By Joyce Frieden

Voters in the upcoming general election -- depending on where they live -- are seeing nurses appearing on their ballots, even if they don't know it.

At least 18 nurses are running for Congress -- 16 for the House and two for the Senate.

This number includes Rep. Mariannette Miller-Meeks, MD (R-Iowa), an incumbent who served as an Army nurse for 6 years before becoming a physician. Three other incumbent nurses -- Lauren Underwood, RN, MSN, MPH (D-Ill.), Sheri Biggs, DNP, FNP (R-S.C.), and Jen Kiggans, AGNP (R-Va.), are also seeking re-election.

Among all 18 candidates, 10 are Democrats, four are Republicans, one is Libertarian, one is an Independent American Party candidate, and two are independents.

In one of the Senate races, in Oklahoma, two nurses -- Ron Meinhardt, RN, BSN (I), and N'Kiyla "Jasmine" Thomas, LPN (D) -- are running against each other as well as against a Republican, Kevin Hern, and three other candidates in a district considered solidly Republican.

Although 18 candidates might seem like a healthy number, "I say, why not more?" Jennifer Mensik Kennedy, RN, PhD, said in an online interview at which a press person was present. "Look at the number of lawyers in office. We should have more nurses."

"Healthcare has created issues and problems for the lives of our patients," she added. "They see the direction the country is going and want to step in. It's great from a healthcare perspective because we know where all the problems are, whether it's regulatory barriers or accreditation issues ... We see all the potential solutions and want to help get things done. Our healthcare system is continuing to get worse, and people can't afford to have healthcare not improving."

In this election cycle, healthcare is part of the affordability issues campaigns are stressing, Jacob Garcia, RN, MSN, chair of the Washington State Nurses Association Political Action Committee, said in a phone call. "Viewing it from my nursing lens, with Maslow's hierarchy of needs, right now [patients'] basic needs are not being met, like shelter and providing for themselves and their family. They are not going to do preventative measures -- insurance is probably going to be one thing they won't pay for."

"I think we are seeing a breaking point within the healthcare system," said Garcia. "Both regular people and those that work in the system know and see how unsustainable it is ... We're already seeing cracks, especially in rural communities; we're seeing hospitals close, big systems gobbling up everyone, and people trying to do more with less."

The list of nurses running for federal office includes:

U.S. Senate:

Oklahoma: Ron Meinhardt, BSN, RN (I) and N'Kiyla "Jasmine" Thomas, LPN (D)

U.S. House of Representatives:

Alabama: Amanda Pusczek, ADN, BSN (D)

Arizona: Elizabeth Lee, RN (D)

California: Genevieve Angel, RN (R)

Georgia: Pamela DeLancy, RN (D)

Illinois: Jennifer Todd, BSN, RN (D) and Lauren Underwood, RN, MSN, MPH (D) (separate districts)

Iowa: Mariannette Miller-Meeks, BSN, MD (R)

Louisiana: Lisa Ballay, LPN (L)

Nevada: Jon Kamerath, LPN (Independent American Party)

North Dakota: Helene Neville, LPN (I)

Ohio: Kristina Knickerbocker, RN, MSN (D)

Pennsylvania: Nancy Mannion, RN, DNP (D)

South Carolina: Sheri Biggs, DNP, FNP (R)

Texas: Steven Shook, RN, MSN (D)

Virginia: Jen Kiggans, AGNP (R)

Wisconsin: Mitchell Berman, RN (D)