Critical Thinking in Practice and Policy

Updated: Jul 1

Originally published in The Pulse newsletter for Montana Nurses Association, April 2020.


Critical Thinking in Practice and Policy In October I attended the 107th Annual Montana Nurses Association Convention in Helena. This was only my second year attending and voting as a Delegate. Last year I was introduced to the MNA convention process and served as a delegate for the first time. I loved meeting others in the nursing community, earning educational credits related to local and global nursing issues, and participating in the parliamentary procedures of being a delegate.

Since 2018 was a Legislative election year, MNA Convention arranged for a panel of speakers made up of Montanans running for local, state, and nationaloffice. I had never considered myself a very politically involved nurse, or citizen, but something caught fire in me that night as I realized if these citizens can speak to issues in government then so can I. In January 2019, I attended MNA legislative day in Helena where several nurses from across the state lunched with Senators and Representatives, we had a Q & A session with Governor Bullock and learned how bills become law.


I was transformed in learning how a citizen led government works and has influence that trickles down to various aspects of my day-to-day tasks, employment laws, and access to resources. I have been in nursing administration before and I understand we must do so many tedious red-tape tasks as nurses. All the extra paperwork takes away from our time at the bedside. I know those tasks are dictated by practice, or law, and have come to fruition in practice because someone felt they were important. But who was that someone? Are nurses making these decisions about how healthcare is delivered at the bedside? Are nurses speaking to rural access healthcare issues at our state government level? Who gets to make the laws regarding violence prevention for healthcare workers? Our MNA works in beautiful choreography with many boards, state department, hospitals, and associations to bring our issues up during legislative session and try to convince citizens, who don’t work in healthcare, why these topics are important. As one of the largest work forces in Montana, how much better would it be if we actually had nurses in our Montana Legislature?

My flame for politics is growing as I begin thinking how all these systems of professional associations, bureaucracy, private industry players and payers are intertwined. It reminds me very much of the body systems, we need all organ systems in communication with one another and functioning at optimal level to survive and thrive. As nurses, we use our critical thinking skills to help understand how heart failure effects urine output and kidney health and vice versa.


As nurses, we are always thinking of the potential unintended consequences of an action, such as medication side effects or post-surgical complications. We can apply these same critical thinking concepts to regulations, policy, and law. When new laws are written it’s difficult to know what the unintended consequences will be 10 years down the road. That is why I am so passionate about looking at every angle of an issue, hearing all sides, and running all algorithms for outcomes prior to making a decision. Isn’t that what we educate our patients to do with their health?

Today, I am asking you to let me be your critical thinking voice in the Montana House of Representatives.

Loni Conley, RN Candidate, Montana State Legislature

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Loni Conley

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