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A Core Value: Humanization of Patients July 20, 2017

Posted by mariemanthey in Manthey Life Mosaic, Professional Practice, Values.
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Many many years ago I was being pressesd to articulate my deepest passion about Nursing.   Specifically,  what did I believe is the fundamental core value of the nursing profession?     After thinking about it deeply, I came up with a deep believe that  our most important role is to facilitate the humanization of patient care,…. which required that we first humanize the experience, practice and focus of nurses.   Nurses cannot humanize patient care unless they are empowered in their role and in practice.  Humanization of health care for patients  means  engagement of patients and their families in decisions about treatment choices, as well as end of life choices.    This ultimate exercise of free will is the pathway to fulfillment as a human….and the restriction of free will is dehumanizing.

I see this goal  becoming closer to reality in many situations, thanks to nursing’s incredible advances, as well as to advances in technology and  many other societal advances.   However,  I think much work is still needed to promote nursing’s role as patient advocates for their greater involvement in decisions.  The culture change we seek is to humanize patient care.   Nurses must support patients ability to accept responsibility for themselves, and to exercise their own  free will about their treatment and their lives, knowledgeable about the options that are available to them.

Empowered nurses are needed to empower their patients.

Whether the setting is an ICU unit, a Neo-Natal unit, or even hospice. Empowered nurses can make sure the patients and their families have all the necessary information to make their own life decisions – about end of life, or about courses of treatment – and that they are empowered to do so.

The change is coming.   Let’s make sure the nursing profession is ready to fully engage in the humanization of health care. The public is more ready than the health care system.

Happy Birthday Marie! July 17, 2017

Posted by mariemanthey in Creative Health Care Management, History, Inspiration, Leadership, Manthey Life Mosaic, Nursing Peer Support Network, Nursing Salons, Professional Practice, Thought for today, Values.
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This is Claire talking (Marie’s daughter, and co-editor of this site), checking in with you on this celebratory day!

I know Marie values each and every one of you, and loves hearing from you and having conversations with you – whether in person, in various professional / civic roles, on social media, here on the blog.

And so today on her birthday, I wanted to formally welcome you all back to this blog.

In the last few months, we’ve started to get active again — exploring various kinds of posts with a multitude of topics including Nursing: it’s history, challenges, future, best practices, values & inspiration etc.. as well as CHCM activities, Marie’s life (Mosaic), Nursing Salons, the Nursing Peer Support Network, activities at the University of MN School of Nursing, and so on.

If you have a moment today, would love to hear any preferences from you about types of content, questions you have for Marie, how often you’d like us to post, how you’d like to hear about posts, and anything else to make this blog a win-win.

We never know how long any of us have here. Marie is the epitome of taking care of herself, taking responsibility for her health and well-being, and we hope to have years and years yet. In any case, the more conversations she can fit engage in, the better!

Oh, one more thing- Happy Birthday Marie!

Thanks much for your participation.

Leadership, by the book: the Army Manual book July 10, 2017

Posted by mariemanthey in Leadership, Professional Practice, Values.
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Re: 
U.S. Army's Army Field Manual 6_22 on Leader Development
i.t.o. psychological & psychiatric criteria for leadership.

This content is written by Prudence L. Gourguechon, widely known national expert on psychoanalysis for the fields of business, law, politics and marketing.

“Despite the thousands of articles and books written on leadership, primarily in the business arena, I have found only one source where the capacities necessary for strategic leadership are clearly and comprehensively laid out: the U.S. Army’s “Field Manual 6-22 Leader Development.”

“The Army’s field manual on leadership is an extraordinarily sophisticated document, founded in sound psychological research and psychiatric theory, as well as military practice. It articulates the core faculties that officers, including commanders, need in order to fulfill their jobs. From the manual’s 135 dense pages, I have distilled five crucial qualities:

Trust

“According to the Army, trust is fundamental to the functioning of a team or alliance in any setting: “Leaders shape the ethical climate of their organization while developing the trust and relationships that enable proper leadership.” A leader who is deficient in the capacity for trust makes little effort to support others, may be isolated and aloof, may be apathetic about discrimination, allows distrustful behaviors to persist among team members, makes unrealistic promises and focuses on self-promotion.

