Ah, National Nurses Week. In honor of the occasion I am going to toot nursing’s horn a bit—not our caring and compassion, but our knowledge base, skills, scientifically-based expertise, and our vital (as well as proven) impact on patient health outcomes.
My Quaker great-grandmother might roll over in her grave, yet against this humble grain I must rub. It is time to retire the June Cleaver, ‘angel in the house’ image of the nurse. It has been said that the nursing profession delivers the "caring" aspect that compliments the medical "curing." Yet this particular narrative about the value of nursing only goes so far.
In the May issue of American Journal of Nurses, authors Suzanne Gordon and Sioban Nelson call it the "virtue script," and they make a powerful argument as to why the script needs revision (AJN, Vol. 105, number 5; "An End to Angels").
The virtue script tells only part of the story. Caring is important and at the same time, is certainly not unique to nursing. It exists as the bedrock of human societies and even seems to exist among animals. The world can appear severely lacking in it, yet people surprise each other all the time with acts of compassion.
All members of the health care team, indeed, all members of the human race, are charged with the responsibility of caring for one another. Do many fall down on the job? Of course. Yet that doesn’t leave it up to nurses alone to shoulder the burden. My personal physician and dentists are very compassionate and caring. We can (and should!) celebrate caring wherever it manifests.
Nurses have so many other roles and responsibilities, and as Gordon and Nelson point out, this expertise must be communicated to the public and to other professionals. I certainly didn’t spend all that money and time in nursing school simply to become an expert in caring!
Every day, nurses promote health and healing by way of our extensive knowledge base and skill set. We provide expert nursing, based on science and rooted in a standardized body of knowledge. Nurses save lives, and prevent diseases and other complications.
The authors of the "End of Angels" article provide a good overview of why even now, decades after Florence Nightingale, nurses themselves and other professionals still cannot articulate these facts.
It is essential to recognize the knowledge base and skills that nurses, as well as other members of the team, bring to the health care picture. When we don’t get recognized for this expertise, nursing risks being seen as simply a handmaid function.
The problem with being a handmaid is that anyone can be one, and when you substitute "anyone" for a Registered Nurse, you get increased post-op complications, increased incidence of pressure wounds/falls/pneumonia among patients. The rate of patient deaths actually increases. These outcomes have been demonstrated in extensive and ground-breaking research. Yet we still struggle with this demon.
The days of an all-powerful medical professional acting on a (perceived) passive patient, directing not only patient care but nursing practice, are long gone. Maybe those days never really existed.
The citizens of the future will need to be educated and versed in the ways of advocating for themselves. They will demand quality care, and will expect no less. Nurses are vital team members who will be an essential part of making this happen.