We've Come a Long Way Baby… Or Have We?
Article Outline
Our profession has made great strides in contributing to the health of the public and to furthering and advancing our own profession. A recent American Association of Colleges of Nursing (AACN, 2007) fact sheet indicates that nursing comprises the largest group of health care professions and that more than half of all health professional students in the United States are nursing students. Although an ongoing shortage of nurses is projected, at the same time, the nursing profession has experienced one of the largest job growths. Hence, is it accurate to say that we have come a long way?
Yes, we definitely have made great strides and achieved many successes for our society's health and health care and for recognition of our professional strengths. Yet, do we have more to do? Absolutely! We continue to be confronted with many misconceptions and inaccurate stereotypes. I am struck by two examples that I noticed recently, both found in the newspapers.
The first example was found in the employment section of a newspaper. There was a large section devoted to employment opportunities for health care professionals. Many positions were listed for registered nurses. There also was a section for advanced practice nurses, but instead of referring to that section as advanced practice opportunities for nurses, the newspaper listed these positions under the category titled “physician extenders.” What exactly is meant by “physician extenders?” Advanced practice nurses practice under their own licenses and collaborate with physicians as well as with other health care providers. “Physician extenders” is not an appropriate phrase to describe these nurses!
The other example was found in the newspaper's crossword puzzle, where a clue was listed as “ICU helpers” and the “correct” answer was RNs. In this case, what exactly is meant by “helper?” Like advanced practice nurses, nurses in the intensive care unit (ICU) have specialized knowledge and skills, and they practice under their own licenses, delivering expert care to their patients. They collaborate with physicians as well as with other health care providers. Although it is certainly not negative or demeaning to be a helper, the term “helper” does not accurately represent the independent and collaborative work of ICU nurses!
Both of these examples are disturbing evidence that, although we may have come a long way, we have certainly not come far enough. We continue to be challenged to overcome stereotypes of being passive assistants to physicians. We continue to be challenged to transcend such stereotypes and assert our own professional nursing identity as an integral part of the health care system.
The AACN Nursing Fact Sheet provides data to clear up misconceptions that have led to these negative stereotypes. It would behoove us all to become familiar with these data so that we can represent to the public an accurate portrait of who we are as health care professionals. One important fact noted on this sheet is that nurses work collaboratively rather than as “assistants.” The fact sheet states, “Nursing operates independent of, not auxiliary to, medicine and other disciplines. Nurses' roles range from direct patient care and case management to establishing nursing practice standards, developing quality assurance procedures, and directing complex nursing care systems” (http://www.aacn.nche.edu/Media/FactSheets/nursfact.htm).
Thus, although we, as nurses, may be clear on our roles, how do we overcome this passive stereotype? And, importantly, how do we continue to focus on improving the health care system and the health of the public while simultaneously needing to focus on our own professional identity? I think that we have struggled with this challenge for decades and that we continue to make important strides. It seems, however, that there always will be people who lack an understanding about nursing and nursing care. Sometimes, in fact, nursing is invisible—seen as part of the infrastructure of the hospital. How do we, then, overcome this lack of understanding?
Perhaps one of the best ways to overcome this challenge is to continue to do the work that we are doing: the novel clinical practice approaches we have developed, the strong research that has led to strong evidence-based practice, the innovative educational approaches. We probably simply need to keep doing our work with a focus on continually improving what we do and being more responsive to the needs of the public. At the same time, we probably need to point out instances where we are made aware of the ongoing misconceptions about nursing. For example, perhaps it would be a good idea to write a letter to the editor of a local newspaper, explaining that “physician extenders” is not an appropriate category for nurses. Perhaps it would be a good idea to write to the author of the crossword puzzle to point out that RNs are not “helpers” in the ICU.
In summary, I see our work in this regard on two simultaneous fronts. One front involves continuing to do our excellent work as nurses in all our various arenas, including education, research, clinical practice, public policy, political activism, and leadership. The other front involves maintaining our voices by not being silent when we become aware of misconceptions. We need to point out the errors and present the facts. Isn't that what evidence-based practice is all about? We need to present the evidence for our strong profession. We need the data to present such evidence. The AACN Nursing Fact Sheet is one example of such data. We need to continue to develop such fact sheets and to share them with our colleagues. With our strong voices and our passion for our work, we can make a difference in the health of the public and in the public's view of nursing as a profession.
Reference
- . http://www.aacn.nche.edu/Media/FactSheets/nursfact.htmMarch 2007;[retrieved 4/07]
PII: S8755-7223(07)00101-9
doi:10.1016/j.profnurs.2007.04.001
© 2007 Elsevier Inc. All rights reserved.
