It’s not always better to be treated by a doctor than a nurse

Five Myths about Nursing

by Rebecca Simik

Washington Post

February 3, 2022

The pandemic has shined a spotlight on the critical role of nurses in hospitals — and the risks they routinely encounter while doing their jobs. The field of nursing, however, is still deeply misunderstood. This is perhaps no surprise: Nurses’ work is often undervalued compared with that of doctors, and almost 90 percent of the nursing workforce is women. Here are five common myths about the profession.

Myth No. 1

Nursing is lucrative.

Nursing is sometimes described as a lucrative career. Since the pandemic began, articles have highlighted the huge demand for these highly skilled professionals, as well as the particularly profitable career of travel nurses — who go wherever they’re needed, sometimes earning $5,000 a week, even more than doctors make.

The reality is that most registered nurses make a solidly middle-class salary. A 2020 report from the Bureau of Labor Statistics found that the median annual wage for registered nurses is $75,330 — respectable but not remarkably lucrative, particularly when many employers don’t give pay raises for additional certifications. According to ZipRecruiter, in some states, average salaries hover around $55,000.

Myth No. 2

Nursing is no longer a desirable job.

The great exodus of health-care workers is a pressing concern, two years into the coronavirus crisis. This is evident not just in the steady stream of news stories about fed-up nurses quitting on the spot, but also in viral Twitter videos like one from an ICU nurse who, in an explosion of angry sentiment, quit after 19 months of working in pandemic conditions.

In fact, interest in this career remains high. An NPR segment from October reported that some community college nursing programs have 800 applicants for only 50 openings. Research data from the American Association of Colleges of Nursing shows that 2020 enrollment in bachelor’s degree programs increased by nearly 6 percent, enrollment in master’s degree programs went up by 4 percent, and doctor of nursing practice programs saw their enrollments jump by almost 9 percent.

And according to the American Association of International Healthcare Recruitment, thousands of foreign nurses, ready to work, are awaiting U.S. visa approval.

Myth No. 3

It’s better to have a doctor treat you rather than a nurse.

It’s widely assumed that doctors are the best at all medical procedures, including starting IVs or drawing blood. This myth shows itself in medical TV dramas like “House”andGrey’s Anatomy” that almost exclusively portray doctors as the only members of a treatment team, or editorial cartoons questioning the merits of nurse practitioners. More recently, physician Sandra Lee, from the reality TV show “Dr. Pimple Popper,” received a lot of negative fallout over a tweet questioning why a WebMD article discussing sunburn vs. sun poisoning was written by a nurse instead of a dermatologist.

One reason this struck such a nerve is that a significant part of what nurses do, besides provide direct medical care, is educate patients and family members. Nurses advise parents on how to care for newborn babies who spent time in the neo-natal intensive care unit. Many procedures typically done by nurses — like placing urinary catheters or, in many states, removing sutures — haven’t been done by doctors since they were in medical school. Furthermore, a physician-run study published in the Lancet research journalfound that nurse practitioners performed as well as junior doctors on all procedures and tasks in their emergency department, except two — taking medical history and educating patients at discharge — on which the nurses performed better.

Myth No. 4

The pandemic has made nurses’ jobs dangerous.

Divisive politics have created increasingly risky situations, with health-care workers sometimes getting threats from those who oppose the coronavirus vaccines or want unproven medical treatments for their sick loved ones. This is reflected in headlines like “Health Workers Once Saluted as Heroes Now Get Threats” and “US hospitals tighten security as violence against staff surges during pandemic.”

The reality, however, is that these jobs were dangerous well before covid-19. Nurses and other health-care workers accounted for 73 percent of all injuries and illnesses resulting from nonfatal workplace violence in 2018, according to a BLS report. The Justice Department and the Occupational Safety and Health Administration have long reported that nurses and other bedside care providers, such as medical technicians and nursing assistants, are most at risk for an incident of workplace violence. The Washington Post’s Petula Dvorak in 2017 called nursing one of America’s most dangerous jobs and highlighted an emergency room nurse in Southbridge, Mass., who survived a vicious stabbing; a Massachusetts health-care safety bill was named after that nurse (the measure stalled in the legislature).

