Contributors: Sarah Oerther, Barbara Dossey, and Mona Shattell

Opinion and editorial articles, also known as “op-eds,” are persuasive commentaries that are featured in most newspapers and other online popular press, which are excellent, effective ways for nurses to bring their authentic perspectives to the public. Op-eds are also crucial because nurses are seldom represented in print media healthcare coverage, according to the Woodhull Study Revisited, whom found that nurses were cited as expert sources in health-related news stories only 2% of the time. In 1998, the initial study found comparable outcomes (4% of news stories quoted experts who were nurses).

The purpose of this post is to highlight how nurses can share their knowledge by authoring op-eds. Below is a case study that exemplifies how nurses can a write op-eds to influence healthcare policy questions and legislative issues. Unique aspects of developing this op-ed included addressing current news stories, an assessment of health needs, and scientific evidence of best practices.

Case Study

In 2018, the U.S. government separated families who were seeking asylum in the US by crossing the border illegally. Dozens of parents were being split from their children each day — the children sent to government custody or foster care, the parents were sent to jail. The op-ed authors were enraged by local media stories of how parents and children were impacted by separation at the border. These stories are what inspired the op-ed. Nurses understood that a traumatic event like being separated from a parent could negatively impact a child. The authors worked together quickly to make sure their op-ed hit this current news cycle.

First, the authors identified the problem to be solved or issue to be addressed. For example, Federal officials at the U.S.-Mexico border separated nearly 2,000 children from their families between April 19, 2018, and May 31, 2018. To overcome this problem, nurses used evidence-based research to show parent-child separation may result in toxic stress.

Next, op-ed authors identified what had been done (or proposed) about the issue so far, they identified other organizations that had addressed the issue, and they looked for any pending legislative or regulatory proposals. For instance, for this op-ed, governmental organizations, including the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Centers for Disease Control (CDC) had already written clinical guidelines to address toxic stress.

Finally, the op-ed authors identified “why” government officials should address this issue. To assist legislators in influencing policy, the op-ed authors discussed the complex nature of toxic levels of stress from a scientific standpoint.

The op-ed, Toxic effects of stress on children separated from parents, was based on a nursing perspective and was provided to help tackle health disparities and injustices. Nurses linked the relevance of parent-child separation with evidence-based research on toxic levels of stress.

Nurses published this OpEd in The Hill – a newspaper mailed directly to all congressional offices and published online. The authors used evidenced-based research to show without the nurturance and calming support of a caring adult who is known to the child, these traumatic separations could alter the structure of the developing brain. Long term, this toxic level of stress can affect other organ systems, leading to long term adverse health outcomes such as mental illness, substance abuse, cardiovascular disease, and premature death.

This OpEd was shared at least 1,238 times online. As a result of this op-ed, a group of U.S. Senators (including Senators Kamala Harris, Dianne Feinstein, Cory Booker, Bernie Sanders, and Elizabeth Warren) wrote a persuasive letter to the Secretary of Homeland Security demanding that children be reunited with their families. The nurse-authored op-ed was cited as the first piece of evidence that separation could result in life prolonged trauma (see footnote on page 1). The policy that led to widespread family separations was ended and thankfully, no law currently mandates the separation of families. This is a clear example of why nurses need to express their voices in the public square. Unfortunately, the U.S. government continues separating some children from parents for questionable reasons.

Nurses make up the United States’ largest healthcare workforce and nursing is the most trusted profession. Nurses need to leverage that trust when it comes to educating the public and policy makers alike. Nurses, especially nurse researchers, should be sharing their knowledge by authoring op-eds. Will you?

About the authors

Sarah Oerther MSN, M.Ed., RN, F.RSPH, is a Ph.D. candidate at the School of Nursing, Saint Louis University where she is also completing a Family Nurse Practitioner post-master certificate. Sarah has published OpEds in The Missouri Times, The Hill, and HuffPost. In 2019, she received the Excellence in Nursing Award from St. Louis Magazine.

