The future of nursing depends on building coalitions.

The editorial in this issue of PHN by Dr. Risa Lavizzo-Mourey (2012) President and CEO of the Robert Wood Johnson Foundation (RWJF), reminds me of the many reasons I sought a career in public health and nursing. The mandate for social change and the pathway for improvement in the health of populations demand that we seek collaboration and build coalitions to assure the future of nursing’s contribution. Coalitions are social movement organizations oriented to a collective goal (Mizrahi & Rosenthal, 2001). Empirical and practice evidence to support the impact of coalitions are found in political, sociological, organizational, and nursing literature. Strategic support for coalition building was funded by the RWJF successfully in the 1990s through the Colleagues in Caring (CIC) programs in the states. These programs produced broad community investment in the design and sustainability of state nursing workforce offices and activities. Once again, RWJF seeks to execute the Future of Nursing (FON) recommendations (Institute of Medicine [IOM], 2011) in the states through the Future of Nursing: Campaign for Action initiative. To date, at least 35 states have been selected by the RWJF and resourced in strategy, communications, and technical support to assure progress on recommendations critical to the health of their respective citizenry. Although state action coalitions vary in structure and developmental progress, they share an unmistakable passion and goal to ignite the public’s interest and commitment to health through transformation of the nursing profession. Clearly, recommendations in the Future of Nursing report (IOM, 2011) give pause to the status quo. Restraining forces have overpowered our driving forces, resulting in arrested progress in global health rankings, inter-professional education, datadriven health outcomes, full scope of practice for nurses, and a better prepared workforce. While we have much to be proud of, the current systems of practice, education, policy, and research have entrenched the status quo from which we must progress. The profession of nursing cannot achieve this through “navel gazing.” Rather, rich and sustainable progress in these FON recommendations will come from investments in community coalition strategy, execution, and sustenance. Coalition building is not for the faint of heart nor for the inexperienced. Coalitions that are successful achieve their goals, are a recognized force by the social change target, and have community support. They acquire longevity and sustainability while acquiring new skills (Mizrahi & Rosenthal, 2001). Successful coalitions involve goal commitment, competent leadership, the right issue, coalition unity, and equitable decision-making structures and processes. Members of coalitions gain a new consciousness of issues as their networks expand and the context changes. Coalition members ranked the top 10% of leadership characteristics to include credibility, dedication, and a proven record; trustworthiness; the ability to be articulate and persuasive; and expertise on issues (Mizrahi and Rosenthal). Successful coalitions are the result of skill and finesse – not luck. Coalitions are built on “connecting with the right people, communicating effectively, understanding political challenges, and navigating them skillfully” (McKay & Hewlett, 2009, p.352). Promoting the health of the public and securing the future of nursing means we must always have the best interests of the public’s health as the foundation for all we develop through coalitions. Educators and students must be educated in coalition building content and best practices and offered clinical opportunities in coalition building. This provides an optimal alignment of clinical experiSee related Editorial by Risa Lavizzo-Mourey on page 95