When every week is nurses week
May 2007 - Is "nurses week" (May 6-12 in the U.S.) just another signal that nurses don't really have enough power or respect, that they're one of those groups society honors for a week so it feels OK about not really valuing what the group does the rest of the year? Will nursing know it's become a truly respected profession only when it has no more need of "nurses week"? Well, we don't see any media exploring those questions. So we'll celebrate the week by looking at some worthwhile "nurses week" media items we have found, most of which rightly address the lack of understanding that is a critical element in the profession's global problems:
Janice Skot's "Today's nurses are at the forefront of Canadian health care," in The Barrie Examiner (Ontario);
Nancy Banfield Johnson's "Honor the Nation's Nurses This Week," in The Ithaca Journal;
Kathleen Bartholomew's "Nurses struggle against the odds," in the Seattle Post-Intelligencer;
K. Nancoo-Russell's "Nurses should not have to work in fear, official says," in The Freeport News (Bahamas);
Suzanne Gordon's "TV Nurses Don't Represent Reality," in the Yankton Press and Dakotan (SD);
and two photo exhibitions:
"The Faces of Caring: Nurses at Work," presented by the American Journal of Nursing and the New York University School of Nursing in New York through June 5, and
"Just a Nurse," by photographer Earl Dotter and journalist Gordon, at the Hospital of the University of Pennsylvania in Philadelphia through May 18.
Nurse Janice Skot, the president and CEO of Ontario's Royal Victoria Hospital, published a good May 8 op-ed today in The Barrie Examiner, "Today's nurses are at the forefront of Canadian health care." Skot provides a lot of information about modern nursing, but one of the most needed bits of information she conveys is simply that she is a nurse--that nurses have the knowledge and skills to become hospital chief executives. Skot's main theme is that most people don't understand how complex nursing really is, and she notes that the theme of this year's Nursing Week in Canada is "Think You Know Nursing? Take a Closer Look." (We applaud this theme, though we have to note that none of the four images on the main promotional graphic (above) actually shows any nurses.) She explains that nurses today are front-line clinicians, educators, researchers, and administrators like her. Their varied tasks include direct care, advocating for patient safety, helping patients adapt to health issues over the longer term, and promoting healthy practices in society at large. Skot notes that an RN today "requires a baccalaureate degree in nursing."
Skot's piece is generally strong, though we saw a couple minor issues. Her suggestion that nurses are "very special" because they have an "X factor" that reflects their "dedication and passion" for patient care strikes us as less helpful than her longer explanations of everything nurses actually know and do. Skot also emphasizes how far nursing has come from the early days of "learning your nursing skills by following the lead of the Lady Superintendent" of a hospital, and we're always a little uneasy about pieces that take such pains to distinguish today's nurses from their predecessors. It seems to us that many professions have evolved considerably over the last hundred years, but you're unlikely to see physicians, for instance, working so hard to distance themselves from their predecessors. Of course, their predecessors got real respect, and it may be easier to show the public that it's wrong about nurses today than to persuade it that it's been wrong for over a hundred years.
Nancy Banfield Johnson published a strong nurses week op-ed May 8 in The Ithaca Journal --something that is getting to be an annual tradition for her --entitled "Honor the Nation's Nurses This Week." Last year, Johnson celebrated the week by persuasively debunking some of the most damaging "myths" about nursing. This year, she devotes her piece to an account of her own three decades in nursing, which, given what Johnson notes are the "few positive role models of nurses in the media," may likewise dispel some myths.
During her college years, Johnson spent weeks in the hospital following a car accident. She was so impressed with the skills of the nurses who managed her recovery that she changed her major to nursing. After getting her bachelor's degree, she became a home health nurse, working with patients with chronic illness, teaching, healing, and keeping them out of the hospital. Johnson earned a master's degree and became a nurse practitioner, which she rightly treats as a natural extension of the work she had always done, with a focus on prevention and teaching in addition to diagnosis and treatment. She later became a nurse manager in a continuing care retirement community. She and her staff prevent life-threatening complications, educate and advocate for residents, provide psychosocial care to the distraught, and when needed, vital end-of-life care. She closes with a pitch for the profession at this time of critical shortage, and urges readers to
help me publicize the positive aspects of a nursing career. Nursing is an autonomous profession requiring scientific knowledge and clinical skill. We need registered nurses saving lives and making significant contributions to the health of our nation. I am proud to be a registered nurse making a difference in peoples' lives from birth until death. I love nursing! Maybe someone you know would too.
Nurse Kathleen Bartholomew's powerful op-ed "Nurses struggle against the odds" ran May 7 in the Seattle Post-Intelligencer. Bartholomew's piece is a more comprehensive argument about the nursing crisis, and the key role it plays in problems that plague the overall U.S. health care system, which is both underinclusive and overpriced. She says hospitals are "financially flailing," and nurses feel the impact, facing sicker patients and increasingly complex care; many nurses are burning out and fleeing the bedside. Bartholomew argues that most of what nurses do is "invisible" to "the patient, doctor, and society." She focuses on nurses' critical thinking and assessment skills, explaining that nurses save lives by constantly checking medications, looking for early signs of complications, reviewing lab results and data. She argues that current pressures have reduced the time nurses can spend with patients, reducing the "compassion" and emotional support nurses can provide, and causing nurses themselves to feel unfulfilled and burned out: "An R.N. who is running around day after day with no time for lunch begins to feel like a robot because of the overwhelming volume of tasks." Bartholomew directly challenges her society's priorities, arguing that it's "not OK for a professional ball player to make $63 million a year while nurses work without meals or breaks, and patients barely see their nurses," or for there to be so many uninsured and so many preventable errors. And she urges readers to pressure the government for change, noting that until they do, nurses will struggle to "solve the problems resulting from a health care system that operates as a business, instead of a universal right."
