These findings are in line with what Eliopoulos says is crucial: nurses must become more involved in policymaking at all levels. She urges nurses to bear in mind that most of the nursing staff providing direct long-term care are women earning “very low salaries” who receive little preventive care and have a high rate of on-the-job injuries. By considering those workers’ needs, nurses can ensure that patients have healthy caregivers, she said—an important aspect of patient advocacy. “We allow decisions to be made that aren't in nursing's best interest. We've got to understand the language of the people who hold the purse strings. And we have the clout to talk about more than care quality. Let us remember who the backbone of care really is.”—Joy Jacobson