Discipline and self-control

“The manual requires that a leader demonstrate control over his behavior and align his behavior with core Army values: “Loyalty, duty, respect, selfless service, honor, integrity, and personal courage.” The disciplined leader does not have emotional outbursts or act impulsively, and he maintains composure in stressful or adverse situations. Without discipline and self-control, a leader may not be able to resist temptation, to stay focused despite distractions, to avoid impulsive action or to think before jumping to a conclusion. The leader who fails to demonstrate discipline reacts “viscerally or angrily when receiving bad news or conflicting information,” and he “allows personal emotions to drive decisions or guide responses to emotionally charged situations.”

“In psychiatry, we talk about “filters” — neurologic braking systems that enable us to appropriately inhibit our speech and actions even when disturbing thoughts or powerful emotions are present. Discipline and self-control require that an individual has a robust working filter, so that he doesn’t say or do everything that comes to mind.

Judgment and critical thinking

“These are complex, high-level mental functions that include the abilities to discriminate, assess, plan, decide, anticipate, prioritize and compare. A leader with the capacity for critical thinking “seeks to obtain the most thorough and accurate understanding possible,” the manual says, and he anticipates “first, second and third consequences of multiple courses of action.” A leader deficient in judgment and strategic thinking demonstrates rigid and inflexible thinking.

Self-awareness

“Self-awareness requires the capacity to reflect and an interest in doing so. “Self-aware leaders know themselves, including their traits, feelings, and behaviors,” the manual says. “They employ self-understanding and recognize their effect on others.” When a leader lacks self-awareness, the manual notes, he “unfairly blames subordinates when failures are experienced” and “rejects or lacks interest in feedback.”

Empathy

“Perhaps surprisingly, the field manual repeatedly stresses the importance of empathy as an essential attribute for Army leadership. A good leader “demonstrates an understanding of another person’s point of view” and “identifies with others’ feelings and emotions.” The manual’s description of inadequacy in this area: “Shows a lack of concern for others’ emotional distress” and “displays an inability to take another’s perspective.””

===========================

From an intraprofessional leadership perspective, this is a universal summary of essential leadership skills from a valid source.   Going back to Florence Nightingale, great leaders when matched to this set of criteria have great capacity to be powerful leaders who truly make a difference. Hospital origins were deeply linked to the military mindset of regimentation, discipline, following the chain of command, and maintaining discipline. Sometimes in ways that de-humanized patient care.

This value-based list of leadership skills represents an exciting awareness important values that can greatly improve performance and promote better engagement.

My own learning during the early development of Primary Nursing included an invaluable gift from ‘military literature’.    I don’t remember the exact document or book, but I know the conceptual paradigm of Responsibility Authority and Accountability came directly from a description of  a military ‘chain of command’ writing.   We were not using words like that in nursing during PN’s early development.

Every sector has a contribution to make to the collective well-being!

=================

References:

http://www.latimes.com/opinion/op-ed/la-oe-gourguechon-25th-amendment-leadership-mental-capacities-checklist-20170616-story.html

Meeting Challenges – Ripple Effects July 3, 2017

Posted by mariemanthey in History, Inspiration, Leadership, Professional Practice, Values.
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Nursing through a lens of history.

As we celebrate the victory in battle that lead to the signing of the Declaration of Independence this weekend, my thoughts are on how often nursing is spotlighted and impacted during wartime.  A cataclysmic example of this is the lasting affect  of Florence Nightingale’s work during the battle of Crimea.

That situation was a terrible one, full of despair and unpredictability.  Florence went voluntarily into that mess  because of how desperate it was, and acted on her values, knowledge and skills to change that reality. The depth of the damage to soldiers and the impact of her reforms  set in motion a profound  reaction, which in this instance included seeds of change vastly greater in scope than that particular problem.   The death rate among hospitalized soldiers was amazingly reduced due to her reforms, and the whole country of England honored her for this achievement.

