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Making history: When nursing succeeds, health care succeeds


Laurel Thatcher Ulrich, the 1991 Pulitzer Prize–winning historian and Harvard professor, wrote about notable women in early American and world history. She also brought to light the work of ordinary people. In an early publication about Puritan funeral services, she remarked that “well-behaved women seldom make history,” reflecting the sense of duty among Puritan women—and noted that mourners came to know the richness of their lives after hearing their eulogies.

In an unexpected twist, the phrase “Well-behaved women seldom make history” was adopted as a clarion call to encourage women to break from tradition and rebel against authority. This slogan has appeared on bumper stickers, T-shirts, and other paraphernalia. Although rarely attributed to Ulrich, its impact has been profound—demanding respect for the voice of women.

Throughout nursing’s history, the collective voice of nurses—women’s and men’s alike—at times has been overshadowed by the voices of others. Nurse author and educator Jo Ann Ashley (d. 1980) rebuked hospitals and physicians for their exploitation and
oppression of nurses in her classic work Hospitals, Paternalism, and the Role of the Nurse. Only through educational reforms, professionalization, and climbing the ladder of paid work have nurses altered the relationships of power and inequality that perpetuated the hierarchies of social culture in health care.

With the goal of improving health care, the Institute of Medicine (IOM) and the Robert Wood Johnson Foundation (RWJF) created the RWJF Initiative on the Future of Nursing at the IOM. The initiative seeks to enable nursing to transform itself into a more effectual force to lead the improvement of healthcare delivery, enhancing the quality and value of health care. On November 30 and December 1, 2010, nursing leaders assembled with other colleagues to make history. They gathered to fortify collaborative efforts to help build a better future for nursing so that in turn, the promise of advancing health through nursing would become a shared future. They pledged support to the initiative’s “Campaign for Action” to implement the recommendations from the initiative’s report, The Future of Nursing: Leading Change, Advancing Health. The group pledged not only to take action on the recommendations, but to ensure the actions are synchronous and synergistic to achieve the inspired direction. Society owns the report; nurses are the primary actors and leaders focused on moving together with partners to create lasting change.

Given that regional action coalitions, professional organizations, healthcare organizations, affinity groups, numer­ous articles, and word of mouth have spread the message about the initiative’s recommendations, I hope you are able to recite the four key messages embodied in the report by now:

  • Nurses should practice to the full extent of their education and training.
  • Nurses should achieve higher levels of education through an improved educational system that promotes seamless academic progression.
  • Nurses should be full partners, with physicians and other healthcare professionals, in redesigning health care in the United States.
  • Effective workforce planning and policy making require better data collection and an improved information infrastructure.

Taking action isn’t about arguing over the past. It’s about partnering for the future—a preferred future for the health of our nation. The 43 report recommendations detail actions for Congress, state legislatures, federal agencies, professional associations, and individual nurses that will transform nursing and rally the nation to build the will to create large-scale changes in healthcare delivery.

It won’t be easy. As we deliberate over how to advance our profession in a time of national economic strife, controversy about the future of healthcare delivery, and long-standing internal disharmony, what better group to rally a nation than more than 3 million of the most trusted professionals? Take a moment to reflect on this year’s National Nurses Week theme, Nurses Trusted to Care. Think about what commitment you’re making to lead change and advance health.

Join or start an action group in the Campaign for Action (www.thefutureofnursing.org). Celebrate the knowledge and skills that allow you to make a difference in someone’s health. Take pride in knowing nurses are leading quality efforts believed to represent the keys to better care. Renew your commitment to lifelong learning. Speak up to influence policy decisions about how nurses practice and how they’re rewarded. The public trusts you, trusts your voice, and needs you to help make history.

Pamela F. Cipriano, PhD, RN, FAAN, NEA-BC



  • The Campaing is doing a wonderful job!
    All Nurses shoudl embrace this!


  • What an encouragement to see Nurses standing united in health care and for each other, for a better tomorrow, for everyone. I appreciate the Campaign for Action. I am looking forward to the information that will be shared there. Thank You.

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