National Nurses Week!
Capturing the true spirit of nursing
This year for National Nurses Week the American Nurses Association has selected a motto that captures exactly the true spirit of nursing: “Working Today for a Healthier Tomorrow.” We are, after all, about hope. You can call it prevention or health maintenance or wellness, for the next minute or the next decade; but nurses in every specialty work for a better future.
As I write this, a newscast tells me that 10,000 nurses are massed in Florida waiting for transport to Haiti. Somehow, I am not surprised — not by the numbers and not by the generosity of our colleagues. They are willing to sacrifice time, money and, let’s face it, their own health, to go to the aid of strangers.
There are several constants in humanitarian disasters: confused public officials, poor infrastructure, scared and hurting people. And close by? Always nurses. And not just the nurses trying to get into Haiti, but also those who were already there. Hundreds worked for the U.N. and in the huge number of orphanages. Churches had many nurses already on site doing one- to two-week stints of mission outreach. All are professionals with high-tech skills and sympathetic natures, hoping to make a difference. They understand the whole person, not just the broken legs or lacerated faces. They will work under conditions unimagined by most of us. In New Orleans, nurses remained in hospitals when the levees broke and continued for days without electricity, water or food, at times with gunfire all around. Relief could not get to them, but they never left their patients.
Some will come home the richer for the experience; some will stay for the long haul. The Reader’s Digest Foundation recently awarded $100,000 to the Share Our Strength Relief and Recovery Fund for New Orleans in honor of Alice Craft-Kerney, RN, and Patricia Berryhill, RN, in recognition of the clinic they spearheaded in the Lower Ninth Ward. Both nurses had survived the storm, Berryhill hunkered down in University Hospital, and both returned to find homes and jobs gone. So they put themselves back to work. Since the clinic’s inception, they have treated more than 1,200 patients whose lives and medical care were disrupted by Katrina.
Yes, we squabble among ourselves (for 40 years and counting) about entry levels into practice. Is an associate degree sufficient or is a bachelor’s degree more realistic in our complicated world? Some suggest only a master’s degree would reflect everything a nurse needs to know to care for the total person. Others ask how that would work with a critical shortage already upon us.
We fight over organizing and collective bargaining: should we have work actions, or do strikes betray the “patient comes first” principle? Just who should represent us — a professional organization made up of only nurses or an industry union?
Then there is the issue dividing nurse practitioners from clinical nurse specialists. Are they the same? Should they merge? What about nursing language? Does our distinctive terminology separate us from other disciplines, making their practitioners wonder what on earth we’re talking about? Or does our language signify, in a way other phrases can’t, the true distinctions that make up the different roles in patient care?
Yes, resolving these issues matters if we are to make progress as a profession. But, taken as a whole, these divisions don’t challenge the core of who we are and what we are about. Instead, they represent our hope that the future of nursing will be better, that the care we give will improve, and that tomorrow will be healthier.
Let’s take this year’s motto word by word. Working, by itself, powerfully describes what we do. Nursing is work — hard work. Few of us have glamour jobs or easy shifts. For example, shaping nursing students into competent professionals isn’t easy, and transforming their wonderful idealism into functional skills doesn’t happen overnight. Meeting the expectations of the Joint Commission requires strenuous lifting by committees to formulate policies and procedures. And the leadership to ensure passage of such a review falls largely to supervisory nurses who struggle to achieve compliance.
It is hard work to care for the sick and it is getting harder every day. Patients are sicker; equipment is more sophisticated. The sick can be demanding and unreasonable. Some die. Some malinger. Yet, by virtue of our professional commitment, we provide patients with the best we have to offer. In every case, we work to make tomorrow healthier in some way for each patient.
Whether staffing a field hospital in Iraq or Afghanistan, or even putting in a weekend with the National Guard, nursing involves real work. It is not fun tending to the wounded in a helicopter fighting to get above a dust storm. Neither is setting up a mobile surgical team in a province mired in strife. In an era when soldiers survive catastrophic injuries, it takes tremendous hope to help rebuild their lives. Much of that hope comes from nurses who are at their sides from the first efforts at stabilization, through transport and until, maybe, forever.
It is difficult to manage a clinic, juggle appointments, pursue follow-ups, track test results. Yet nurses do all this, day in and day out, plus weekends and holidays.
