What can I do as just one nurse?
As a nurse, I have often heard my colleagues question their ability to influence health in their communities. At times I have felt this same sentiment. What can I do as just one nurse?
Nurses have a unique perspective of how a community’s physical, social, and economic environment can affect patients’ health. And as we expand our understanding of what creates health, nurses have the opportunity to be a powerful voice when it comes to influencing the health of their communities.
Nightingale as precedent.
Nightingale in Scutari ward during Crimean War/Library of Congress
Nurses working to improve health through environmental modification is not new. The story of Florence Nightingale is well-known. As a nurse, Nightingale recognized changes needed to improve the health of soldiers in a hospital during the Crimean War, when more of the hospitalized soldiers were dying from the spread of infectious disease than from war-related injuries. Through her work with a group of nurses, she was able to significantly decrease the mortality rate at the hospital by making changes to the hospital environment and improving sanitation.
While environmental changes in U.S. communities today focus more on issues like combating the obesity epidemic than preventing the spread of typhoid and cholera, Nightingale’s story reminds us that environmental changes can significantly influence health and that nurses can be at the forefront of those changes.
Socioeconomic and environmental factors influence health.
We know that when looking at factors that influence health, our health is powerfully affected by a combination of socioeconomic (40%) and environmental factors (10%), while only 20% of our health is influenced by clinical care. Nurses can play an important role in helping others in their communities understand how these factors influence health and in making community-level changes that would address these areas. From access to healthy foods to water quality to physical education requirements in schools, there are a multitude of factors that influence health that nurses can positively help address.
A nursing perspective in the room.
Many recent efforts to improve health in our communities focus on the importance of hearing from diverse viewpoints and collaborating across sectors. The Robert Wood Johnson Foundation’s Culture of Health framework focuses on how professionals from different sectors, including nurses, can create changes within our communities to support health equity and make health a shared value. Having a nursing perspective in the room when changes that affect community health are being made is vital to ensure that nurses are able to advocate for their patients on a larger scale. As the most trusted profession for the past 16 years, and with close to 3 million members, nurses must recognize the value and power of our voices in helping shape health in our communities where we live, work, learn, and play.
A voice in local community organizations.
One way for nurses to do this is by seeking a board or governing role for a local community organization. The Nurses on Boards Coalition is an organization that highlights the importance of nurses serving in decision-making processes in our communities in order to improve health. The coalition’s goal is to have 10,000 nurses newly involved on community boards and in governance roles by 2020. Currently there are 5,338 nurses reported on boards since the initiative began in 2014, with 536 reporting joining a board in just the last 90 days.
While it is important that perspectives from different professional fields are involved in decisions that influence health in our communities, it is imperative that nurses be included at the table. Nurses know how factors in the community affect the patients and families they work with. Every day nurses see the influence of socioeconomic and environmental factors on the health of individuals and families. For example, a nurse who is working with patients who lack reliable transportation to such crucial health-related resources as pharmacies or grocery stores will understand the negative impact this barrier can have on the patients’ overall health.
So consider how your voice as a nurse could influence health in your own community. Consider joining a local organization that supports something you are passionate about, like increasing healthy food access. Be involved in discussions and decision-making within that organization from the perspective of a nursing professional. Share your insight into how the community environment can affect patients you work with.
While alone we may feel that our voices sound small, if nurses are sharing their voices in communities across the country, our collective voice for positive changes will grow much louder.
Mallory Bejster, DNP, RN, is the RN–BSN coordinator and an instructor of nursing at the University of Central Missouri, a community health nursing clinical instructor at Rush University, and a Public Voices Fellow of the OpEd Project.
Dear Dr. Bejster,
I enjoyed reading your blog and I find it very motivating and inspiring student nurses like me to seek for organizations in the community to join and be able to support clients and family members. Being a nurse means being the closest health care provider to the client, and this can take place anywhere from the acute care environment of the hospital to the comfort of the client’s own home. Nurses come in to this very special relationship carrying all that they earned during most of their lifetime, and that includes knowledge, skills and attitude, with the goal of helping patients reach the best optimum level of functioning they can achieve and teach them how to maintain it through life style changes and environment modifications. A healthy community starts with a healthy individual, and prevention from the disease is the best mean to stay healthy.
Before I came to the United States, I used to be actively involved in the association of diabetes educators in my home country. As much as I affected many members of my community in a positive way as much as they helped me learn and grow. As a nurse, giving back to the community should be more than just a duty, it is more like a source of a sense of accomplishment, pride and identity.
All my respect,
Samia
Dear Dr. Bejster,
I enjoyed reading your blog and I find it very motivating and inspiring student nurses like me to seek for organizations in the community to join and be able to support clients and their families. Being a nurse means being the closest health care provider to the client, and this can take place anywhere from the acute care environment of the hospital to the comfort of the client’s own home. Nurses come in to this very special relationship carrying all that they earned during most of their lifetime, and that includes knowledge, skills and attitude, with the goal of helping patients reach the best optimum level of functioning they can achieve and teach them how to maintain it through life style changes and environment modifications. A healthy community starts with a healthy individual, and prevention from the disease is the best mean to stay healthy.
Before I came to the United States, I used to be actively involved in the association of diabetes educators in my home country. As much as I affected many members of my community in a positive way as much as they helped me learn and grow. As a nurse, giving back to the community should be more than just a duty, it is more like a source of a sense of accomplishment, pride and identity.
All my respect,
Samia
Dr. Bejster,
I have found your post very interesting. As you said, together as a collective, our voice will grow much powerful. It is very important that alongside our role at the bedside, we start to get involved in the reform of the health policies and how they positively impact the health in our communities. I am a firm supporter of the primary prevention and education of our population; these activities can be promoted by nurses that are actively working in their communities and are aware of the specific needs of that population. Nurses can make a difference by bringing their knowledge and experience and be able to advocate for patients at a larger scale. It is time to actively support the presence of nurses in key positions and promote a real change in our health care system.
Thank you.