Beyond that, roughly 86 percent of registered nurses are female, and the field is still subject to over-sexualized stereotypes. Each Halloween brings a new wave of “naughty nurse” costumes; type “nurses” into the GIF search box of any messaging app, and you’re likely to find sexually suggestive images. Sandy Summers, a registered nurse, argues convincingly that these images fuse “caregiving with easy sex,” creating a dangerous atmosphere of disrespect. One research review found that 43 percent had reported experiencing some form of sexual harassment. Julia Lehman, an emergency department registered nurse, told me that sexual harassment is so common, she builds deflection statements into nurse trainings that she leads.

Myth No. 5

Nurses are superheroes.

Because of the nature of their jobs, nurses often perform remarkably well under stress. But this has turned into the harmful misconception that nurses are somehow superhuman in their resiliency. A contestant on CBS’s “Tough as Nails” cited being a nurse as a reason she should be successful in the show’s grueling competitions. Well-meaning posters, T-shirts and even art from the likes of Banksy depict medical workers in superhero masks and capes; Marvel Comics created “The Vitals,” a comic book featuring nurses in pandemic-related medical adventures. Research shows that the perception of toughness permeates the field.

The sober reality, however, is that living up to this superhero image is impossible — not unlike Luisa in the Disney movie “Encanto,” who is both heroically strong and tragically anxious. In a Washington Post-Kaiser Family Foundation survey last year, 62 percent of health workers said worry or stress related to covid-19 had a negative effect on their mental health.

A 2020 study from the University of California at San Diego established a higher rate of suicide in nurses compared with the general population, which led the school to develop a suicide prevention program specifically for those in health fields. This and other crisis interventions help considerably. Code Lavender, an alert system created in Hawaii and championed by the Cleveland Clinic, draws a rapid-response team of traditional and holistic practitioners to help hospital staff or patients within 30 minutes of a report of a particularly traumatic incident.

Five myths is a weekly feature challenging everything you think you know. You can check out previous myths, read more from Outlook, or follow our updates on Facebook and Twitter.

By Rebecca Simik

Rebecca Simik is a graduate student in the science writing program at Johns Hopkins University. She was a research associate at University of California, San Diego, for 20 years and managed both clinical psychiatry and neuroscience research groups focused on severe mental illness.

Meet the Six Nightingale Awards Winners of 2020

A deep thank you to my friend and fellow writer Michele Murdock who sent me the first Star Nurses publication, which documents the collaborative effort between the Washington Post and the American Nurses Association (ANA) to nominate six nurses from across Maryland, Virginia and the District of Columbia who “go above and beyond.”

Hopefully, we will have more collaboration between the ANA or other nursing organizations and news media in order to spotlight nurses who make a difference. What a great way to educate the public about what nurses really do. As you can see, the six nurses selected for the first Nightingale Awards practice in diverse settings and have varied backgrounds. 

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WashPost PR Blog

The Washington Post and the American Nurses Association Announce the 2020 STAR Nurses Award Winners

By WashPostPR

September 2, 2020 at 1:51 p.m. EDT

The Washington Post and the American Nurses Association (ANA) announced the winners of the 2020 Star Nurses Awards, recognizing registered nurses in the Washington, D.C. area with the Nightingale Award for excellence in their field. The six winners, who were nominated by patients and peers and were selected by the American Nurses Association and a panel of fellow RNs, are recognized for their achievements across a range of criteria including compassion and positive community impact. Below is the list of 2020 Nightingale Award Winners:

The winners were announced last night at the STAR Nurses Awards Ceremony, and were featured in the Star Nurses Magazine, which features each nurse and their story. For more information on the program go to: www.starnursesdc.com

All Heart

Photo Credit: Reflections of Zion Imagery ©

A veteran registered nurse on the Cardiovascular Intensive Care Unit at Winchester Medical Center, Lisa Dellinger is still passionate about her profession—and loves sharing her enthusiasm with new graduates. 

Lisa Dellinger, RN

“I like admitting hearts,” admits Lisa Dellinger, a Cardiovascular Intensive Care Unit (CVICU) registered nurse (RN) at Winchester Medical Center in Winchester, Va. “We come together with procedural precision, and everyone knows their jobs without being told. That still lights a fire in me.”

Admitting a heart is the process of receiving a heart patient following surgery. These critically ill patients do not go to a recovery room. They come directly to the CVICU, where a team of healthcare providers ensures that all their lines and drips are accounted for and they are transferred safely.

“It’s like solving a puzzle,” Lisa added. “It’s a puzzle I can unravel, and I can keep my patients safe.”

