Articles

Nurses are caring for America!

By Mary E. Foley, MS, RN

A close nurse friend has developed a talk called the “Ten Commandments of Politics.” In one of my first columns in this newspaper, I spoke of one of these 10 commandments: “talking to strangers about nursing.” As the first quarter of 2002 – a time of personal and professional highs and lows for me – draws to an end, another commandment comes to mind: “We are all one illness or injury away from being a consumer of care.” The point of that message is that everyone should care about the health care system and be an advocate before you have to experience it first-hand. Well, I have experienced care first- and second-hand over the last quarter, and let me say that it was the nurses who made the difference, and who are, indeed, caring for America – one patient, and one family, at a time!

As president of ANA, I usually focus on the macro issues of “nursing.” When concentrating on my own care, or that of loved ones who found themselves as patients, my attention became focused on the micro issues of “the nurses.” In January, I had a very successful hip replacement at “my” hospital, Saint Francis, in San Francisco. This experience re-immersed me in the world of hospital care, a setting in which I have worked and enjoyed nursing since 1980. My surgery went very well, and I was well cared for by a team of friends and previous co-workers. Nursing care and the attention of the nurses to pain control was critical to my recovery.

My second recent encounter with the health care system was more frightening, but, again because of nurses, had the same positive outcome. I have a close friend – the woman who encouraged me to pursue nursing ( thank you, Nyla) – who experienced a series of minor cardiac problems in January that, unfortunately, led to a large cerebral incident. She was rushed to Boston, where they performed surgery, and I am pleased to say she is now in rehab. With her usual determination and support from friends and family, she will fully recover. Also key to her recovery, though, was the magnificent nursing care I observed over two weekends, in critical care and step-down units. As her family – who are not in health care – noted, they felt she was safe, they were well cared for, and at each step, they were aware of what was happening, why something was being done and what may happen next. Because of the nurses, the family felt prepared for whatever may happen, from the darkest first few hours right through to preparation for transfer.

And lastly, as I became caregiver to my friend Catherine before and after her surgery in March, we also saw good nursing. But we also experienced some not-so-good nursing care one morning, poor care that was the obvious result of inadequate staffing that caused the nurse providing care to be stretched too far.

These recent exposures confirmed for me the importance of the work that ANA has been engaged in during the past 10 plus years and that is reflected in our current agenda: patient safety and advocacy. In my own example, I observed a new level of pain assessment that validates the emphasis on pain as the fifth vital sign and the essential role of the RN as the caregiver who must be able to assess, administer and monitor effectiveness of pain control. This pain assessment also validates pain as an appropriate measure of nursing effectiveness, and supports the inclusion of that measure in the nursing care indicators!

My observations in Boston affirmed that the RN must have an assignment that supports his or her ability to fulfill all the roles nurses can play in the care of a patient and a family. This experience also speaks to the importance of standards of practice and continuing competence, words that a consumer of care may not fully understand, but they can certainly appreciate.

And in the third case – where the nursing care did not meet the patient’s needs – the nurse was assigned too many patients, who were in two separate wings of a very long corridor, and this overload compromised the delivery of timely or individualized care. In that case, the value of having a patient advocate, whether another nurse or a friend, became evident.

After observing in my personal life how nurses are truly caring for America – and what can happen when the nurse is not there – I returned to my professional role to witness through two major events how the ANA is positioned to make a difference in the future of the profession and patient care. When the Johnson & Johnson campaign unfolded last fall, we were pleased to be among the advisers to the concept. Respecting the company’s request to not say too much about the campaign until it was fully launched in February, I think we were as surprised and pleased with the level of commitment and the quality of the message – “Nurses Dare to Care” – as anyone. At a reception for the campaign in Washington, DC, where Health and Human Services Secretary Tommy Thompson, Rep. Lois Capps, RN, (D-CA) and Sen. Tim Hutchinson (R- AR) spoke, it was clear that the political leaders of this country, and some corporations, understand the serious impact a nursing shortage could have on the health care of this nation. At the official campaign launch in New York the next day, exciting and encouraging new data were released about the public opinion of nursing as a career choice. And then, the ads! Seen by the entire country, and much of the rest of the world, during the 2002 Winter Olympics, these ads truly captured all that is awe-inspiring about our profession! I was stunned by the power of the ads, and by their sustained visibility. I know nurses are buzzing about them, and I believe a new generation of nurses may have been created! (See page 6 for more on the campaign.)

The second event signifying ANA’s ability to effect positive change in health care was the February 12 unveiling of the Robert Wood Johnson Foundation’s campaign to raise public awareness about the social and health effects of the uninsured. A media campaign has been launched, and ANA is prominently credited as one of the coalition partners in each television and print ad. (See page 7 for more on this campaign.)

I am very proud of our professional organization’s advocacy for safe, quality patient care and of the efforts of nurses nationwide to make this a reality. It is almost time for us to celebrate this during National Nurses Week, May 6-12. This year’s theme is “Nurses Care for America,” a reminder to the public of the professionals who form the backbone of health care in this country. During National Nurses Week, let’s put two of the “commandments of politics” to work for nursing. Use the knowledge that “we are all one illness or injury away from being a consumer of care” as motivation to “talk to strangers” about our profession. Let’s share our stories about the differences nurses make in people’s lives every day. Each example can help illustrate how nurses everywhere are caring for America!

Mary E. Foley, MS, RN, is president of the American Nurses Association. Article originally printed in The American Nurse (March/April 2002).