What do nurses actually do?

I love this quote by Donna Wilk Cardillo . . .

Thoughts like these are changing how the world sees us as nurses. And believe me, it needs to change.

Strong and compassionate, yet tired.

Intelligent and maintaining the health of the planet, yet it's not for everyone.

I am drawn to content that breaks labels and reframes ideas. I love thoughts that challenge the norm and perspectives that make us uncomfortable. That's why I'm starting Rethinking Nursing, a newsletter about examining the controversies in nursing, whether we find common ground or not. It's about inspecting all of the issues--from abortion issues and opioid abuse to anti-vaccine pushers and non-compliant patients--from a nursing perspective.

Unfortunately, most people don't even know what a nurse does. Seems like a great place to start the conversation.

What does a nurse do?

Imagine for a moment that you're at home. The phone rings and a sweet voice asks, "We're doing a survey about nurses and need to ask you one simple question: do you know what nurses do? Yes or no?"

If you're like most of the world, the majority of people won’t know what it is that nurses actually do. It’s not the public’s fault. Nurses have been quiet about it for too long.

I’ve been a nurse for over 20 years and none of us expect non-nurses to understand the scope of nursing practice from which we unwind our magic every day.

But when television and media — (cough) a medical drama?Nurses?from a few years ago— portray my incredible profession as unfriendly, incompetent, and poorly trained, it’s time to spread the word: that is not who we are!

I cannot sit by while those who are not nurses — television networks, writers, actors/actresses — create pathetic portrayals of my profession.

So I’m here to clear up the confusion. For the record, nurses include licensed practical nurses, registered nurses, and advanced practice nurses, each with their own educational requirements and scope of practice.

Every nurse should be able to provide solid reasons to back up their professional existence. I’ll go first.

Nursing is a Profession

Nursing is a proud profession with a long history. Unfortunately,?most people don’t know that nursing is a profession, in and of itself.

Professions are distinguished by certain characteristics such as autonomy of practice, formal education requirements, adherence to an established code of ethics, expansion of professional knowledge, and the common culture and values surrounding its members.

The?National Council of State Boards of Nursing?is the regulating body whose U.S. members include the state boards of nursing from all 50 states, the District of Columbia, and four U.S. territories. Self-regulation is another characteristic of a profession.

We are not doctor’s helpers. We have our own set of nursing diagnoses, treatments, and professional knowledge base from which we practice nursing. We have our own specialties with corresponding advanced education that contribute to our strong professional identity.

Our profession is competent and knowledgeable, and we detest comments like?“You’re so smart, you should have been a doctor.”?This insult is proof that nurses are failing to educate the public about who we are.

Hospitals are Nursing Institutions

People aren’t admitted to hospitals unless they need nursing care. In addition, practitioners within those hospitals cannot provide medical care without nurses. Nurses make up?30% of hospital personnel. That’s about 1.8 million jobs as of May 2019.

The media often discuss healthcare workers as “doctors and staff” but this terminology misses the one thing that makes nurses distinct:?nurses are the one group that is indispensable to hospitals.

Nurses Aren’t Cute and Lovable or Incompetent and Untrained

For too long, nursing has been touted as a virtuous profession in which caring and goodness stand as the pillars that direct our actions. And don’t even get me started about how ridiculous perceptions of baby angle nurse figurines or “naughty” nurse Halloween costumes have diluted and poisoned nursing’s public image.

It’s nursing knowledge, not nursing virtues, that make the difference in this profession.

--Julie Nyhus MSN, FNP-BC

The discipline of nursing consists of a body of nursing knowledge that draws from various philosophies, research, theories, ethics, and aesthetics (Smith & McCarthy, 2010).

Yes, strength, commitment, and compassion are part of the professional robe we don, but nursing practice is erected solidly on five discrete nursing knowledge types: empiric, personal, aesthetic, ethical, and emancipatory.

Regardless of which nursing theory, philosophy, or dogma I use to describe nursing to non-nurses, these abstract concepts only cloud the issue.

So, here’s an incomplete list of what nurses actually do.

What Nurses Do

Nurses work with high-tech, complex equipment, and toxic medications.

Nurses exercise critical thinking skills commensurate with their diverse specialties and educational levels.

Nurses contribute to academia, physical and social sciences, law, psychology, medicine, sociology, business, social work, and communications.

Nurses make snap decisions in life-and-death situations.

Nurses study pharmacology, anatomy, pathophysiology, and ethics.

Nurses contribute to medical cures and medical diagnoses.

Nurses create innovative ideas, processes, products, and procedures.

Nurses use physical assessment skills to deliver holistic care.

Nurses save money and lives.

Nurses administer medications and treatments.

Nurses study psychology and communication.

Nurses lessen suffering and rescue people from preventable complications.

Nurses play critical roles in patient safety.

Nurses teach, advise, and educate.

Nurses prevent medical errors and costly complications.

Nurses advocate and intervene for patients.

Nurses practice from a foundation of evidence-based knowledge.

Nurses work with vulnerable humans who are anxious, frightened, irritable, and sometimes angry.

Nurses help those people survive and thrive.

Nurses are valued as the?most trusted profession in the United States?for the 20th year running.

Nursing Care is?Consequential

Nurses appreciate the gratitude and trust, we do. But allowing the media to fictionalize nursing has only allowed us to remain misunderstood. It’s wonderful that we are trustworthy, but it benefits no one if what we actually do remains disconnected from those who trust us.

It’s not our patient’s fault. It’s not the public’s fault. It’s not even the media’s fault that nursing has been sentimentalized beyond recognition.

Our unique education and credentials belong to our profession alone. So it is our responsibility to spread the word about who we are and what we do. And, as a group, we can no longer afford to support our profession on the shaky stilts of trust and compassion alone.

We will never boost our professional status when it’s associated with ridiculous medical dramas or organizations that have their own agendas such as Johnson & Johnson or the DAISY Foundation.

Most people, even nurses, think these entities are advancing the profession but, with all their ‘honoring’ and ‘saluting,’ they’re downplaying the nursing standards and practices that make us a profession. Their focus on compassion mitigates the vast body of nursing knowledge that underlies our professionalism.

To raise the status of our profession, we have a legacy of clinical knowledge and skills at our disposal, and it’s time we used it. It’s our responsibility to push past the simplistic care narrative that surrounds us.

It’s our job to let the masses know that what nurses do every day

does not “come naturally.”

What we do is the product of education, instruction, self-mastery, expertise, experience, and, at times,

absolute grit.

---Julie Nyhus MSN, FNP-BC

Nursing is?consequential,?not because nurses care but because of what nurses know.

In peace and love,

Subscribe to Rethinking Nursing. Reflecting on dynamite-infused issues through the lens of the nursing profession is crucial and inside our profession is the safest place to have these hard conversations.

Who am I?

I'm a nurse writer living the daily rush of being a nurse practitioner. I believe that nursing is the greatest profession on earth, that hard work wins out over luck every single day, and that giving back is the only way we receive. I live in gorgeous Northwestern Indian, just 5 minutes from Lake Michigan, with my husband and Bernese Mountain dog. When I'm not crafting words for my novel, various newsletters, or nursing journals, I spend time biking, knitting, and playing saxophone with our band, The Hip Replacements, (the hubby plays drums and sings).

Find me on Medium @nyhusjulie or Twitter @JoolzFNP.

Visit my blog www.NPRush.com.

References

Smith M, McCarthy M.P. Disciplinary knowledge in nursing education: Going beyond the blueprints. Nursing Outlook. 2010;58(1):44–51.?https://dx.doi.org/10.1016/j.outlook.2009.09.002