From an early age, Lisa was always a problem solver. Although she dreamed of becoming a pediatrician, she knew she could not afford college. Instead, she joined the military and gained experience as a medical technician. It was during this time that she decided to become a nurse. “I realized that nurses get to spend more time with patients, so I knew I wanted to be a nurse,” she recalled.

Today, after 24 years in the field, Lisa is still passionate about nursing. In fact, she is most inspired when helping new graduates navigate the challenges of the profession.

“I love working with new grads. I love being able to pass on some of my knowledge—and hopefully some of my enthusiasm,” Lisa said. “I always tell new nurses that I would rather they ask me a hundred questions than do something to harm a patient.”

Lisa strives to teach new nurses what really matters. While she expects the nurses she mentors to be very attentive to the medical details of patient care, she thinks it is even more important that they get to know patients as people. Learning a patient’s personality can help nurses motivate them to get out of bed and get better, she explained.

“Ultimately, it’s our job to be our patients’ advocates—to be their voices,” Lisa concluded.

Lisa is a strong voice and an even stronger force. She is all heart.

A Big Voice for Small Patients

Photo Credit: Reflections of Zion Imagery ©

As a pediatric oncology nurse researcher at Children’s National Hospital, Pamela S. Hinds, RN, Ph.D., FAAN, helps young patients find their voice and make sure it is heard.

Pamela S. Hinds, PhD, RN, FAAN

Sometimes they want a back rub. They might want to chat about their fingernails. Most of all, they want to be heard. They are young cancer patients. And they have a strong advocate in Pamela S. Hinds, RN, Ph.D., FAAN, a nurse researcher at Children’s National Hospital.

Pamela performs pediatric oncology research that enhances patient outcomes and improves nursing practices. Over the course of her long career, she has had many emotional experiences with young patients and has really learned to listen to them.

“There are so many children whose faces and stories stay with me,” Pamela said. She recalled one young woman who had acute lymphocytic leukemia and experienced several recurrences requiring multiple bone marrow transplants. “I would end each day with a few quiet moments with her. It would soothe her so much when I would just rub her back,” she remembered.

Pamela also recollected a teen girl with a rebellious spirit and an extremely aggressive form of cancer. The girl tried desperately to find something positive. “She would say to me, let’s talk about the one part of my body that’s normal: my fingernails. So we would talk about her fingernails,” Pamela recalled.  

For Pamela, the diverse stories of the many children she has treated are what motivates her research. As the principal investigator for a number of federally funded grants, Pamela can amplify children’s voices to help them get better, more compassionate care.

“For many years, we didn’t ask children questions,” noted Pamela. “We never asked them what it was like to be receiving cancer treatment. We just delivered the treatment.”

Pamela and her team created a comprehensive set of questions to help care providers talk to—and understand—seriously ill children. The questions are now available for use across the country via the National Cancer Institute of the United States.

Speaking of the emotional challenges of her field, Pamela admits, “It’s very painful. But I believe in the power of love. And I see love every day—the love of a parent for a child, and a child for a parent, and also of staff to children and children to staff. That’s an amazing thing.”

That is amazing, and so is Pamela S. Hinds.

Starting (and Staying) Strong

Photo Credit: Reflections of Zion Imagery ©

As a school nurseViktoria Holley-Trimmer is responsible for the health and safety of every student in her building.

Viktoria Holley-Trimmer, MS, RN

You have to start somewhere. Good days start with a nutritious breakfast. Good students must first be healthy students. Viktoria Holley-Trimmer is making sure that students in the District of Columbia start healthy and stay healthy—as a D.C. public school Registered Nurse.*

“I always tell people that I didn’t choose nursing. Nursing chose me,” says Viktoria of how she came to the profession. During the nursing shortage of the 1980s, Viktoria was offered a full scholarship to attend nursing school. She took it, and she has never looked back.

At Francis Scott Key Elementary School in D.C., Viktoria is helping young people achieve their best possible health, so they can thrive as students. “The day in the life of a school nurse includes something new every day,” she said. “Kids are just so amazing.”

From bandaging scraped knees to coaching scared kindergartners to helping kids manage serious long-term illnesses, Viktoria is responsible for the health and safety of every student in her building. She also does regular education sessions with the children, teaching everything from proper hand washing technique to healthy eating habits.

A big part of school nursing is taking care of the broader community. And Viktoria is certainly committed to strengthening her community. Every year, Children’s National Hospital holds a cereal drive to provide breakfast options to underserved children during the summer months. Viktoria is one of the leading contributors.

