Posing statements as questions, friends often ask me about my career trajectory: "You're not a nurse anymore?" When, in response, I explain that even though I have not laid hands on a patient for some years I'm still a nurse, I'm met with puzzled silence. How is it that people who have known me for years, who know what I do and who I am, can ask me this question? When do they suppose I stopped being a nurse? Was it when I moved into education? Was it when I initiated my first research project? Was it when I wrote my first manuscript? Or was it when I sat through a patient safety meeting as a hospital researcher?
As a discipline, we nurses have never been very good at marketing the essence of our profession. For example, I challenge anyone to ask a group of students why they came into nursing. The answer, as I know from years of experience, is highly consistent: "I want to help people." The sentiment is laudable, but is it informed? I suspect not. Even our professional peers-people we work with every day-do not really understand our purpose as nurses (Setnar & Orne, 2017); to our coworking health professionals, nursing is "perplexing."
I'll accede that nursing is inherently opaque. What most people construe as "nursing" is a set of imminently visible activities inherent in management of patient care. The more smoothly those visible activities are accomplished, the less complex they appear.
We are characterized by others in terms of evident features of nursing-what we do. Paradoxically, though, the seeming ease of "doing" nursing belies the complexity of the preparation, knowledge base, and fund of information required to do nursing well. In a 2013 editorial, Middleton urged nurses to shout about the complexity of nursing. It certainly is the case that nurses' actions-the things that they do-are noteworthy. From Florence Nightingale (recognized as a national hero when she returned home after her service in the Crimean War) to Rear Admiral Susan Orsega (chief nurse officer in the U.S. Public Health Service and selected early this year as the U.S. Surgeon General), nurses have influenced the health and safety of patients and their communities. But understanding the impact of nursing on people and their communities requires moving beyond what nurses do to recognizing what knowledge drives and shapes their work.
As Tehan et al. (2019) opined, "nurses must be skilled in translating information through the nursing lens to support individuals in realizing meaning, choice, quality of life, and healing in living and dying" (p. 69). Only as they translate what is happening around them can they take action that makes doing nursing optimal. They must see "the apple in the seeds," as Martha Rogers once so astutely noted.
I applaud Middleton's (2013) efforts from nearly a decade ago to shout about nursing's complexity. Today, I respond to her appeal, shouting out that what nurses know makes their contributions to the well-being of patients and communities a reality. Their knowing-doing informs practice that truly impacts the well-being of patients and communities, moving nurses' work far beyond completion of items on a checklist to the conduct of comprehensive and optimally fitting interventions-to interventions that really make a difference.
As an author, committee member, professional colleague, planner, teacher, theoretician, researcher, and sometimes technology repair person, I'm still a nurse. Nursing's unique and essential knowledge base guides my work and structures my beliefs. It provides a way of understanding how people, their environments, and their health fit together. It offers a trajectory for planning and implementing actions to maximize people, environments, and health. Because of what I know and what I do-even in its invisibility-I'm still a nurse.
Conflict of Interest
The author declares no conflict of interest.
Laura Dzurec, PhD, PMHCNS-BC, ANEF, FAAN
Hartford Hospital
Hartford, Connecticut
References