Nurse or leader: pick one
April 1, 2006 -- Today the Long Beach Press Telegram ran a piece about local nurse Judy Fix, who saved the life of an injured motorist at the roadside. That's good. Unfortunately, Kristopher Hanson's piece was headlined "Ex-nurse didn't forget," and it referred to Fix as an "administrator" at Memorial Medical Center and a "former nurse." In fact, Judy Fix is the hospital's Chief Nursing Officer and Senior Vice President of Patient Care Services, managing 1,800 RNs. We doubt that many people would refer to Memorial's chief of medicine as an "ex-physician." What's the difference? In our view, it is the persistent view that only nurses who currently work at the bedside are really nurses, and that nurses cannot be leaders, scholars, or policy-makers without ceasing to be nurses. In other words, it is the view that nursing is not a serious, autonomous profession.
The piece explains that 62-year-old Long Beach resident Allan Pollard recently had a bad car accident in Orange County. One arm was shredded and "nearly ripped off," and within minutes he had "lost nearly half his blood." Of course, no mass media account of the good works of a nurse would be complete without some regressive angel imagery. So here, we learn that Pollard met his "guardian angel," not just in a quote from him, but also near the start of the piece, from the reporter. To its credit, the piece does include a quote from the now-hospitalized Pollard, who says he heard a voice saying "I'm a nurse and I can help." This should have given Hanson and his colleagues another clue that Fix does not regard herself as an "ex-nurse." In any case, the piece notes that the "angel was a mere mortal and former nurse" whose "quick action that night likely saved Pollard's life." Fix, driving home from her "administrator" job at Memorial, saw the accident before paramedics arrived. Her "experience as a trauma room nurse flooded back." She knew the blood loss had to stop, so she (in her words) "just applied a death grip to his arm" and kept talking to Pollard; she notes that she knew that his continued talking meant there was circulation. Paramedics arrived about 13 minutes later.
Though Fix did not expect Pollard to be able to keep his arm, we learn that Memorial "surgeons George Macer, Wilheim Irvine, Fritz Baumgartener and Roman Letwinski performed more than six hours of surgery piecing his arm bones, tendons, muscles, arteries, nerves and skin back together." Pollard was on a ventilator for three days, and he has many pins in his arm, but "doctors expect his hand and elbow to recover most of their functions in the months and years ahead." Pollard notes that his arm is "getting better every day," that Fix's arrival at the scene was "a miracle," and that "[s]he saved my life." But in the piece's description of his surgical and post-surgical care, no nurse is named or described. Evidently all surgical and post-surgical care of importance has been provided by physicians. This marked contrast to the description of Fix's actions at the roadside suggests another trend in media coverage of nursing. Nurses may merit comment when they do something surprisingly "heroic" outside normal care systems, like saving a life by themselves (can you believe it?). But nurses' work within hospitals is completely subsumed within that of physicians. Nurses may be heroes once or twice at the roadside, but physicians are heroes at work all day, every day. This discontinuity appears even though the piece quotes Fix herself as saying she was just doing her job. The reporter takes this as an expression of modesty, but it also suggests (again) that she is not an "ex-nurse."
In view of the piece's indications that Fix is no longer a nurse, it is especially striking that it actually notes that she "now oversees Memorial's 1,800 RNs as the hospital's senior vice president of patient care." Of course, this omits the important "chief nursing officer" part of her title, but regardless, does the paper imagine that supervising 1,800 nurses is not nursing? Perhaps nursing does not strike most journalists as the kind of serious profession that would require management by others trained in that same field, as medicine, law, and other professions do. Of course someone who has not recently worked at the bedside will be rusty on the care provided there, but that does not mean she is no longer a nurse. Sadly, it is common for the media to suggest that nurses who work as managers, policy-makers, and scholars are not nurses. And the media is not alone in this. At least one major nursing union has suggested that only nurses who currently work at the bedside are "real nurses," as part of a dispute with management (including nursing management) over staffing legislation. Whatever issues there may be between bedside nurses and other nurses, it is destructive of the profession as a whole to suggest that nursing is limited to the bedside, as we explained in a recent FAQ, where we noted:
[T]o say that nurses are not "real" nurses simply because they do not currently provide direct care will suggest to many members of the public that nursing is not a real profession whose members might actually be senior health policymakers, executives, and scholars, but a category of rank-and-file workers who happen to provide custodial care to patients. In fact, by the "real nurse" standard, Florence Nightingale would not have been considered a nurse for most of her career.
We thank Mr. Hanson and the Press Telegram for its coverage of Judy Fix's heroic actions after work. But we wish that it had included a recognition of the importance of the nursing that she and her 1,800 nursing colleagues do every at Memorial Medical Center.
Please contact the author Kristopher Hanson at firstname.lastname@example.org and please blind copy us at email@example.com and let him know that nurses have leaders and they aren't always practicing at the bedside.