This brings us to our second word: today. Right now, there 2.4 million registered nurses in the United States and 15 million worldwide. But it is not enough. We need more, not just for the patients that present today, but for the patients of tomorrow, and the ones not yet born. We need more so today’s nurses are not so stressed and overworked that they leave.
Today we need more men who are nurses to strengthen our profession and make it truly representative of our population. Men care in a different but critical way, and our profession needs all they have to offer. We need more minority nurses to provide culturally sensitive service to our communities. Nurses are working on these fronts right now. The Association of Men in Nursing comes to mind, as does the Commission on Graduates of Foreign Nursing Schools and the National Coalition of Ethnic Minority Nurse Associations.
Don’t forget: Individual nurses can be effective in increasing our numbers. When we speak positively of our profession, of its pay and variety, of the chance to make real change, we become an incentive to candidates. Our position is unique. Repeatedly, nurses lead the list of professions most trusted by the public, yet we lack status in almost every way. We need to spread the word. We need to be sure the public understands that nurses provide the backbone of health care in this country and that hope for a healthier tomorrow lies with us.
Healthier tomorrow is the last part of this year’s motto — and it sounds good. Today might not be so perfect, but tomorrow holds the promise of something better: the hope of better effort and better outcomes. You need only think of the 238,000 nurses all over the United States who have participated in the National Nurse Study. Since 1976, they’ve been sending in their toenails, blood and urine specimens, not to mention questionnaires, so that new insights on health and disease might emerge.
Thanks to the efforts of this one group of nurses, researchers have learned much about the interplay of diet and exercise in the development of cancer, cardiovascular disease and diabetes. What other group would have such understanding and reliability? As the study moves into phase three, more and more minority participants are being sought so that results reflect more accurately the effect of lifestyle on the health of everyone. Nurses understand what we do today promises hope for tomorrow.
Think also of the Nightingale Initiative for Global Health, or NIGH. It is a nurse-inspired grassroots movement to foster global awareness about the priority of health. So far, signatories from 106 countries have affirmed the Nightingale Declaration, which says:
▶ We, the nurses and concerned citizens of the global community, hereby dedicate ourselves to the accomplishment of a healthy world by the year 2020.
▶ We declare our willingness to unite in a program of action, sharing information and solutions to resolve problems and improve conditions — locally, nationally and globally — in order to achieve health for all humanity.
▶ We further resolve to adopt personal practices and to implement public policies in our communities and nations, making this goal for the year 2020 achievable and inevitable, beginning today in our own lives, and in the life of our nations and in the world at large.
This year’s National Nurses Week motto captures the essence of modern nursing: wellness, largely interpreted as “prevention.” Almost everything nurses do is to prevent something: malnutrition, birth defects, epidemics, wound infections, pressure ulcers. Look at the work of Barbara Braden, RN, and Nancy Bergstrom, RN. Together they developed the Braden Scale for Predicting Pressure Sore Risk that is widely used to establish clinical practice guidelines. Not an insignificant accomplishment, especially if you consider the cost of decubiti in terms of health and dollars.
We help people deep breathe and cough to prevent pneumonia. We encourage smoking cessation to prevent lung disease. Even our most basic nursing chores, like double-checking wristbands, aim at maintaining health. We check eyes to prevent school failure. And now, in Haiti, nurses will be working to prevent all the diseases disaster can bring: cholera, typhoid, T.B. They are working for a healthier tomorrow, bringing hope to a shattered country.
Whether you look to the future of nurse informatics, one of our fastest-growing specialties, or you look back to our historical heroes, we are working toward a healthier tomorrow. Nurses did the first studies on how prenatal care prevented maternal and infant deaths. Some, like Clara Maas, gave their lives in the studies to prevent yellow fever. This work is the essence of what we are as nurses, and we know the value of our efforts from Florence Nightingale down through Lillian Wald to current efforts to establish an Office of the National Nurse. We are all about the future.
Even if tomorrow will bring the death of some, we are still about prevention and hope, always seeking ways to make the next step better. Even the hospice movement is about hope.
So as we celebrate this week, think about all the ways you work toward a healthier tomorrow, for yourself, your patients and your community. It isn’t just about the swag or the banners — although those are great. It is about knowing we do it all and we do it best.
Elizabeth Hanink, RN, BSN, PHN is a freelance writer with extensive hospital and community-based nursing experience.