By Amanda Anderson, a critical care nurse and graduate student in New York City currently doing a graduate placement at AJN.
I’m a sucker for beauty pageants. There’s something about the old-fashioned simplicity that fascinates me. While Miss America is, at its roots, a generous scholarship program, it’d be hard for me to say that I tune in for anything other than the sparkle and style.
With that said, I still love a Miss Congeniality angle, which this year’s Miss Colorado seemed to proffer in a much-praised speech. Similar to Sandra Bullock’s character, Gracie Lou Freebush, Kelley Johnson’s nurse-specific monologue was both engaging and educational. But her talent struck a little closer to home—she used the phrase “I’m just a nurse.”
Her two-minute speech won her a second-runner-up prize, as well as millions of hits online. But what did it get us nurses?
Sure, all PR for our profession is great, but the age-old, ubiquitous slur that served as the tagline for much of Ms. Johnson’s monologue makes a lot of us uneasy. Although Ms. Johnson very skillfully ended her monologue by refuting her initial proclamation, the public expression of it deserves a second look.
“Just a nurse” is not a new phrase to our profession; a brief scroll through Tumblr will do more than update the casual viewer. However, most of us steer away from association with the phrase; it discredits, it’s a conversation killer, and it has long been seen as a sarcastic way to circumvent responsibility. Shawn Kennedy, editor-in-chief of AJN, wrote back in May 2010 that nurses—regular ones—make our health care work. The phrase infuriates her, simply because it discredits the profound work we do on a day-to-day basis.
But after listening to Ms. Johnson’s speech, I wonder if we’ve been missing the opportunity behind the phrase all along. Instead of telling Joe, the patient she talks to in her monologue, “No, I’m just a nurse,” when he asked her if she could alter his medications, perhaps Nurse Johnson might have said, “You know, Joe, I can’t change your medications, because I’m a nurse. This is not a nurse’s responsibility—it’s a physician’s. But I can tell you why each one of them has been ordered, which ones might cause side effects, and how you should take them when you go home.”
In the actual speech, Kelley Johnson goes on to say, “Because I couldn’t do those things [change treatments and medications] for Joe, we connected on other levels,” and then tells of personal stories they shared. While this is a beautiful account of a nurse speaking with a patient in a human way, Johnson downplays the profound impact of her intervention—she held her patient’s hand—one that is nursing specific and should be credited with measurable improvements to both her patient’s clinical status and her hospital’s financial and performance outcomes.
To sit at her agitated patient’s bedside and hold his hand until he was calm means that she circumvented the conventional, possibly easier therapy—calling a doctor for a medication order, or an order for restraints. Instead of these approaches, which have been shown to lead to poor outcomes for the elderly, and instead of delegating the task to unlicensed personnel via a direct observation order, Nurse Johnson’s simple nursing intervention might have saved Joe from undue complications.
I applaud Nurse Johnson for speaking about her profession, and for doing so in such an engaging and succinct manner. The public desperately needs to understand what we do at the bedside, and I’d wager that this starts with each of us who are working there.
We can change the way we speak about ourselves with a very simple edit: “Joe, I’m your nurse. I can’t do those things, but let me tell you what I can do.” A good way to start is to very simply and clearly introduce ourselves to our patients at the start of our shift.
As I wrote a few years back about my own discovery of the power of claiming my professional identity, “By neglecting to state who we are—the nurse—we give up control of our identity, our rights to our work, our voice as a profession; our silent namelessness allows us to become whatever stereotype is the most convenient, or the most useful.”