Originally Published on
But You Are So Smart
It happens every time…I’m in a hospital helping a friend or family member navigate their healthcare, and the doctors always asks me if I’m a doctor. No, I say, I’m a nurse.
This just happened yesterday. Last week my mom had a terrible fall, resulting in a bad fracture requiring emergency surgery. She is an elderly woman, frail and medically complex. Most doctors who encounter my mother are not prepared to address all her medical issues because, simply put, there is no way they can possibly “study up” enough to be “caught up” on her many problems. That’s where I come in. I do know my mom’s many, many complex medical conditions, and can speak about her recent surgeries and medical activities, complexities and medications. So when physicians come into my mom’s hospital room, truth is, I’m more an expert that they are—at least when it concerns my mom.
And in this situation, like what happened yesterday, where I am able to give the new physician a comprehensive patient history and post-operative report, he assumed I was a fellow physician…I mean, what kind of nurse could do that?
Nursing Is Actually A Very Technical Profession
The fact is nurses are extremely sophisticated health care professionals whose knowledge spans across all aspects of health care and medicine. Nurses need to understand general physiology, pathophysiology, treatment for diseases, and management of diseases through acute and chronic stages. Not only do nurses need to know these broad reaching medical skills but they also need to understand how to coordinate care, how to ensure the treatment plan for the patient makes sense and ensure that a patient’s care is coordinated and communicated between professionals in a timely manner—both in and outside of the hospital setting. Nurses need to represent the views and wishes of the patient and family to the physicians (and other care providers), as well as make sure the physician’s goals are agreed to by the patient. (Whew—that’s a lot of stuff nurses need to know and do!)
At the center of all health care are nurses. Nursing done right (which it does not always accomplish) is simply one of the most valuable roles in healthcare.
Why Then Is There A Nursing Shortage?
So why does the Bureau of Labor Statistics anticipates a nursing shortage in the coming years?
During my long career as a nurse, I’ve lived through nurse surplus, nurse shortage, nurse identify crisis, nurse role expansion. I think this point-in-time for the nursing profession is the most exciting I’ve ever seen. There are new positions and new roles and positions that have not existed before for nurses to work with patients, with providers, with healthcare systems, with biotech companies.
How Nurses “Make or Break” Care
We (as a society) need to understand extremely valuable the role of nursing, otherwise, fewer bright young people will enter the profession. Nurses are responsible for over 85% percent of patient care and, importantly, they help ensure miscommunication does not occur between the health care providers—and let’s pause to focus on this for one moment. According to reputable sources (The Joint Commission) up to 80% of serious errors are due to miscommunication, which lead to a failure in ordering important tests or reviewing important findings, etc… So properly sharing of information in a timely manner is critical to patient safety. This is where nurses come in: because nurses are the ones most familiar with the patient and help push care along to make sure the “ball is not dropped.”
Nursing is “Fungible”
In financial circles people talk about how money is “fungible.” Meaning it is fluid—a dollar can be used to buy a piece of equipment or to pay a staff salary. Well, I say nursing is fungible since the Registered Nurses’ license allows the nurse to be a bedside nurse, a clinic nurse, a hospice or home nurse, or a care coordinator, or an advisor to technology companies or to health insurance companies, or work with local, state or federal agencies developing new and important public health policies. Nurses can work in real time, remotely, or telephonically. Nurses are running companies and are CEOs of hospitals and health systems.
Nursing Has Been Good To Me
While I think the work of other health care professionals is extremely worthy and at times enviable (I mean, it would be fun to be a surgeon for a few days, or an anesthesiologist…) I think for those of us that imagine many different careers over one life time, there is nothing like nursing.