Barbara Dossey, PhD, RN, AHN-BC, FAAN, HWNC-BC, is internationally recognized as a pioneer in the holistic nursing and nurse coaching movement. She is a Florence Nightingale scholar and nurse theorist. She is Co-Director, International Nurse Coach Association (INCA) and Integrative Nurse Coach Academy, North Miami, Florida; International Co-Director and Board Member, Nightingale Initiative for Global Health (NIGH), Santa Fe, New Mexico, and Gatineau, Quebec, Canada.

Mona Shattell, PhD, RN, FAAN is associate dean for faculty development and professor at the Johns Hopkins School of Nursing in Baltimore, MD. She also holds a joint appointment in the Johns Hopkins Bloomberg School of Public Health, in the Department of Environmental Health and Engineering. She is the Editor of the Journal of Psychosocial Nursing and Mental Health Services, and the author of more than 140 journal articles and book chapters. She is an active social media user, content developer, and public thought leader. She has published op-eds in the New York Times, The Atlantic, Health Affairs Blog, Huffington Post, PBS, and others.

Co-authored by Kimberly Baltzell, Director, University of California San Francisco School of Nursing, Center for Global Health.

Registered nurses are many of “The Ebola Fighters,” which just last week TIME magazine named as the 2014 Person of the Year. To the vast majority of people, registered nurses deliver health care to persons who are sick. We’re glad that we’re honoring these individuals. Direct, hands-on patient care work is hard, and the personal risk to health care providers is great.

In general, this is how people view registered nurses — in scrubs, providing care that physicians prescribe. What’s not as evident is that there are other aspects of nursing — that is, that registered nurses have their own practice independent of physicians, and that registered nurses can get Ph.D.s in nursing and then systematically find ways to improve how health care is delivered. It’s this second point — registered nurses as scientists/researchers that we would like to discuss.

Both of us are Ph.D. registered nurses and both of us are scientists/researchers. We each have heard the following statements when someone hears that we have Ph.D.s in nursing, “a Ph.D.? Why not just go to medical school?” or “I didn’t know you could get a Ph.D. in nursing.” In these moments, we explain how nursing practice is distinct from medical practice and that a Ph.D. is a research degree and an M.D. is a practice degree. We say, “Yes, Ph.D.s in nursing exist” and this is what we do.

Here are some examples of the kinds of research that nurse researchers/scientists have conducted, which have resulted in improvements in care — In an emergency, a fighter pilot may reach for a mask to determine if his/her oxygen levels are dangerously low. If a women giving birth in Zambia begins bleeding profusely, a simple Velcro bodysuit designed to apply pressure and stop the bleeding may be used. A patient undergoing cardiac surgery has a greater chance of survival in a crisis due to new resuscitation standards. Cancer patients outcomes may be linked to clusters of symptoms, giving the health care provider important clues on what type of treatment to prescribe.

All of these creative solutions to critical problems involved nursing research, nursing science. You thought the role of a nurse is to deliver care at the bedside or in the community. That is true, however, that work at the bedside or in a community gives nurses a bird’s eye view of what needs to be fixed or improved. These same nurses may then go on for more education culminating in the terminal degree — a Ph.D. in nursing. These Ph.D. nurses design and conduct studies that help enhance health, decrease suffering, and improve the quality of health care. Nurse scientists work on real life problems in virtually every area of healthcare, in every setting, in every country.

The U.S. government may be recognizing the value of investing in nursing. In fact, last week the House of Representatives passed a bill which impacts nursing and health care. Additional funds have been designated for Ebola preparation and treatment, both here and in West Africa. Importantly, there are increases in funds for both advanced nursing education and nursing research through the National Institutes of Health.

So, if you or someone you care about has benefited from modern day health care, chances are a nurse researcher/scientist was involved in the design or innovation. In fact, those hands that care for you at the bedside may well be delivering interventions pioneered by a nurse scientist.

This blog was originally posted on Huffington Post on December 17, 2014.