From Silence To Voice

The definition of a profession is “a calling requiring specialized knowledge and often long and intensive academic preparation” (Webster Dictionary, 2008). By definition, I would consider nursing to be a profession, without a doubt. Nurses have spent too much time and effort in academic settings not to use the word profession. Nurses are taught and academically prepared by leaders in the nursing field who have the specialized knowledge that will specifically train nurses to meet the challenges of the profession. Nursing theorists, who are experts in nursing, have contributed great amounts of work to promoting nursing as a profession. According to Alligood and Tomey, “Nursing theory has been a prevalent theme in the nursing literature for the past 35 years and has stimulated phenomenal growth in the nursing profession” (Alligood & Tomey, 2006, p.3). I see the profession of nursing as something special, something different than just a job. I think most nurses feel that they have been “called” in some way to the profession.

The future of nursing is in the hands of nurses themselves. By encouraging further education and continuing education, the profession of nursing will continue to evolve and gain power. By learning to speak out and publicize the plight of nursing today, nurses can either help the public understand why the healthcare system needs to change, and how changes can be made, or if done carelessly, may contribute to a negative image in the public eye. I think nurses hold the power to change the healthcare system in our country, but we must first become organized and work together.

The American public has viewed nursing historically as a profession that is admired, respected, and trusted. According to the Gallup survey on honesty and ethics, “eighty-three percent of Americans placed nurses in the number one position as the most trusted professionals for the ninth consecutive year” (Gallup.com, 2007). The poll asks the public which profession they perceive to be the most honest and ethical and for the past nine years since Gallup added nursing to their survey, nurses have been consistently ranked first, with the exception of 2001, after 9/11 when firefighters took first place. I think this poll is a great example of the faith that the public has in nurses and the positive perception that nurses have in the eyes of the public. We can use this to our advantage when it comes to communicating with the public. I believe the public would welcome hearing from nurses and listening to their stories more often if only we offer them.

The opening statement in “From Silence to Voice” states “envision how things would be if the voice and visibility of nursing were commensurate with the size and importance of nursing in health care” (Buresh & Gordon, 2006, p.11). The size and importance of nursing as a profession is huge. If you have any doubts about that, just think how the healthcare industry would be crippled without nurses. The silence of nursing means that nurses are not speaking out about the services they provide, they are not speaking to the public about the crises they face such as staffing shortages and decreased wages. Nurses keep their mouths closed when it comes to speaking out about the things that are important in healthcare settings such as nurse/patient ratios and other issues that involve patient safety. Nurses even fail to let their voice be heard in more private situations when they have been wronged by physicians, or talked down to by physicians. By failing to open our mouths and engage others in diplomatic discussion about our profession, we are contributing to the stereotypes that nurses “obey” doctors, that nurses aren’t as smart as others in the healthcare field, or that nurses shouldn’t command the same amount of attention in the media that others in healthcare do.

Nurses have many opportunities to advance the public’s understanding of healthcare issues, but first they must take steps to ensure they are going about it properly. Buresh and Gordon state that there are three steps nurses can take to “end the silence about nursing” and they are first, to “realize that no one but nurses can truly inform the public about nursing”, second, “for every nurse to make public communication and education about nursing an integral part of her or his nursing work”, and third, “for nurses to overcome the internal obstacles that silence them” (Buresh & Gordon, 2006, p.20). It is true that nurses know and understand their own challenges far more than anyone else in the healthcare field and they are intimately knowledgeable about healthcare issues that pertain to the public such as cleanliness and patient safety issues for example. In the recent local healthcare scandal regarding the endoscopy clinics, nurses were lacking in their representation in the media with the media focused mainly on the physicians involved. Perhaps if there had been nurses willing and ready to speak out about the issue, the situation wouldn’t have happened in the first place. By speaking to the media and becoming involved in professional nursing organizations that are concerned with promoting healthcare legislation, nurses can make a voice for themselves and also speak out to advocate for the public safety as well.

If someone asked me “why did you become a nurse when someone as obviously intelligent as you could have been a doctor?”, I think my first thought would be how insulting the question is. But after analyzing the question, I think it is possible that a person might ask that question with all sincerity and would deserve an honest answer. I would tell them that I don't regret not being a doctor. Nurses, depending upon where they work, know their patients much better than an MD ever does or can, and are therefore much more able to deliver holistic care that encompasses all of the patient’s needs. Doctors are under a lot of pressure, spend hundreds of thousands on education and insurance, spend endless hours at work or on call and have huge amounts of liability. It's not about money, it's about helping people, and I feel that I do a better job helping people as a nurse, than I ever could do as a doctor, and for that I am thankful. Doctors may get the credit for a 'cure' but it's