Imagine a World Without Nurses

J.Adderton, BSN, MSN

Quote

“The nurse is temporarily the consciousness of the unconscious, the love of life of the suicidal, the leg of the amputee, the eyes of the newly blind, a means of locomotion for the newborn, knowledge and confidence for the young mother, a voice for those too weak to speak, and so on”.

- Virginia Henderson (nurse, researcher, theorist and author)

Have you ever tried to imagine what the modern world would be like without the nursing profession? Nurses play a continuous role in the life of a single patient, a family, a community, a region, nationally and worldwide. How would our most vulnerable populations navigate the always changing and complex healthcare system to receive necessary care? In 2018, the Gallup poll ranked nursing as the most trusted and ethical profession for the sixteenth consecutive year. Nurses are a trusted constant in healthcare. Nursing also has a long history of contributions to the health, social and economic wellbeing of the populations they serve. In order to imagine a world without nurses, it first necessary to recognize just how important many contributions the nursing profession has made to society.

Contribution: Communication

Quote

“Nursing encompasses an art, a humanistic orientation, a feeling for the value of the individual, and an intuitive sense of ethics, and of the appropriateness of action taken.”

- Myrtle Aydelotte (nurse, professor, and hospital administrator)

The nursing process is a scientific method for the implementation of nursing care. However, interpersonal skills and communication is also a vital element of nursing practice. Nurses’ ability to communicate with patients is just as important to successful outcomes as technical ability. Effective communication is a contribution made by the nursing profession that promotes care ranging from individual care to healthcare policy. Nurses contribute by truly listening to the needs, fears, concerns, thoughts, and feelings of others. Maintaining good personal relationships allow the nurse to ask questions in a way that does not judge or scare, but rather, promote trust and acceptance. It is a true gift when nurses connect with individuals of all cultural and socioeconomic backgrounds with the same level of sincerity.

Contribution: Collaboration and Coordination

Quote

“In proportion as my own discomfort has increased, my conviction of necessity to search into the wants of the friendless and afflicted has deepened. If I am cold, they too are cold; if I am weary, they are distressed; If I am alone, they are abandoned.”

- Dorothea Dix (author, teacher, and reformer)

The nursing profession is unique in providing continuity of care from hospital to home and all other settings of healthcare. Nurses are a “constant” in healthcare and participate in care from birth to end of life. The collaboration and coordination of healthcare services is an important contribution of modern nursing. Nurses collaborate and work together with other disciplines to provide the best care to patients. Nursing curriculum incorporates the required education, scope of practice and areas of expertise in other disciplines. Nurses advocate for their patients by using the resources and knowledge provided by disciplines outside of nursing.

Current healthcare trends bring added challenges to care coordination and it is easy to imagine chaos without the influence of nurses. It is not difficult to identify the unique contribution the nursing profession will bring to these real-time healthcare trends:

Addressing the opioid crisis
Importance of the patient experience in a value-based payment system
Changing nursing workforce (generational communication challenges, borderless nursing)
Rising cost of specialty drugs
Technological advances- wearable sensors and biometric garments

These trends represent only a small sample of constant change within healthcare. Nurses will consistently advocate for education, access to resources, collaboration and continuous improvement to improve individual health in today’s healthcare environment.

Contribution: Explanation

Quote

“Apprehension, uncertainty, waiting, expectation, fear of surprise, do a patient more harm than any exertion”

- Florence Nightingale (founder of modern nursing)

Anxiety and fear are common in any setting where someone is receiving healthcare. First, there is the fear of medical assessments, diagnosis, and treatment. Fear and anxiety have negative health consequences as well as negative patient experiences. The “white coat” phenomenon is an example of interaction with a healthcare setting or providers increases a person's blood pressure above their baseline. Hospitalized patients experience restrictions placed on their personal freedom, mobility, and choice. In a world without nurses, patient fear and discomfort would contribute to negative physical and emotional outcomes. Nurses reduce the “fear of the unknown” through explanation and education. With respect and empathy, nurses are in a unique position to reduce patient fear and discomfort through anticipatory guidance.

Contribution: Education

Quote

“Nursing’s story is a magnificent epic of service to mankind. It is about people: how they are born, and live and die; in health and in sickness; in joy and in sorrow. It's mission is the translation of knowledge into human service. Nursing is a compassionate concern for human beings. It is the heart that understands and the hand that soothes. it is the intellect that synthesizes many learnings into meaningful administrations.”

-Professor Martha Rogers

Nursing as a profession has a clear pathway for nursing education. There have been many historical nursing figures to contribute to the knowledge and skill of nursing. In 1874, Linda Richards became the first trained nurse and eventually became the superintendent of Boston Training School. Lavinia Dock (1890) published the first manual of drugs for nursing and in 1978 Bertha Harmer published the first scholarly nursing textbook, Principles and Practice of Nursing. Over the years, nursing education has provided students with standardized programs of study. As a result nursing students enter the profession with the practical knowledge to deliver safe and effective care. It would be difficult for nurses to contribute to a growing a body of skill and knowledge without the desire for continued professional and educational development.

Contribution: Empathy

Quote

“As a nurse, we have the opportunity to heal the heart, mind, soul, and body of our patients, their families and ourselves. They may forget your name, but they will never forget how you made them feel”.

– Maya Angelou (American poet)

Empathy does not always come naturally to all nurses. The ability to put themselves in another’s shoes by seeing situations from another’s perspective is developed with life experience. Nurses play an important role in listening to patients and families and validating their experience. Without nurses modeling empathetic behaviors, the art of connecting those receiving care would be diminished. Nurses also model the ability to relieve suffering through compassion. The ability to show kindness, caring and willingness to help others is one of nursing’s greatest contributions.

Final Thoughts

Quote

“Unless we are making progress in our nursing every year, every month, every week, take my word for it- we are going back.”

- Florence Nightingale, (founder of modern nursing)

This article speaks to only a few of the many invaluable contributions nurses have made and continue to make in healthcare today. Nurses are a constant in the delivery of care from birth through end of life. Nurses have a unique opportunity to advocate for access and equality of healthcare by involvement in the legislative process. The profession of nursing makes progress every day and without a world of nursing, we would move backward in the health of individuals, communities and the world. Without nurses at the helm, navigating healthcare would be much like a ship in stormy waters without a lighthouse.

References:

Steadman, L. and Milligan, G. (2019). Is nursing a profession? Journal of Nursing

Hockey, L. (1976). The nurse’s contribution to care, Ciba Foundation Symposium, 1(43):59-74.

Kourkouta, L. and Papthanasiou, J. (2014). Communication in nursing practice, Journal of the Academy of Medical Sciences of Bosnia and Herzegovina, 26(1):65-67.

The University of Texas at Arlington. (2019). Important communication skills for nurses

Imagine a World Without Nurses

Contribution: Communication

Contribution: Collaboration and Coordination

Contribution: Explanation

Contribution: Education

Contribution: Empathy

Final Thoughts

References:

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