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Defining Nursing Project

Much of the difficulty that nurses face when interacting with the public or non-nurse colleagues in the workplace is that few people outside of nursing actually know what nursing is. This is the root cause of the undervaluation of nursing that leads to its insufficient strength. We seek to define nursing to help the public understand, as Florence Nightingale long ago said "what nursing is and what it is not" so that lack of understanding of the nursing profession does not inhibit progress and collaboration.

We will seek to identify health care practices that may undermine nursing's status as an autonomous profession and then work to improve those practices. For instance:

Is a provider's authorization for a medication or treatment generally referred to as a "prescription" or "care plan," or is it instead referred to by the damaging misnomer "order," which wrongly suggests that nurses follow physician plans without question?

Does prescribing software contain a user-friendly function for the nurse to state whether s/he agrees that the prescription appears to be in the patient's interest, with the ability to explain any concerns and to suggest an alternative treatment or medication if appropriate?

Do health forms and questionnaires require patients to supply the names of physicians even in practice areas in which their provider may be an APRN? HOSPITAL

Can nurses be further empowered to embrace their autonomy through reforms that limit what can be done in certain contexts without nursing agreement, for example as part of checklist protocols? HOSPITAL

Would it be helpful to remind nurses of their ethical duties to protect and advocate for patients, duties that apply even when physicians or other colleagues may wish care to proceed in a different way? NURSE EMPOWERMENT

Would it be useful to enhance the authority of the nursing management structure relative to the physician one? HOSPITAL

There are myriad practices within the health care system that can be improved to promote full nursing autonomy.

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.

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