If you haven’t read the Viewpoint column in the March issue of AJN, “Just a Nurse, or a Bedside Leader?“, we recommend it. The author, Amy Constanzo, director of nursing administration at University of Cincinnati Medical Center, puts into eloquent words one of the central “unthought knowns” in the daily experience of many nurses. Constanzo writes:
“Despite the Institute of Medicine’s Future of Nursing report that calls for nurses to be ‘full partners, with physicians and other health professionals, in redesigning health care in the United States,’ the mental model of ‘just a nurse’ is still out there, inhibiting potential.”
But she’s not pessimistic. She believes “just a nurse” is a mental model like any other, and mental models can be changed—but only if you make it your quest to do so. Constanzo proposes an alternative mental model for nurses: “I am a nurse.” On the surface, it’s a simple statement, but it’s also, she believes, a statement of both strength and possibility:
“When you say ‘I am a nurse,’ you are claiming the values of nursing and your contribution to assisting patients in achieving their best level of health. To do so requires a clear vision of nursing as a profession and of nurses’ contribution to the health care team.”
How do you describe your work as a nurse—to yourself, and to others?
I totally agree with the writer. Bed side nurses have robust just in time information about the patients and it will be in the best interest of all actors to work hand-in- hand, in a professional manner, so as to benefit from these informations. For example, when a doctor writes in the note no input or output recorded on the patient in 12 hours, and the doctor fail to pick up the phone and double check with the nurse. Let’s be clear, asking the nurse to record all findings in real time sounds sophisticated but not always feasible. Especially when the nurse is working solo.
I am not sure how or when the image is going to change. I’m not sure it ever will. Some people maintain that this image will change if all nurses are required to get a BSN. I am not so sure. Nursing has some autonomy, but perhaps not enough. Again, I doubt more autonomy will solve the problem. My only point to this article is that I think it will take more than a change in phrasing. Changing the language is a place to start, and a good one, but I don’t think it is the complete answer.