In particular, she provided compassion, and she managed the environment to a degree of sanitation that was new to that setting. The depth and cohesion of her response to that situation was beyond what anyone expected.  No one involved in that war would have  predicted or imagined that the outcome of that war would be the modern practice of nursing.

When people engage in the struggle to do their best in difficult times, positive outcomes are more likely.. not only in that moment, but decades and centuries later.

Reading List – Treasures! June 30, 2017

Posted by mariemanthey in History, Inspiration, Leadership, Professional Practice, Values.
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Here are some books I’ve enjoyed and gained a great deal of insight and resources from. I’d love to hear your thoughts on these and your favorites as well!

The Power of Now by Eckhardt Tolle — I learned the incredible value of learning how to observe my thinking…..thus creating the opportunity to grasp a powerful truth.   That I am more than my thinking.   I am a whole being and by stepping away from my thinking I learn that my thoughts do not define who I am.    My being is more than my thoughts.   That awareness shifts my perspective on life.. Fascinating and exhilarating!

Small Great Things by Jodi Picoult – an ambitious tackling of the racial issues of our time, through the setting of nursing.   A highly experienced black nurse is forbidden by her nurse manager from taking care of the baby of a white supremacist couple….at their insistence.   The story from there presents a dilemma for the black nurse that results in a life-changing lawsuit.

Blessed Unrest by Paul Hawken (2007) – the world is undergoing transformational  changes of people, on a  small scale – in conversational salons and discussion groups, between neighbors and friends. These group conversations are about serious topics like spirituality and the role of governments.   And he makes the point that conversations can change people and people change the world.

The Immortal Life of Henrietta Lacks  by Rebecca Skloot incredible (true) story of medical ethics involving HeLa – two dime-sized tissue samples taken from Henrietta. The cells possessed unusual qualities and yielded amazing benefits for science; the effects for Henrietta and her family were.. less. Bioethics, racial injustice, and history co-exist in this story which starts in Baltimore, involves the Tuskegee Institute, and spreads benefits globally (for specific groups and humanity in general). Talk about health care disparity – really incredible. Recognition, Justice and Healing – hopefully this book brings us a step closer to these goals.  The film, staring Oprah Winfrey, premiered on HBO this past April and will be on DVD soon!

As it happens: RBC Symposium Day 3_ Wednesday, June 21 June 21, 2017

Posted by mariemanthey in Creative Health Care Management, Inspiration, Leadership, Professional Practice, Values.
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This is the busiest day of the CHCM International Relationship-Based Care Symposium, so to keep the posts from getting too long, will be sharing snippets & segments!

Launched by the wonderful Keynote by Lois Swope on compassionate care; with an all-attendee mid-day session on relationship-building in Indian Health from Phoenix Indian Medical Center; and concluding with a Poster Session; the day also included two breakout sessions with 5 choices each of those sessions! (Please join me in thanking the CHCM staff, they’ve been working extremely hard to bring this all together!)

As it happens: RBC Symposium Day 1 June 19, 2017

Posted by mariemanthey in Creative Health Care Management, Inspiration, Leadership, Manthey Life Mosaic, Professional Practice, Values.
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Today is the pre-conference afternoon of the 2017 International Relationship-Based Care Symposium, here in Minneapolis at the Hilton Minneapolis!

Here are links to the handout materials available at this time:

Gratitude_Human_Connection

DeepenFacilitationCapacity

It’s been great already to have a brunch at my home – to which I invited international guests, several local nursing leaders and CHCM consultants. Conversations ranged over various topics including comparisons between people’s situations in different countries.

The conference itself is a very enthusiastic experience! I have been constantly in motion and it’s wonderful. Everyone is very happy to be here and many are saying ‘this is exactly what we need at our hospital!’

This afternoon I was able to be a surprise guest at the Daisy Foundation session. I spoke about the the impact of Florence Marie Fisher coloring in my coloring book, and also what a wonderful thing it was for me to be able to nominate her for the DAISY award. In closing I brought in Florence Nightingale as well.

I enjoy talking about the power of nursing: as I experienced in my lifetime the impact of my nurse when I was five years old.  I like to make it clear that the work that I’ve been involved in leading is directly the result of Florence Marie Fisher coloring in my coloring book.

