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Nurses Have an Amazing Capacity To Do More! March 24, 2006

Posted by manthey in Professional Practice.
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I know if I said this in a speech before an audience of nurses, many would get angry, and some would probably walk out. And yet, it is a statement I believe to be true. Not all nurses. Not in all work situations. Not all the time.

But over my many years in the profession, I have seen the restraints that handicap our role expansion and have envisioned the contribution nurses could make to the health care of society if those restraints were removed. The realities I call restraints are both internal and external. Some are imposed by regulations designed to protect the job security of others, as well as the job security of nurses. Some are in place because of historical precedents not yet dissolved … precedents like inadequate education, cost constraints, physician-nurses role delineations disputes, and the sexual discrimination still somewhat prevalent in today’s society. Some of these are so big, and are kept in place by such powerful forces, they seem insurmountable.

Others are restraints of our own making. These include a pervasive reluctance/fear to accept responsibility for ourselves, our practice and our interpersonal relationships. They include a “within the profession” reluctance to assert the right of control over nursing practice by virtue or our license. They include a willingness to work in environments that are dysfunctional … without either fixing the problem or leaving the work setting. They include an incredible tolerance for ‘within the profession’ disputes about solvable problems like entry-level educational standards and proper utilization of support staff (including Lens). Enormous amounts of energy are dissipated at the highest levels of professional development on issues that require strategic and tactical decision-making among various interest groups within the profession. Decisive action in these areas, (while probably not agreed to universally) would still have the power to restore energy to more productive uses.

What do I envision? For openers … the lack of continuity at the system level that patients suffer from could be solved by developing procedures for call-backs to patients homes. Not all patients, not all the time, but it a responsible nurse can decide whether to do so or not. I can envision a role for RNs that includes time for “‘looking at the big picture” and exercising real coordination/cooperation among specialties in highly complex situations. This can be done by providing appropriate technical support staff. I can envision nurses partnering with physicians (or other primary providers) collaborating in decision making, along with empowering patients to participate/own health care decisions. I can envision nurses creating support structures for non-nurse care providers that both educates them in the techniques of patient care and also supports them emotionally

I am a partner in a company that has software for healthy people to track their own health care data and set goals under the guidance of an advanced practice nurse. The employees enrolled in our program have significantly fewer major health problems, and cost their employer much less for health care.

We are so bogged down in task performance, so diminished by our sense of self-worth and so willing to abdicate responsibility for what we are licensed to do that we haven’t taken the time to lift our eyes, envision a new future and and learn how to play together to create a world here nurses are having a major impact on the health of society and are manifesting healthy lives ourselves!

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