Nursing would be a dream job if there were no doctors - Gerhard Kocher
Last year, the New York Times published an article by Dhruv Khullar, an ER physician. The premise was that thoughtful communication with patients improves care and leads to better outcomes. Khullar writes with compassion, and makes a strong point for "letting patients tell their stories" (the article's title) and viewing patients holistically rather than merely as individuals with diseases. It had the workings of a promising article, but I was left rolling my eyes.
Let me be clear: I am always happy to read about healthcare providers advocating patient-centered approaches. In this age of bionic eyeballs and fecal transplants, reminders of our basic humanity are certainly welcome. But here's the rub: what Khullar is describing isn't a novel technique. What Khullar is describing (and is lauded for in the comments section) is basic nursing practice.
Was Khullar inspired by the nursing model of care? I carefully reread to make sure I didn't miss something. Any stories about a nurse colleague who influenced him? Any mention of how nursing and medicine differ, and how nurses, who are often viewed (incorrectly and patronizingly), as "doctors' little helpers" might actually be onto something? To my dismay (although not my surprise), he omits any meaningful mention of nursing or where the discovery that viewing patients as humans could be important might have come from.
Nursing practice is based in holistic, person-centered care that views patients as people with complex lives, rather than the embodiment of an illness. A "diabetic" isn't reduced to that cold, hard word. Rather we nurses think of our diabetic patients as people—as a person, say, with a family, a job, and three dogs who likes to go orienteering on the weekends and also happens to have diabetes. This is an important distinction because a) generally people don't like being viewed as diseases, and b) if a person cannot fit the treatment that's suggested into their lives, it doesn't matter how impressive the treatment is, they aren't going to benefit from it.
Nurses working in traditional hospital settings are assigned between two and five patients per shift, depending on specialty, and spend significantly more time with patients than other providers at the hospital do. Talking to patients, watching their progress, and hearing their stories are vital parts of a nurse's role. Important subtleties in a patient's condition or details about their lives are almost always picked up by nurses, as they are the ones who get to know the patient best. Nurses who choose to continue their education and become nurse practitioners (NPs) are educated to diagnose and treat conditions and bring this holistic view of individuals to their care. This is one of the attributes that makes NP practice unique and the reason that I decided to pursue it.
Despite its unique perspective, nursing is undervalued and misunderstood. The profession is often sexualized (ask a nurse if they have been sexually harassed on the job; the answer will likely be yes) and our intelligence overlooked. I have been asked if I was forced to choose nursing because I couldn't get into medical school (I didn't apply). Nurse scientists produce extremely important healthcare research (here are just a few examples), yet few people know anything about it, even when it directly improves their health. (To be fair, nursing does not do the best job promoting its research, but I also believe that the failure to view nursing as an academic discipline and a science also contributes to this lack of visibility.)
As with many societal ills, I suspect that we can partly thank misogyny for this. Even as male-identified students are now in the minority in some medical schools, medicine is still viewed as a "male" profession and nursing a "female" one, and I believe that this contributes to nursing's devaluation in relation to medicine. In her book Has Feminism Changed Science?, Londa Schiebinger refers to nursing, a profession that she cites as welcoming for women, as "soft science." Yet the aspects of nursing that are seen as "soft" (person-centered care, patient advocacy, and "letting patients tell their stories"), are now being celebrated by physicians as novel strategies and even being repackaged with a new name: narrative medicine.
In the article Narrative Medicine: A Model for Empathy, Reflection, Profession, and Trust, Rita Charon defines narrative medicine as "the ability to acknowledge, absorb, interpret, and act on the stories and plights of others." Charon states that "despite medicine's recent dazzling technological progress in diagnosing and treating illnesses, physicians sometimes lack the capacities to recognize the plights of their patients, to extend empathy toward those who suffer, and to join honestly and courageously with patients in their illnesses." Charon mentions nursing, but she lists it with other professions that have "recently realized the importance of narrative knowledge." A more factually appropriate shout-out would have been to acknowledge that the principles bolstering "narrative medicine" have been nursing's main tenets for quite some time.
