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Letter to the National Post (Canada) sent June 10, 2003 By Bernice Buresh

If Christie Blatchford is ever hospitalized, I hope for her sake that she is taken care of by nurses who regard nursing as a "capital-P" profession. Contrary to the meek handmaidens that Ms. Blatchford yearns for ("Militant Angels of Mercy," June 7), professional nurses have the intelligence, education, skill, clinical judgment, and, yes, compassion to provide the complex care that she will need to survive and recover.

Although I meet hundreds of nurses each year in Canada and the US in my work as a writer and lecturer on communication, nursing and health care, I seem to have missed the cohort that doesn't care about helping sick people. I don't know how many "just plain mean" nurses might exist, and neither does Ms. Blatchford. But it does strike me as odd that she dismisses the surveys that show high public esteem and support for nurses, and requires instead public hugging of nurses as proof of affection--in a SARS environment yet!

What I do know is that every assertion she makes about nursing is incorrect, and I trust the extensive research on these issues a lot more than I do Ms. Blatchford's flighty impressions and unsupported generalizations.

Take, for example, her belief that the "great nurses" work in critical or emergency care as opposed to general medical units, or that working conditions are not the source of nurse disgruntlement. In fact, while all nursing is stressful these days, patient-to-nurse ratios are lower and controlled in such areas as critical and trauma care while they have been increasing markedly in general medical-surgical wards. The well-documented result is that patients in these units face escalating risks of death and serious complications, while nurses, who are trying to deliver complex care to too many patients, are highly vulnerable to injury and burnout.

Similarly Ms. Blatchford is certain that physicians routinely listen to what nurses have to say. Then why is it that a landmark study on end-of-life care in hospitals found that the majority of patients died in pain with their wishes ignored because physicians paid no attention to the information nurses tried to convey, both in the normal course of events and even when researchers intervened with nurses specially trained in communication techniques? Or how about the infamous Winnipeg case in which a dozen infants and young children died and others suffered serious injury at the hands of a surgeon who was allowed to continue operating by physicians in authority even though nurses filed formal complaints about his dangerous lack of competence?

In fact, the meek, self-sacrificing doormat that Ms. Blatchford pines for would be a menace to patients. Patient's lives depend upon retention of the nurses now practicing and successful recruitment of bright, young women and men who are self-confident and daring enough to take on nursing's tough challenges. In the midst of a critical nursing shortage, we'll get these people not through "love," but by according them the respect, recognition and reward they deserve.

Like Ms. Blatchford, I lament erosion of professional standards, particularly among columnists who use provocation to get noticed, but who cannot be bothered do any real reporting.

--Bernice Buresh, Cambridge, Massachusetts
(I am co-author of the book, From Silence to Voice: What Nurses Know and Must Communicate to the Public.)

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