Changing how the world thinks about nursing

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Q: You want a career in science? Then why are you applying to nursing school?

A: Nursing is a science.

It's understandable that many would not include nursing in the category of "scientific" fields. Too few people outside of nursing know that the profession requires years of intense college-level science education. Few know that nursing awards degrees including the Bachelor of Nursing Science, the Master of Science in Nursing, and the Doctor of Nursing Science. And too few know that, like physicians, nurses use the scientific method to resolve complex health problems, and that their work draws on disciplines including biology, chemistry, and psychology. Nurses engage in evidence-based scientific practice to advance the health of individual patients and entire communities. And nursing journals publish ground-breaking scientific research on topics ranging from forensics to the prevention of neonatal infections.

Few people today would, on hearing that a promising youngster planned a career in "science," think of nursing. The media both reflects and reinforces the common view that nurses merely assist the scientists they view as being responsible for human health: physicians. We recently saw a newspaper columnist react with mirth and scorn at the idea that a local university was planning to award doctorates in nursing. Of course, we're not suggesting that the media is solely responsible. Some nurses may reinforce these views by minimizing their own expertise or deflecting attention. But the media could be far more receptive.

In the news and current affairs media, the view that nursing is not really a science comes out in various ways. The media often fails to consult nurses on health topics in which they are expert, and it almost never discusses nursing in pieces about trends in "science." In June 2007, the Marc Steiner Show on Baltimore National Public Radio affiliate WYPR featured a discussion of how Americans are not learning enough science, with New York Times science reporter Natalie Angier. Truth executive director Sandy Summers called in to explain that one critical area in which Americans need greater scientific knowledge is in nursing. Summers noted that the continuing failure to understand nursing's true value, including that it is in fact a vital health science, was a key factor in the underfunding of the profession. That underfunding contributes greatly to the nursing crisis and threatens the lives of patients, since fewer nurses means worse patient outcomes. If decision-makers understood nursing's importance as a science, funding for nursing education, research, and practice would increase. The host and guest on WYPR's Steiner show seemed baffled by these ideas.

Since former Harvard president Lawrence Summers's notorious 2005 remarks about women in science, the media has also been full of "women in science" pieces analyzing the extent to which women have entered and succeeded in "science and engineering" fields. A lengthy piece by Cornelia Dean in the December 19, 2006, issue of The New York Times is a good example. "Women in Science: The Battle Moves to the Trenches" discusses the progress women have made in such fields since they started entering the relevant university programs in larger numbers in the 1970's. It's true that this piece, like many others, is more concerned with those who have become university professors in fields like molecular biophysics than it is with the applied sciences or health care. But it does note that half of U.S. medical students are now women. And one of the women quoted at length is a New York psychologist.

Yet there is not a word about nursing, or the thousands of women with nursing doctorates who are now teaching and conducting research at U.S. colleges and universities. Indeed, we have yet to see such a "women in science" piece even mention nursing, much less discuss the fact that that scientific field now has over 2.5 million female members in the U.S. alone. More than one million U.S. nurses now have at least a bachelor's degree in nursing, and hundreds of thousands have at least a master's degree. But we can't recall a media piece about national competitiveness in "the sciences" discussing the role of nursing.

In non-press media on science, nursing fares no better. For instance, nursing is typically ignored in "science" museums. Last year we noticed that the web site of London's famed Science Museum said the Museum had, within its general Clinical Medicine collection, a sub-collection on "Nursing and hospital furnishings." Evidently nurses have much in common with inanimate equipment. Today, a search of the Museum's web site for "nursing" reveals virtually nothing about the profession at all.

Of course, the failure to consider nursing as a science is a natural result of nursing's history as a job done mostly by women that has received little respect for its practitioners' skills, knowledge or innovation. The fact that the field continues to be ignored, even in articles that are all about "women in science," seems to reflect what Suzanne Gordon has called "dress for success" feminism. Many women have now entered traditionally male fields. But that change has not been accompanied by a re-examination of the value of traditionally female fields like nursing. In this regard, recent feminism seems to mean that women can gain respect by entering fields like medicine, but that fields like nursing are now for losers--they represent everything bright, ambitious women have gladly left behind. As prime time television physician Meredith Grey (right) once memorably observed: "Did you just call me a nurse?" One result of this widespread attitude, unsurprisingly, is that nursing struggles to get adequate funding for research--just like the "women in science" who have received so much recent media attention. Specifically, nurses get 0.75% of the US National Institutes of Health budget, even though nurses make up the majority of health professionals in the US. As an example, see the President's proposed 2008 budget as of July 1, 2007. The National Institute of Nursing Research (NINR) receives 0.48% of the NIH part of the budget. The NINR told us in 2005 that nurses seeking funds from other Institutes receive about 0.25% additional funds, for a total of about three-quarters of one percent of the entire budget.

What can be done? We suggest the obvious: continue to remind everyone that nursing is a vital health science whose members work on the cutting-edge of health care practice and research. One good example of this approach is the video "Nurse Scientists: Committed to the Public Trust," produced in 2004 by the Friends of the National Institute for Nursing Research (FNINR). Another example is the statement of Johns Hopkins nursing dean Martha Hill, PhD, RN, FAAN, congratulating her colleague Jacquelyn Campbell, PhD, RN, FAAN, on receiving the 2006 Pathfinder Distinguished Researcher Award from FNINR. Dr. Hill noted that Dr. Campbell had joined "a most distinguished group of premiere nurse scientists."

Declare yourselves scientists, nurses. You have nothing to lose but your close association with hospital furnishings.

Last updated July 1, 2007.

 

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