Does medicine truly not realize that it is describing nursing's essence or does it not want to admit that it might learn something from nursing? Physicians are obviously a vital part of our healthcare system; I have never met a nurse who would deny that. And yet, the importance of nursing is often ignored at the expense of both nurses and patients.
Recent attempts by hospitals in several European countries to cut costs have resulted in the partial replacement of registered nurses with "nursing associates"; individuals with lower levels of training than RNs. Unfortunately, this might not be the best way to save money. Research conducted by Linda Aiken at University of Pennsylvania found that the replacement of an RN with a lower-skilled worker might put patients' lives in jeopardy. More specifically, the researchers state: "Substituting one nurse associate for a professional nurse for every 25 patients is associated with a 21 percent increase in the odds of dying." This rather horrifying statistic is a warning of what happens to the quality of healthcare when nurses are undervalued. I suggest that we give nursing its due, recognize its strengths and unique perspectives, and stop trying to undercut its worth. We'll all be patients someday and we'll be lucky to have RNs taking care of us.
Source: Shoshi Violette Aronowitz, What Does Good Medicine Look Like? Ask a Nurse, Tonic, January 10, 2017.
In what looks like an urgent game of catch-up, medical and nursing schools across the country are retooling how and what they teach. This is also getting a boost from concern about the looming shortage of primary caregivers.
Nursing is no paragon of gender equality: Even though men are a minority, they are paid more than women. The stigma against men still runs deep, particularly among older patients and in parts of the country with more traditional gender roles, nurses said.
Right now, there is a baby nurse who is searching online and deep inside for an answer. There is a brand new member of the profession who is questioning her calling. There is a newly-minted graduate who wonders how school seemed to teach her everything and nothing all at the same time. There is a greener-than-grass new hire who is praying that she doesn’t kill somebody at work tomorrow, and wonders if she already did yesterday.
Today’s nurses aren’t just caring for the sick; they’re changing our very notion of modern medicine and health care delivery. Nurses are giving TED talks, publishing scientific research, developing mobile medical applications, and actively addressing health care policy.
A family’s rapport with the nursing staff can improve the care a patient receives; tips for cultivating the relationship that go beyond baking brownies.
The best way to appreciate nurses during Nurses Week is to support legislation that would help them better care for their patients.
After years of relative equilibrium, the job market for nurses is heating up in many markets, driving up wages and sign-on bonuses for the nation’s fifth-largest occupation.
In fact, they've been doing scientific research since the days of Florence Nightingale.
Hospitals are freeing up nurses to do the one thing they often don't have enough time for: taking care of patients.
We nurses need to come together as a profession so we can use our collective power to benefit our reason for being — our patients.
We exist in a world where we cannot help but feel thankful, for we are not the ones confined to the bed or strapped to a ventilator or tethered to an artificial heart or kidney or lung. We work in a place where tube feeds replace turkey; where sepsis trumps stuffing; where we battle broken hearts and downtrodden spirits instead of afternoon naps and football snaps.
A path to a “second act” almost invariably involves setbacks. But Rachel Christian’s five-year journey to become a nurse is proof that even the largest of hurdles can be cleared.
The country has experienced nursing shortages for decades, but an aging population means the problem is about to get much worse.
The combination of an exodus of RNs and an influx of aging patients could create a health care crisis.
Nurses do the work that neither hospitals nor patients could live without, which comes at an ever-increasing physical and emotional cost, as they are expected to aid sicker patients for longer hours with less support.
Sitcoms satirize them, the media ignore them, doctors won't listen to them, and now hospitals are laying them off, sacrificing them to corporate medicine -- yet their contribution to patients and families is beyond price.