I don’t think that that concept can possibly be emphasized too strongly: the power of good nursing care!

Much more to come, looking forward to sharing it with all of you!

 

 

Blast from the Past: Feisty Former Chicagoan (1978) May 13, 2017

Posted by mariemanthey in History, Inspiration, Leadership, Manthey Life Mosaic, Professional Practice, Values.
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Primary Nursing: Hospitals bring back Florence Nightingale

ChgoTrib_2.78_PageOne
ChgoTrib_2.78_PageTwo

This article was one of the first in mainstream media about Primary Nursing, Marie Manthey .. and Florence Nightingale!

The picture on page 1 is so wonderful, isn’t it?

Here are some excerpts from the article, which you can see directly via the links at the top of this post.

“We’re not just dealing with inert lumps of flesh that hurt” Davis says. “We’re dealing with people’s emotional well-being, too. And that’s what makes nursing exciting again.”

Chicago Tribune: Sunday, February 2, 1978

by Joan Zyda

Sometime after World War II, the American registered nurse was forced into being less like Florence Nightingale and more like a factory foreman.

The shortage of nurses resulted in assembly-line nursing, which brought with it an assortment of nameless, often uncaring persons who trained for brief periods before being turned loose on patients. They were practical nurses, vocational nurses, technicians, orderlies, nurse’s aides, and nursing assistants.

If you’ve been in a hospital in the lst three decades, you have seen this production line in action. Somebody took your temperature, somebody else gave you a bath, somebody else took your blod pressure, somebody else brought in your food tray, somebody else …

Conducting this “orchestra” was, and still is, the chief duty of the registered nurse in most hospitals. Despite years of learning to care for sick people, she ends up in a supervisory job that takes her out of the mainstream of patient care. If she sees patients at all, it’s only briefly when she gives them a shot or a pill, or if there’s a “problem.”

“The patients are completely perplexed and often get irritable or depressed by this fragmented and impersonal care; it frights and frustrates the doctors; the morale of nurses sinks to an incredible low, resulting in a high turnover rate and absenteeism; and it has caused a decline in patient care at many hospitals,” says Dr. William Shaffrrath, diretor of the National Joint Practice Commission in Chicago.

The commission was set up in 1972 by the American Medical Association and the American Nurses Association to solve the growing dissatisfaction with hospital nursing care.

Teh solution, with which the commission has been shaking the pillars of medicine, is to put the registered nurse back at the patient’s bedside, where she can use her training. Some hospitals have already done this, including Rush-Presbyterian-St. Luke’s Medical Center, University of Chicago Hospitals, Good Samaritan Hospital in Downers Grove, and Evanston Hospital.

“Most nurses we talked to are frustrated. They don’t want to be supervisors,” Schaffrath says. “They prefer hands-on nursing in the Florence Nightingale tradition. They want to walk cot to cot, tending to and cheering on the patients.”

Schaffrath credits Marie Manthey, 42, a fiesty former Chicagoan and now vice president of patient services at Yale-New Haven Hospital in Connecticut, for blowing the whistle on nursing. She has advocated for the “return to the bedside” alternative in articles in several prominent medical journals.

As a registered nurse for 22 years, Manthey has had an inside look at the failings of her profession.

“Registered nurses have become faceless people, and it’s the system’s fault,” she says. “Nursing has become extremely production-oriented with very little concern for human needs. Most nurses are embarrassed about that. They say, almost apologetically, ‘Well, I’m just a staff nurse,’ which equates to, ‘I’m just a housewife.’

“But if nurses got their identity back,” Manthey says, “they’d be a proud people again. Then they’d be saying, ‘Hey, wait a minute. I am a staff nurse. I am an important person.”

“Nurses are supposed to be in the thick of things,” Manthey says firmly.

Manthey has coined her remedy, “Primary Nursing” a system whose main goal is just that — to get the nurse to provide total nursing care to a patient during their hospitalization. That means the same nurse does all the work for a patient from admission to discharge.

“The Nurse and the Patient get to know each other,” Manthey says.

With Primary Nursing, the nurse takes over many tasks she used to assign her aides.. because they’re all relevant to patient care.”

