “They’re paired with faculty mentors who’ve had experience advocating on Capitol Hill or studying health systems to help them prepare.”

The feedback from students was overwhelmingly positive, and the course was officially renamed Health Care Delivery Systems and Policy this year.

“We cover the legislative process, but we also connect to nursing’s social justice pillar and how advocacy fits into that,” says Ellis. “We ask them to select a health access or equity related policy to advocate for. I also introduce them to nursing education and workforce policies that need more sponsorship, so they understand how those policies impact their experience as students.”

Students in the course have already witnessed the direct impact of their advocacy. “One of our successes last year was getting a co-sponsorship of the PRECEPT Nurses Act, which provides a tax credit for eligible nursing mentors,” says Ellis. “Another legislator was so impressed with student advocacy for those who are on Medicaid and Medicare that she asked us to collect additional stories to document community needs.

“I feel so in awe of our students who get this type of experience and go on to expand the opportunities to other students,” adds Ellis.

‘Nursing is political’

In addition to her research and teaching responsibilities, Ellis has also been serving as a faculty advisor for the student-led Legislative Action Group, known by its acronym SNAG-LAG. The group was founded in 2023 by Julia Strimling (N’26) shortly after she transferred to Georgetown from Duquesne University in Pittsburgh.

“At Duquesne, I had been involved in the student nurses association as a legislative co-chair, so I was starting to dip my toe in,” says Strimling. “When I came to Georgetown, I wanted to make sure I took advantage of being in DC, to create a space where students could really get involved.”

The group’s first event, a meeting with a Nebraska legislative health staffer arranged by Associate Professor Sarah Vittone, attracted more than a dozen students. “We’ve had a number of Hill days since then and have also gone to hearings. We even attended a Senate mark-up, which was a really interesting experience.”

Strimling is especially passionate about mental health policy and ensuring parity of coverage. This spring, her advocacy helped secure the vote of her Congressmember, Rep. Greg Steube (R-Fla.), for legislation that supports grants and activities to improve mental and behavioral health among health care providers.

“Nursing in and of itself is very political,” says Strimling, who begins working this summer in the Neurosciences Intensive Care Unit at MedStar Georgetown University Hospital after earning her BSN degree in May, and plans to become active in the hospital’s Health Care Advocacy and Legislative Council. “Nurses are the ones that people open up to, who have those initial conversations about social factors that are determining health outcomes—food security, housing security, affordable insurance.

“We also see the impact when people are afraid to get to health care because of previous experiences of discrimination or concerns about immigration status. Every one of those factors is influenced upstream,” she says.

In February, Ellis—a member of the Nursing Community Coalition—connected with three national nursing organizations and arranged for SNAG-LAG members and other interested nursing students to attend the National Black Nurses Association Hill Day, the National Association of Hispanic Nurses Health Policy Summit, and the American Association of Colleges of Nursing Student Policy Summit.

Ellis also arranged for Strimling to meet with the president and members of the Florida Nurses Association. “They were so impressed with Julia,” she says.

“She now is equipped with skills that she can bring back to other nurses. There are so many seeds that will come to fruition from these opportunities.”

Nurse-citizens

Waite emphasizes that once nursing students enter the workforce, they carry civic as well as professional responsibilities. “You are a nurse by profession—you have to understand how policies are linked to health—but as a citizen you have a duty as well. It’s not just about writing policy, it’s how to instill it. Social justice is not passive.”

Georgetown nursing alumni like Anna Dykstra exemplify the role of nurse-citizen, bringing evidence-based health information to researchers who can use it to advocate for more effective treatment and policy. In her experience on the Pine Ridge Reservation, she and her colleagues identified critical factors that exacerbated the syphilis outbreak.

“Syphilis is complicated to diagnose and treat. The secondary and tertiary stages require a longer course of oral antibiotics, or three penicillin injections given every week for three weeks,” she says. “Some patients came in for the first treatment but didn’t return because they couldn’t afford gas or they faced extreme weather conditions.”

The unit was understaffed, and some of the patients simply lacked health literacy, not knowing what syphilis was or how it was transmitted, she adds. “Education is the most effective way to counteract the disease, but figuring out how to implement the education is challenging,” says Dykstra. “That’s the direction the research project is going.”

Dykstra has recently embarked on a new project after being selected as a participant in South Dakota’s Billie Sutton Leadership Institute. “We have huge maternity deserts in our state, where it can take hours to get to a hospital. I will be looking at the possibility of nurse midwives providing prenatal care in rural areas.” She sees the federal Rural Health Transformation Program as a potential source of funding.

“During my time as an R.N. and now a nurse midwife, I worked in a lot of different settings—the South Dakota Department of Health, the Monument Health system in the Black Hills, the Indian Health Service. I’m hoping to reach out to the key players in these organizations and bring them together to figure out how we can make this happen.”

A seat at the table

Given the crucial perspective nurses bring to policymaking, there is a need for significantly greater nursing involvement, particularly at the federal level.

“One of the Congressional committee meetings I attended was discussing the future of the health care workforce, and there was only one mention of nursing,” notes Strimling. “There are a lot of doctors in Congress, but not as many nurses, and not as many nurses testifying as witnesses.

“It was a big surprise to me how underrepresented nurses are.”

Ellis recalls similar experiences. “I worked for the World Health Organization, developing resilient systems to support the increase of the nursing and midwifery workforce. In meetings with medical doctors, public health folks and non-clinicians, I would be the only nurse,” she says. “We need to expand our conception of what types of tables nurses need to be at.”

“I want to plant seeds so that we can have more nurses in Congress,” Waite adds, citing the example of Congressmember Lauren Underwood (D-Ill.), an R.N. and former Georgetown Berkley School of Nursing faculty member who co-founded and co-chairs the Black Maternal Health Caucus.

“For many of the issues legislators are called to address, they have no foundational knowledge on health policy—none. Nurses need to be in those spaces, and they need to be in those seats.”