When someone asked Edward Everett Hale, the first chaplain of the United States Senate, if he prayed for the Senators, he said, “No sir. I look at the Senators and pray for the public!” And there are times when I feel the same about nursing, if for different reasons! Nurses and nursing have so much to offer – and our nursing organizations have stepped up to the plate and advocated successfully for both nurses and the public. But we nurses often speak with divided loyalties and fractured language (jargon). We bristle over words like training and medical when members of the public have no idea what our problem is. Sometimes I honestly believe that we have a death wish – or at the very least suffer from the Cinderella Syndrome. Well, it’s time to stop it!
Yes, all of you out there: listen up! Healthcare reform not only has passed; it contains a number of provisions that could offer unprecedented opportunities for nurses, if we are savvy enough to take advantage of them. For once, let’s not take our cues from what we hear from unhappy physicians and nervous hospital administrators. Certainly there are specific provisions for nurses (workforce initiatives, grants, increased reimbursement for advanced practice nurses, etc.). But also there are enormous opportunities for nurses in many of the other provisions.
It is also true that physician’s assistants and perhaps some other as-yet-to-be-invented midlevel practitioners could take advantage of these provisions. Undoubtedly some will, and I wish them well…but there is no doubt in my mind that nurses are ideally suited to do more for the public than any other single group. And we number in the millions if only we are open enough and smart enough to put forward the resources we have to help the public. To do so successfully we must understand and internalize:
1. The fact is that health reform is all about the public and the public’s access to healthcare services. It is not about reimbursement for doctors (or nurses for that matter). It is not about profit (or margin for the not-for-profits), politics, or market share.
2. Nurses have certainly “walked the walk” but we rarely “talk the talk”…Everything we propose and everything we are involved in must be seen in light of what the public wants and needs, and spoken of in terms the public not only understands, but also resonates with…
3. We are entering a period of rapid and chaotic change: be an active part of it. Enthusiastically volunteer for innovative programs; participate in the “medical home;” be part of the “hospital-at-home” projects; help design “accountable care organizations.” Don’t cling to the old ways –create new ways (and don’t worry about what they are called).
4. Help nursing’s leaders develop an “elevator” definition of what nurses have to offer, why nurses are a good choice, and just how diverse we nurses are. And we have to be able to say it in two minutes or less using ordinary words that ordinary people understand. This is critically important! If you have any ideas – please share them here – and now!