Our comfort zone is nurturing patients and serving as the foils to their fear. When we step out of it and into a position of fear ourselves, we lose our way. Some a little more than others. And some not at all.
Despite our major role in keeping patients healthy, nursing is undervalued and misunderstood.
If you are interested in becoming a Registered Nurse, one of the things you need to know is where you can go for information and for help. Thanks to technology, you can get access to pretty much any information you would like online. The Internet offers access to medical libraries and informational sites, as well as to case studies that can help you learn. It is also possible to find sample care plans online.
The career and education resource for minority nursing professionals, students and faculty.
Welcome to the Nursing Times website, for nursing jobs, NHS jobs, nursing news, nursing careers, clinical articles, nurse jobs, nursing courses, and nurse prescribing.
Scrubs is not just another clinical nursing site…there are plenty of those! Scrubs is the one and only site that’s 100 percent about you – personally and professionally – and the very specific joys and challenges you face because of the noble career you chose.
The largest most active online nursing community. Join 272,783 nurses from around the world to learn, communicate, and network.
Applied Nursing Research works with nursing professionals across the globe to gather the latest healthcare analysis, fieldwork & insights. With over 35 years of experience in the field, we've become the premier source for academics, healthcare professionals & patients.
ExceptionalNurse.com is a nonprofit 501 (c) 3 resource network committed to inclusion of more people with disabilities in the nursing profession. By sharing information and resources, ExceptionalNurse.com hopes to facilitate inclusion of students with disabilities in nursing education programs and foster resilience and continued practice for nurses who are, or become, disabled.
NurseBuff is a popular nursing humor and lifestyle blog.
Website features industry news, products and a newsletter in addition to other resources pertinent to the nursing industry.
LeeAnn Sandberg - Nursing Student @ University of Penn
Created by nurses, for nurses, Lippincott's NursingCenter.com is the premier destination site for your clinical and professional informational needs. We are committed to providing credible, current, authoritative, evidence-based resources to help you in your practice.
and many more specialty journals.
A more efficient way to find nursing license requirements in your state.
Nursys® provides online verification to a nurse requesting to practice in another state and nurse license lookup reports to employers and the general public.
RN.com has been serving the nursing community since February 2000, and has become the industry's leading nursing resource provider. Founded by health care providers, we are dedicated to providing both our customers and clients with the highest level of customer service.
Working Nurse is a monthly magazine and website that delivers career advice and opportunities to Southern California RNs. We focus on the career of being a nurse. Our jobs are local. Our content is inspiring and useful – from interviews with nurses about their specialties to profiles of extraordinary historical nurses to advice from nursing leaders. Our mission is to be an effective career resource for the RNs of Southern California.
The American Nurses Association (ANA) is the only full-service professional organization representing the interests of the nation's 3.1 million registered nurses through its constituent and state nurses associations and its organizational affiliates.
Direct links to major nursing sites, including the world's busiest.
Dental Nursing is the only monthly journal dedicated solely to addressing the clinical and professional issues relevant to dental nurses. All perspectives are covered, and our distinguished editorial board guarantees that only pertinent, high-quality articles are selected for publication each month.
Welcome to the National Institute of Nursing Research. We are dedicated to improving the health and health care of Americans through the funding of nursing research and research training. Our mission is to promote and improve the health of individuals, families, communities, and populations.
National Nurses United, with close to 185,000 members in every state, is the largest union and professional association of registered nurses in U.S. history.
NNU was founded in 2009 unifying three of the most active, progressive organizations in the U.S.–and the major voices of unionized nurses–in the California Nurses Association/National Nurses Organizing Committee, United American Nurses, and Massachusetts Nurses Association.
The Online Journal of Nursing Informatics (OJNI) is a professional, refereed, electronic journal for healthcare professionals who are interested in nursing informatics. Topical areas covered deal with the theoretical and practical aspects of nursing informatics as it relates to the art of nursing.
The National Nursing Network Organization.