Everyone Has a Role in Building the Future of Nursing

May 13, 2016, 11:30 AM, Posted by

Nursing students working on a mannequin during a class.

Six years ago, I graduated from nursing school at the age of 40-something—a feat accomplished while working full time, attending class and doing clinical rotations nights and weekends—with no small amount of support from my husband, my teenage children and my almost-3-year-old.

Frankly, when I graduated, I should have given each of them a gift for their support.

Instead, my then 15-year-old daughter gave me a copy of the book Critical Care by Theresa Brown, who, like me, was a second-career nurse. She’d heard her interviewed on National Public Radio and thought I might enjoy it. What I read in that book got me through some very rough overnight shifts when I was working per diem at my first job in long-term care. Her book reminded me that every new nurse is scared, tentative and not quite sure of her or himself. Yet somehow we muddle through, and we do the very best for our patients.

Fast forward to 2013, and I’d come to work at the Robert Wood Johnson Foundation.

I was lucky enough to meet Theresa at our inaugural Flip the Clinic event, and then again at a health care narrative convening in Rhode Island. And when my daughter started attending the University of Pittsburgh, we had breakfast every now and again.

In emails, texts, phone calls and conversations over pancakes, she has continued to inspire me. We have shared our joys about caring for patients, and our frustrations with the imperfect health care system.

During National Nurses Week (May 6–12), Brown came to our Princeton campus to discuss her work and her passion for giving nurses a voice.

The Nursing Paradox

The celebrated author and nurse was once an English professor. But inspired by the care she received from midwives who helped her through a difficult pregnancy (“I thought midwives had the coolest job in the world.”), she completed an accelerated BSN program and became a registered nurse.

Realizing soon after that most healthcare stories were told from the perspective of physicians, she turned to amplifying the voices of the bedside nurse. Articles in the New York Times followed, sharing the fear of being a young nurse and losing a patient in Perhaps Death Is Proud; More Reason to Savor Life or the misconceptions that stalk the profession in Why Nurse Stereotypes Are Bad for Health.

In her May 3 talk to RWJF, Brown addressed a paradox. Nurses remain, from year-to-year, the most trusted profession in public opinion polls. Yet they face issues of respect that have dogged them since Florence Nightingale founded modern nursing.

Yes, it is lovely and flattering to be trusted but if we’re so trustworthy,” asks Brown, “why does nobody listen to us? Many patients feel that it’s really the nurses that truly understand what’s going on. But it’s said in a whisper. Why a whisper? We can’t give a voice to this?

Misunderstandings about the role nurses play persist. Nurses struggle to gain respect from those who don’t accept or understand that role, as well as patients who don’t realize that getting the proper medication (a nurse’s responsibility) is vastly more important to their health than the temperature of their dinner (decidedly not a nursing role).

The Barriers

“The barriers are formidable,” says Brown, “both institutional and individual.”

Brown believes that support from within the profession, as well as an educated workforce, are obvious ways to advance the profession. The movement toward the bachelor of science degree excites her. “The move to have nurses have a BSN is profound and supported by data,” she said. “Unity of educational background and expectations in the clinical setting is fabulous. It’s the right thing to do. If we can make that more affordable, that would be huge.”

Five years ago, the Institute of Medicine (IOM) released a groundbreaking report that called for the removal of barriers to advanced practice nursing. Some states are responding by granting nurses the ability to provide the full complement of services they are educated and trained to deliver.

Respect and Support

Brown had several suggestions for nursing students wanting to advance their own mission. Be more collaborative. Ask to be included in rounds so you can be a part of the discussion. And seek interprofessional opportunities to grow your knowledge base.

During this week—one in which we celebrate nurses—I’ve thought a lot about all Brown and I have discussed, and what she’s taught me. I’ve been both the victim and the observer of nurse bullying—which is not just urban legend; it’s a real fact of life for nurses everywhere, particularly new nurses. But it’s those positive relationships with fellow nurses—nurses like Theresa Brown—that remind me why I chose nursing as a second career in my mid-life.

As this week draws to a close, I’d like to encourage everyone to change the way they think about nurses. If you want to celebrate them, don’t give them another tote bag or a tray of cookies. Instead, encourage them to support and inspire each other. Give them a supportive environment in which to advocate for their patients and for each other. And if you’re a nurse, look around you, and find that timid new nurse. Remind them that they have it within themselves to be a fantastic nurse. That’s the best way to celebrate the hard work nurses do every day, every week of the year.

RWJF is funding a collaboration with the National Center for Interprofessional Practice and Education to design and accelerate the development of creative, robust and sustainable interprofessional initiatives in which graduate nursing and one or more other professions actively learn and work together.

Beth Toner

Beth Toner, MJ, RN, a senior communications officer, provides communications support for several areas of focus at the Foundation. She helps provide strategic communications support to investments in projects and programs designed to give all in our society an equal opportunity to pursue a healthier life. Read her full bio.