On May 8, The Freeport News (Bahamas) ran an article by reporter K. Nancoo-Russell about "Nurses Recognition Month 2007" that focused on a different problem: how to protect nurses from violence in the workplace. "Nurses should not have to work in fear, official says" is based on strong remarks by the government "Nursing Officer" I. Julian Mullings during an opening ceremony for the Recognition Month. Mullings reportedly called for increased security measures at health facilities following incidents in which patients had terrorized and even killed nurses:
We have seen the escalation of crime and violence coming into the work circuit not only by staff members, but against staff members, nurses in particular, from patients and relatives themselves because they are not served fast enough or because the attention given to them was considered less in quality compared to another patient, just to name a few. ... We cannot have a patient attacking the very person who was placed there to care for them. There must be serious consequences for these actions against a nurse and it is up to us to speak up and let our voices be heard against such acts.
Mullings reportedly argued that nurses cannot be expected to continue caring for those who have attacked them (non-nurses might be surprised to hear that that occurs). He noted, with some understatement, that that places the nurse in a "vulnerable position" and can "create psychological trauma." Mullings suggested that in addition to the patient's bill of rights, perhaps there should be a "Nurses or Employee Bill of Rights" which would make clear that such violence will not be tolerated. Mullings specifically commended the relatively few men in nursing in the Bahamas, noting that recruiting more of them is especially important in addressing the global shortage. The piece closes by noting: "Activities planned for Nurses Recognition Month include a morning devotion, nurses' breakfast, float parades and a nurses' symposium."
On May 9 and 10, the Billings Gazette ran "Nurses on TV poorly represented, if at all" and Yankton Press and Dakotan (SD) ran the same op-ed under the title "TV Nurses Don't Represent Reality," by journalist Suzanne Gordon. Gordon argues, correctly, that the two hugely popular Hollywood hospital shows, ABC's "Grey's Anatomy" and Fox's "House," offer a vision of care in which "nurses barely exist." Gordon observes that "Grey's" has hardly ever shown nurses "doing the work they would actually do on a surgical service in a teaching hospital," like using their advanced skills to monitor the patient during surgery or afterwards, preventing or at least catching life-threatening errors and complications. "House" shows a team of "cracker-jack diagnosticians" who "administer and monitor all the meds, check all the vital signs and alert one another if a patient's condition deteriorates" (all things nurses actually do) and who eventually solve their diagnostic mysteries with none of the input from nurses that is often critical in real life. Gordon observes that nurses actually do a lot of the diagnosing and physician teaching in hospitals, and that recent research shows that more nursing care means better patient outcomes, including fewer deaths. She concludes:
In the middle of the worst nursing shortage in our nation's history -- which, according to the Bureau of Labor Statistics and others, [means] we'll be short by about 800,000 nurses by 2020 if things don't change quickly -- Hollywood tells us that hospitals are a doctor-only affair and that patients can recover without any nursing care whatsoever. We shouldn't let Hollywood lull us into thinking that nurses do next to nothing.
"The Faces of Caring: Nurses at Work"
Nurses week has also become a time of serious photo exhibitions showing nurses at work. The American Journal of Nursing and the New York University School of Nursing are presenting the winners of the international photo competition "The Faces of Caring: Nurses at Work" to coincide with nurses week. It is sponsored by Johnson & Johnson's Campaign for Nursing's Future, the Beatrice Renfield Foundation, and the Jonas Center for Nursing Excellence. (AJN editor Diana Mason, one of the contest judges, serves on the Center's advisory panel.) The Center's review of the 2005 exhibition noted that the photos "show the human connection that is a key part of the profession" and "remind us of the joy and pain that nurses can share with their patients." Our reviewer found the 2005 exhibit a "serious effort to increase understanding of the importance and diversity of nursing" that offered "some gripping, thought-provoking looks at the front lines of modern health care." The new exhibit is at New York University, Helen and Martin Kimmel Center for University Life through June 5, and we urge all who can to see it. [Address: 60 Washington Square South (at LaGuardia Place); New York, NY 10012-1019 (map, directions)]
The Hospital of the University of Pennsylvania in Philadelphia is also hosting a nurses week photo exhibit called (with clear irony) "Just a Nurse." The exhibit features the work of photographer Earl Dotter and Suzanne Gordon. According to a Penn press release, the exhibition is the result of visits to all 40 of the hospital's units, and available samples suggest that the exhibit offers a good look at Penn's nurses playing a variety of critical roles at the hospital. The press release quotes Gordon as noting that "[n]urses are a critical link in helping us solve our health care crisis. We desperately need to raise awareness of nursing's importance and encourage more young people to enter the profession." Victoria Rich, PhD, the hospital's chief nursing officer, adds:
Earl and Suzanne have given a voice to the too-often silent story of [the] nurse's vital role in patient care. Nurses are microbiologists, chemists and scientists. They are strong patient advocates. We need to make sure more people know about, seek out and benefit from their expertise.
As we noted in our review of the 2005 AJN exhibit, it is a challenge for photos alone to convey the kind of information that these quotes do and that is so vital for the public to understand. The public may see nurses in the OR during a coronary artery bypass graft operation, but understanding the knowledge and skill the OR nurses apply there is hard to convey in a still image. That's why it strikes us as such a good idea that the Penn exhibit also includes text by Gordon. We encourage all who can to visit the exhibit through May 18, 2007 at 3400 Spruce Street in Philadelphia, PA 19104-4206. (map, directions)
We commend all responsible for the above items, and wish you a nurses week without end.