/ end content on front page of article, clip 1of2

___________________

For further content from this article, see clipping number 2, and/or let us know if you’d like us to post further excerpts here.

Isn’t it amazing to look back and remember the days when Nursing was at that factory-process level??

Symposium Update! Urgency Building for this Exciting Event! May 8, 2017

Posted by mariemanthey in Academia, Creative Health Care Management, Leadership, Professional Practice, Values.
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CHCM’s International Relationship-Based Care Symposium

From Silos to Synergy: Showcasing Fierce Commitment to Extraordinary Care

June 19 – June 23, 2017

Minneapolis, MN

While people will be attending this event from around the country and around the world – some of you will be able to attend any/all days without traveling at all. CHCM Symposiums are sited in vibrant health-care communities, in order for those particular communities to have the special privilege of attending events within the comforts of home.

This post is especially for those of you who have that privilege this year!

The Relationship-Based Care Symposium is a magnificent program and since you live here, the options for
attending provide a wide range of choices. You really don’t want to miss this opportunity.  This is the first time we are offering the symposium locally to the Twin Cities community.   You can opt to attend one of the three
days…all three….or the pre- or the post- conference, or all of them.

This is a great opportunity.  Look carefully at all the speakers and you will see why you don’t want to miss this event.

Some highlights are:

* DAVID COOPERRIDER, the developer and creative thought leader of Appreciative Inquiry, a strengths-based approach to organizational change based on the best in people and their organizations
* ROGER NIERENBERG, a maestro who, with the help of a professional orchestra, provides a multi-sensory immersion experience of organizational dynamics and teaming
* ROBIN AND MEREDITH YOUNGSON, co-founders of New Zealand-based Hearts in Healthcare, which focuses on organizational strategy and movement building that’s centered on making health care more
compassionate
* THE DAISY FOUNDATION, enhancing patient care by celebrating compassionate and extraordinary nurses through meaningful recognition
* DEAN CONNIE DELANEY WILL speak on the amazing topic THE SOUL OF TECHNOLOGY!
* TEDDIE POTTER WILL FACILITATE A DIALOGUE with Robin Youngson and an interprofessional team of young clinicians on PARTNERING ACROSS GENERATIONS.

The journey forward of Primary Nursing, and it’s broader implementation as Relationship-Based Care, will be celebrated, cultivated and innovated further at this  once-in-a-lifetime event.

Symposium Registration Information

Please check out the Brochure and the website and your co-workers and professional community. To obtain the group rate please email:  rbcsymposium@metroconnections.com with the list of all attendees in your group and you will receive a registration code.

This activity is planned and implemented by the University of Minnesota, Interprofessional Continuing Education and Creative Health Care Management. In support of improving patient care, the University of Minnesota, Interprofessional Continuing Education is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC) to provide continuing education for the healthcare team.

Register for the RBC Symposium today!

Please let me know any questions you have about this exciting event. We look forward to seeing all of you there!

The Mosaic of Marie Manthey’s Life April 30, 2017

Posted by mariemanthey in Creative Health Care Management, History, Inspiration, Manthey Life Mosaic, Nursing Peer Support Network, Nursing Salons, Professional Practice, Values.
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ColoringBookCover

by Marie Manthey

I became ill at the age of 5 and was hospitalized for a month at St. Joseph’s Hospital in Chicago. It was a traumatic experience in a couple of ways. First of all, my parent’s didn’t know how to prepare me, since they had never been hospitalized themselves.. so they just said I was going to a large building. They left me there for a month, visiting twice a week, and sometimes when one or the other of them came, a very painful procedure was done involving an IM injection of their blood. As a result, I felt not only abandoned but also frightened and confused about the pain associated with their visits.

Florence Marie Fisher is the name of a nurse who cared for me. One day she sat at my bedside and colored in my coloring book. For me, that translated to ‘cared for me’ … and I decided then that I wanted my life to be about that kind of caring.

From that time on I knew I would be a nurse. I entered a hospital diploma program right after high school, and worked for the next four years as staff nurse, assistant Head Nurse, and Head Nurse. During the last of those years I started going to night classes in the community colleges .. not necessarily at first to get my degree.

