The Coalition for Better Understanding of Nursing Project
Every day the media puts out thousands of unhelpful images of nurses that affect the way society thinks about
nursing. Helping society to see nursing as a more valuable profession should be a priority for leaders of nursing schools, professional organizations, hospitals, and foundations. The Coalition for Better Understanding
of Nursing would bring these organizations together to pursue that critical goal through several key strategies.
As part of the Coalition effort, we are seeking funding for the following specific projects:
The DVD project
Nurse shadowing project
Increasing the Profile of Nurses at Hospitals
Increasing Awareness Among Decision-Makers
Legislators
Hospital Executives
Insurers
The Physician Project
One key element of the project would be to educate physicians about nursing. Why educate physicians? Because they create or provide advice on much harmful media about nursing. In addition, many of the problems in today's work environment stem from the fact that physicians do not understand what nurses do or that nurses are autonomous professionals. Nurses can't practice with full autonomy until physicians understand nursing better and treat nurses as colleagues instead of underlings.
The DVD project
We would like to prepare a DVD for circulation to all medical schools to teach medical students (and their instructors) about who nurses are, what they do, and how they interact with physicians. Wide dissemination of the DVD to medical schools in the U.S. and abroad would improve relations between the professions as well as nurses' ability to practice with full autonomy. Each summer from 2003-2007 the Robert Wood Johnson Foundation distributed copies of Joseph Turow’s DVD essay "Prime Time Doctors: Why Should You Care?" to about 20,000 U.S. medical students, showing that medical schools are open to such outreach.
Nurse shadowing project
We seek to promote programs in which medical students shadow nurses at medical schools in the U.S. and abroad. These programs, like the one pioneered at Dartmouth and another fashioned after it in Wisconsin, help increase understanding among those who have a great influence on public understanding of nursing and the nursing practice environment.
Increasing Seats at the Table Project
We would like to organize an effort to encourage greater nursing participation in hospital boards. Hospitals are nursing institutions--they exist to provide nursing care. If patients did not need 24/7 nursing care, they would seek health care at outpatient centers. Since hospitals are primarily nursing institutions, they should be run and directed by nurses. Yet we know of no instance in which nurses are a majority on a hospital board. In fact, nurses rarely sit on boards or serve as CEOs. (For example, based on our analysis of the websites of the top 17 hospitals listed in U.S. News and World Report, few nurses sit on hospital boards. Though getting an accurate count was very difficult, we found fewer than 1% of hospital directors were nurses.)
Increasing the Profile of Nurses at Hospitals
We want to help hospitals tell the public about their nursing expertise and leadership by having information about how nursing is going to help patients on their websites. When nursing information does appear on hospital websites, it is almost always directed at nurses for recruiting purposes. This even includes information on the hospital's Magnet status, as if no one could care about that except for nurses. Although hospitals are mainly nursing institutions, visitors to hospitals and their websites see little or nothing about nursing. In March 2012, we examined the websites of the top 17 hospitals as listed in U.S. News and World Report to see how good of a job the sites did in giving visitors information about the hospitals' main reason to exist. We examined the main pages, "about us" pages, specialty pages, patient information pages, clinical specialty pages, and provider pages. Out of these 17 hospitals, we found a link to nursing information on only one of these webpages, Duke University's "about us" page. None of the other hospitals had links to nursing information from these pages that the public is likely to see. Apparently those building these pages do not think nursing is important to their mission as a hospital, or at least that it's not important in promoting the hospital. We must change that to help nurses improve understanding of their profession and practice to the full extent of their abilities, which is what best protects the health of patients.
Increasing Awareness Among Decision-Makers
We propose to take several key steps to educate influential decision-makers about the nature and value of nursing. If we are able to increase the value that decision-makers place on nursing, we think it will improve the likelihood that they will increase funding for the profession. Funding for nursing is downright abysmal. Nursing residencies get $1 for every $375 that go to physician residencies. The National Institute of Nursing Research receives only $1 out of every $200 of the budget for the National Institute of Health. Nursing education gets $1 for every $50 that goes to physician education, even though nurses outnumber physicians by about 4 to 1. If there is a way to measure just how much society and decision-makers undervalue nursing, these are those numbers. If we educate decision-makers about the disparity between the value of nursing and the funding for it, we believe that we can convince them that the world just cannot live well with an underfunded nursing profession.
Legislators
Legislators control funding for nursing education, research and residencies, as well as the rules that govern nursing practice, including the regulation of staffing levels, overtime, whistleblowers, and scope of practice. We would create a DVD for legislators explaining how valuable and cost-effective nursing is and how investing in it now will save millions in the future. For example, the DVD could make clear how nurses can prevent hospitalization. The Coalition would disseminate it widely and have it for use as a tool when member organizations do in-person outreach to legislators.
Hospital Executives
Hospital executives make decisions that affect nurses and nursing care, yet so often, they appear to be ill-informed about what nursing really is. So nurses are replaced with technicians and assistants. Patients are ill-served when nursing care and nursing assessments are performed by people who have not been educated as nurses. When nurses deliver nursing care, the care is more effective and patients are less likely to return to the hospital, or get sick and die. Creating a DVD about the cost-effectiveness of nursing may help hospital executives make better decisions about nursing. This DVD would likely overlap with the DVD for legislators, but it would be aimed specifically at hospital executives.
Insurers
We would like to form a task force to educate Medicare, Medicaid, and private insurers about nursing autonomy and skill to improve reimbursement for nursing. This effort would include RN care and APRN care to improve preventative care, keep patients out of hospitals, and promote effective care models, including health homes for follow-up and nurse-family partnerships.
Highlighting the Edge-Leaders Project
We propose to develop video programs and other materials to help nurses working on the cutting edge make their work accessible to the media, so as to convey what the profession is doing to advance global health. For example, consider this clip by former US AIDS Czar Kristine Gebbie, RN, DrPH, then-Associate Professor, Columbia School of Nursing.
Disseminating Best Practices
Best practices save patient lives and save money, yet to our knowledge, there is no good place to gather and disseminate this information so that all nurses and health institutions can have access to it. Coalition members could work together to submit their research, practices and data to a common database on the Coalition's website, so that all nurses could have access to practices that strengthen the profession, improve patient care, and save health care resources.
The Nursing Autonomy Project
We envision identifying systems within health care that undermine or encroach on nursing autonomy and working to change those systems. For instance, does new prescribing software contain a user-friendly system for the nurse to confirm either that he or she agrees that the prescription appears to be in the patient's interest or that he or she does not agree, with the ability to explain why and suggest an alternative? Each prescription should go through such a system. And can hospital billing systems be modified to extract nursing services from "room and board"? Do patient health records forms and questionnaires require patients to supply the names of physicians even in practice areas in which their provider is an APRN? There are myriad processes within the health care system that should be changed to promote full nursing autonomy.
Providing Health Information to the Public Project
We would like to establish a model for nurses to provide easy-to-understand health information to the public. Nurses are the health professionals who are educated specifically to teach patients about health care. Unfortunately, some health professionals fail to clarify key points and use highly technical language when imparting health information. Nurses often find themselves translating information that physicians give, including critical diagnostic and treatment data, so patients can understand it. There are sources of relatively straightforward health information, like WebMD, but as their names suggest, the information is still imparted mainly from the physician perspective.
We propose having nurse experts build a series of health education pages where patients can learn about various topics from a pragmatic, holistic nursing perspective. That will present nurses to the world as health experts.
Back to the Overview of Proposed Projects of The Truth About Nursing.
Educate the world that nurses save lives!
