As summer progresses, I continue to think about the demand for change in the healthcare profession and nursing. The Manifesto provides us with a unique tool to begin the change process, and a foundation for the call to change.
Here is another quote from the document that may be of interest to examine with some depth:
The situation we find ourselves in has been created from an array of forces. While economic issues have helped create a situation in which nurses cannot practice nursing, we, as nurses, have participated by remaining silent. Our professional sovereignty is threatened. The health of global humankind is at risk. It is now time to ask ourselves, who benefits from the situation as it now exists? As long as we know that the current situation inhibits the fullest expression of nursing’s highest values, and that people who need our care are not receiving the best we can offer, we know that we, and those we serve, are not benefiting. If nurses are to significantly contribute to a mission of caring for people and communities, we must find our voice, acting now to create situations in which our values come to the center and from which we can realize our best intentions. (Cowling, Chinn, & Hagedorn, 2000, paragraph 3).
I have to agree that healthcare is big business here in the USA, a place where democracy, free enterprise, and capitalism have created a healthcare system which profits in the billions of dollars every year. For more information on the profit status of insurance companies, I found this link helpful and easy to follow: http://www.huffingtonpost.com/2011/05/14/health-insurance-companies-make-record-profits_n_861946.html.
As nurses we have in many aspects blindly given over our practice to the regulating agencies and facilities where we work. Instead of as a profession deciding the services we can and will provide, which includes enacting our core values of caring and presence for those on a healing journey, we have chosen to allow our practices to be largely dictated to us. I believe that the high rate of burn out among nurses, and the great professional exodus of many new nurse graduates, is related to the inability to enact a caring-healing presence at the bedside.
So how is that we find our voice in order to create the type of transformative change that is so desperately needed in our healthcare system? While I believe joining a professional nursing organization is a place to start, I think we have found that having over one hundred specialty organizations in nursing has in some ways defeated our ability to come together and create a single strong voice. The American Nurses Association also has it challenges with membership and creating true, meaningful action. As the largest number of healthcare providers in the USA, a clear strong united voice and resultant action that demonstrates how our values can be realized in the healthcare system.
I think partnering with patients offers the profession a lot of hope for the future. As patients demand more access to complimentary and alternative modalities, nurses are the ones who could be enacting these interventions. Patients also know the importance of a caring presence at the bedside as they journey through suffering and the healing process. Patients are also some of our greatest teachers, as they remind us over and over again of the importance of nursing and the urgency of the need for loving kindness and caring in our professional actions. The rewards of nursing are indeed encapsulated within the patient-nurse transpersonal experience, and we have failed on many levels to support one another in explicating, teaching, supporting, and enacting the intricacies of this process.
I also believe that there is great hope for the future: each of us has the power to enact and create the kind of nursing practices we envision. Many of my students have found that by changing their views of themselves and the world, and begin to take action in creating change in how they practice nursing. With an emphasis on self-care and holism, the students often find themselves empowered to begin to solve workplace issues. They begin to return to the sacredness of their work, and enact their own healing journeys.
I suppose the questions remains in how to continue to reach the many, many nurses who are suffering in oppressive work situations. How can we best support and empower these nurses to take back their practices, and accordingly allow for our true nursing values of caring, compassion, empowerment, and patient advocacy to emerge?
Cowling, R., Chinn, P.L., & Hagedorn, S. (2000). The Nurse Manifesto. Retrieved June 27, 2011 from http://www.nursemanifest.com.