I was invited to enroll in the degree program at the University of Minnesota, which was one-of-a-kind at that point. After 15 months of full-time study, I received my Bachelors degree in Nursing Administration. Soon after I was recruited into the U of M’s Masters program in Nursing Administration, in what was the last of the 3-quarter Master’s degrees.

Before finishing that degree, I was recruited by Miss Julian to be an Assistant Administrator of Special Projects. This was a new position that gave me an unbelievably valuable opportunity to learn first-hand about leadership and administration. I was able to experience directly not only organizational dynamics, but was also privileged to work with a group of administrators who used Senge’s principles of a learning organization even before he’d written ‘The Fifth Discipline.’

It was during this time that I became one of two Project Directors for Project 32 (at the University of Minnesota), a pilot program to improve hospital services from an interdisciplinary/interdepartmental perspective. This project eventually morphed in to Primary Nursing, and my career became about understanding and implementing organizational changes that result in the empowerment of employees and the accompanying development of healthy workplace cultures.

Throughout the next ten years of my life in nursing administration – first at another community hospital within the Twin Cities, and then at Yale New-Haven Hospital in Connecticut – I freely helped others with Primary Nursing.. Always accepting visitors and often speaking both locally and nationally as well as publishing as time allowed.

During this period of my career, what had been a manageable, socially acceptable level of alcohol consumption escalated in to full-blown alcoholism. There was an intervention and I entered a 6-week residential treatment program on the East Coast, and have been sober ever since.

In my first year of sobriety as I was feeling my way forward, there were no positions in Nursing Administration available to me. Instead I wrote my initial book on Primary Nursing .. and returned calls to all who had ever asked me to speak, putting out the word that I was available for speaking and consulting. The result was that Creative Nursing Management, Inc. was born, now the longest-running nurse-managed health care consulting firm in the U.S.

When I finished writing Primary Nursing, the publisher asked me who I wanted to dedicate it to.. and that had to be Florence Marie Fisher, the nurse who had colored in my coloring book when I was five. We weren’t able to contact her then, and so I gave up on that idea of actually connecting with her.

My career as a successful entrepreneur has continued ever since. Running a business was not ever something I thought I would do. I didn’t see myself as a businesswoman, but rather as a professional woman. Nevertheless, through many trials and many errors, the company grew. I often say we were successful not because of my business acumen, but rather because my work was authentic and based on real-world realities and values.

In time we grew into a multi-faceted, multi-national firm called Creative Health Care Management. I sold the firm when I turned 65 (in 2000) to the employees themselves. Now in semi-retirement (still, in 2017!) I remain involved in the important work of developing nursing practice and improving patient care.. just without the stresses and challenges inherent in leading an entrepreneurial entity.

An additional aspect of my work today involves tackling the challenge of Substance-Use Disorder. A group of us concerned with the problem of shame and stigma associated with SUD formed a Peer Support Network here in Minnesota, and we are partnering with entities involved in all aspects of the situation.

Another vitally important component of my professional life today has to do with my involvement with my alma mater. After transitioning away from day-to-day involvement in the running of CHCM, I became active in the Alumni organization at the U of M School of Nursing, and also became an adjunct faculty member there. In 1999 the University of Minnesota awarded me with an honorary doctorate, which was thrilling beyond compare. Today I am also active with the Heritage Committee at the School of Nursing, and am engaged in other ways as well with the University.

I also continue to be a part of my own and others’ Nursing Salons – a safe space for nurses in all walks of the profession to share conversations and support one another.

My ongoing interest in changing the way we think about workload and resources is part of the same picture. As healthcare incorporates more and more technology, the temptation strengthens to discard the human caring aspects.

As nursing matures as a profession, I am more convinced than ever, that the choice to care – and to express care and compassion by one’s behavior – is the absolutely correct choice nurses must make in order to continue to serve society justly.

Clinical competence must be on one side of the nursing coin, and care on the other. This is the ‘Coin of the Realm’ nurses must choose if, in fact, the covenant between nursing and society is to continue to exist.