The 2020 election is underway, and many candidates are discussing increased access to health care on the campaign trail. Whether they’re focused on securing the future of the Affordable Care Act, expanding Medicare or designing single-payer or universal health care systems, they’ll need high quality nurses at every level—yet our voices are largely missing in the media and in the midst of their debates.
There are over 3.5 million nurses in the U.S.; all told, we count for 57 percent of healthcare professionals. And yet, nurses are quoted and called upon as sources on health care in the media only two percent of the time—down from four percent 20 years ago. According to the Center for Health Policy and Media engagement, journalists don’t understand the extent of nurses’ roles, work and education.
Apparently, our employers don’t either. The U.S. Bureau of Labor Statistics show that current and projected nursing shortages will impact health policy that expands access to care. New research from New York University published in the Journal of Advanced Nursing found that most nurses are overworked; of the 4,500 nurses in 13 states who participated in the study, nearly half work voluntary overtime (in addition to 12-hour shifts) and 13 percent hold a second job.
My father was a physician, and my mother was a registered nurse. I grew up exposed to the greatness of both of these professions, and when I decided to pursue nursing, I was well informed on my path. Nearly 20 years later, I am often asked by young college students aspiring to health care professions why they should choose nursing.
The cultural image of nursing is steeped in patriarchy and outdated stereotypes. Because nursing is a female-dominated profession, and nurses are thusly seen as caring, helpful—and subservient. The “good nurse” is there to assist the physician and care for the patient. Her role is defined by others, and often invisible. Television shows from “Julia” to “Grey’s Anatomy” often show nurses as background assistants who contribute little in the health care setting. In too many plot lines, mistaking physicians for nurses even serves as an insult.
This historical image betrays the true profession.
I recently saw a 27-year-old patient presenting with a painful ear. She told me that her ear had been hurting when she made her appointment but had started to get better. I listened to her story and examined her. Her ear was fine—but her hands were contracted. When I had her walk to the exam table, I noticed an odd gait. That was when I learned about her fractured care and missed opportunities. I ultimately reached out to a neurologist colleague to discuss the patient and my findings; he and I worked together to track down old medical records and determine that her maladies had nothing to do with her painful ear. She was suffering from an inherited polyneuropathy—a diagnosis she had yet to receive before she came to me.
Nursing is an evolving field that seeks to collaborate and innovate in health care. Nurses have spent countless hours caring for patients. We know a thing or two about health care. This is evident in the expanding roles of nurses, the growing field of nurse research and goals for nurses on decision-making panels. But confusion about our roles persists.
A wide range of nursing roles fall under the general term—from the Licensed Practical Nurse, an associate degree role that allows this level of nurse to provide basic healthcare needs under the supervision of a Registered Nurse; to the Registered Nurse, often a baccalaureate degree prepared for the delivery of complex critical care; to the Advanced Practice Registered Nurse, a masters or doctoral degree preparing the nurse for the delivery of advanced primary care, preventative care and specialty care.
Everyone should be informed on the essential role nurses play in all forms of healthcare. The Robert Wood Johnson Foundation in 2017 declared that nurses were a catalyst for change in improving the public’s health. Nurses have been identified by the Institute of Medicine as a key part of the future of health care. Most of today’s Registered Nurses have Baccalaureate degrees, many with Masters and Doctorates. Nurses are providing primary care and hospital-based specialty care, conducting NIH grant funded research and serving as congressional representatives.
Our limited collective understanding of nurses undermines the profession. Many times, I have heard from well-meaning family and friends: “You are so smart! You could be a doctor!” To be sure, there are some who would argue that ambitious nurses should go off to medical school rather than becoming Nurse Practitioners, Nurse Midwives and Nurse Anesthetists. But these arguments miss the mark.
Nurses actually like being nurses. And we can be so much more than old dogma would say.
The person who weighs my child, takes his blood pressure and asks us about medication changes when my family goes to the pediatrician is no longer a nurse—that person is a medical assistant. When I hear from my child’s school that he has fallen and needs stitches, I don’t pick him up from the school nurse—I find him instead in the office of the school health clerk. When I go to a pharmacy and receive my flu shot, it’s not administered by a nurse—instead, I’m served by a pharmacist.
But at the pediatrician’s office, my child may only be seen by the Nurse Practitioner. And when I delivered my children, the person adjusting my Pitocin and telling me when to push was a Certified Nurse Midwife. Groundbreaking research on reducing HIV risk was recently done by a Nurse Researcher. Lauren Underwood, the freshman Congressional representative for Illinois’ 14th District, is a Public Health Nurse.
It’s time to consider nursing in a new light—on the campaign trail and in our culture at-large.