A new nursing role: what do you think?

Article Outline

• Copyright

IN OCTOBER 2003, at the American Association of Colleges of Nursing (AACN) annual meeting preconference, discussion centered on a new nursing role that would begin to address some critical health care issues that we are facing. This issue of the Journal of Professional Nursing (JPN) features two articles that describe innovative ideas for a new nursing role and reflect some discussion at that meeting. Dr. Kathleen Long writes about the efforts on behalf of the AACN Board of Directors to reenvision nursing education and practice by creating a new nursing role to meet the needs of our rapidly changing health care system. Ms. Karen Drenkard describes an example of a new nursing role that reflects a reenvisioning of nursing education and practice from her perspective and experience as chief nurse executive in a large health care system; this view focuses on the actual enactment of a new role in the practice setting. As JPN editor, I am very pleased to include these two contributions to the Journal, particularly as a way to begin a dialogue among our readers about the pros and cons of these ideas. As I have done in past editorials, I continue to invite you to write to me with your thoughts and ideas. In regard to these two articles specifically, I invite you to respond to what the authors have written.

Kathleen Long and Karen Drenkard have raised several salient issues that deserve discussion and debate, and the Journal is a perfect forum for this. One issue is how a new nursing role would be defined and differentiated from current nursing roles. Another is what the education preparation of this new nurse should be. Is a new licensure needed for this new role? What are the costs involved in developing and preparing this new nursing role? How many of these new nurses are needed, and where are they most likely to make a difference?

We certainly live in complex and challenging times, especially as we tackle the serious and often overwhelming problems in our health care system. As we address the specific issues noted above, we must also constantly keep in mind some provocative questions. How can we make constructive changes that are in the best interests of patients and meet the needs of our diverse nursing constituency? How do we honor the nurses who came before us and simultaneously look toward the future in which, inevitably, change must take place? What criteria should guide the changes that we make? Clearly, improving the quality and safety of patient care is an enormous priority, but what are the best approaches to achieving these outcomes? These are a few of the many questions with which we must grapple, distill, debate, and decide: a hefty, but most admirable task!

I thank both Kathleen Long and Karen Drenkard for providing their very thoughtful and informative articles and for encouraging the JPN readership to become involved in tackling the important issues raised in their articles. An effective way to move forward is to have a healthy debate about these ideas, with the goal of moving toward constructive change. In addition to encouraging you to write letters to the editor as a way of stimulating discussion, I also encourage you to send manuscripts for consideration for publication that address these issues or present other creative approaches in the clinical setting. If you have colleagues with whom you have opposing views about particular issues, it would be most interesting if you sent an article that contains a “point-counterpoint” discussion, in which you argue the opposing views. We could then have readers respond through commentary. So, please let me know your thoughts!

In discussing a potential new nursing role, it is also important to keep in mind all the exciting and creative aspects of our current broadly defined nursing role. One example of an exciting aspect of our role is how we can contribute to the media. Drs. Lynda Davidson and Lynn George have contributed a commentary piece for this issue of the Journal on their recent role in television: they were called on as nursing experts during a recent hepatitis outbreak in a community just outside Pittsburgh, Pennsylvania. This hepatitis outbreak made national news and created much anxiety in the general public. One way that health care providers can respond to the public’s anxiety is to provide accurate information. Drs. Davidson and George did just that on television news, presenting the facts and answering questions from viewers who called in to the program. I thank Drs. Davidson and George for giving us such an informative article that addresses an important role that we, as nurses, play in the public arena. I encourage any of you to share with the Journal interesting aspects of your own roles to add to a more comprehensive view of what we do as nurses and to show how we can be effective in diverse and creative ways.

In writing this editorial, I was struck with how complicated our work really is. Each of us may have a daily routine at work (though I’m not sure that’s even accurate because we all probably tackle the process of “multitasking” each day), but our work is anything but routine. Instead, we must be constantly alert to the world around us, to what is occurring in our immediate contexts as well as in the larger contexts of health care, of politics, and of global events. All of these contextual aspects influence our daily work, especially when our daily work is so consumed with trying to make this a better world for all of us. As we keep in mind this global purpose of making this a better world, we must focus on the specifics. For us right now in nursing, looking at a potential new nursing role provides a specific focus with its own complexities and challenges as well as potential for improving the current state of health and health care.