“Last year, I collected more than 11,000 servings of cereal for children in D.C.,” said Viktoria . “I talked to the parents and the teachers and rallied them to the point where they brought me cases of cereal.”

Even with schools shut down due to the Coronavirus crisis, Viktoria is continuing to care for her community. She is currently working as a contact tracer for D.C., fighting the community spread of the virus one phone call at a time.

From her cereal drive efforts to her day-to-day work in the school, Viktoria is ensuring that children in the District know that someone cares—that someone is committed to giving them a strong start.

Quite a Journey

Photo Credit: Reflections of Zion Imagery ©

Cherissa Jackson is the Chief Medical Executive at AMVETS (American Veterans), a registered nurse, a veteran and a proud post-traumatic stress disorder (PTSD) survivor.

Cherissa Jackson, RN

Cherissa Jackson has covered a lot of ground. She traveled thousands of miles to complete her tours in Iraq and Afghanistan. Back at home, she has logged hundreds of miles running—in an attempt to outrun her post-traumatic stress disorder (PTSD). As the Chief Medical Executive at AMVETS (American Veterans), Cherissa is using her skills as a registered nurse and her personal experience with PTSD to help other veterans recover.  

As a single mom to twin daughters, a veteran, a nurse and a leader, Cherissa has overcome some major obstacles—but none has compared to PTSD.  Cherissa served 23½ years in the U.S. Air Force, many of them as a nurse. She served as a battlefield clinician in Iraq in 2005 and 2006 and in Afghanistan in 2011.

“I treated soldiers for PTSD. I knew the signs,” Cherissa recalled. “When I started experiencing some of those same symptoms, I hid in silence for five years.”

When her daughters left for college, Cherissa stopped hiding. “I had a PTSD break. I knew I had to get help,” she explained.

Years later, Cherissa has learned how to manage her PTSD. She uses a tried-and-true regimen of faith, meditation and exercise to keep her disorder at bay. Exercise is key. She said, “I tell people all the time that when I run, I sweat like crazy. That’s me purging those bad thoughts and feelings. That is me getting rid of what I experienced in Iraq and Afghanistan.”

Cherissa has shared her struggles with PTSD in several national magazines, and she wrote a best-selling memoir, “At Peace, Not in Pieces” about her experiences. “I strive to inspire others not to live in silence,” she said. “There is a way to be functional and not be ashamed to admit you have PTSD.”

When she joined AMVETS in 2019, Cherissa began running the organization’s HEAL program. HEAL, which stands for healthcare, evaluation, advocacy and legislation, aims to reduce veteran suicide, unemployment, homelessness and hopelessness by providing vital resources.

In addition to her work with HEAL, Cherissa is concentrated on elevating the issues that women veterans face. She created the Women Veteran Journey Map, an online tool that illustrates the unique experiences of women service members.

Cherissa may have suffered in silence for far too long, but she is sharing her journey with PTSD and advocating for other veterans now. She’s covered a lot of miles, and she is determined to leave markers to help those who follow.

Caring and Coaching

Photo Credit: Reflections of Zion Imagery ©

In addition to teaching, Jonas Nguh, Ph.D., RN, a professor of nursing at Walden University, is deeply committed to serving marginalized communities—and inspiring his students to do the same.

Jonas Nguh, PhD, RN

When Jonas’s phone rang in the wee hours of the morning, he was startled. The voice on the other end of the line was frantic, screaming, “Thank you, thank you!” Jonas Nguh, Ph.D., a registered nurse and professor of nursing at Walden University, inspires these reactions from his students.

The caller went on to explain that she was one of Jonas’s former students and that she had just passed her board exam to become a registered nurse. “She told me I was one of the only people who never gave up on her and that kept her going,” Jonas recalled. “She called me before she even called her husband!”

“It’s just amazing to me that I can use my abilities to improve the lives of others, whether that is the people in my community, my students or people around the world,” Jonas added. “I love working with people and for people.”

It is that genuine love of people that brought Jonas to nursing and that makes him such an accomplished educator. The youngest of five children, Jonas grew up in an impoverished community in Cameroon. He has three older sisters who are all nurses.

“I think I was born into nursing,” he said with a smile. “Now I get to prepare the next generation of health care providers.”

In addition to teaching, Jonas is deeply committed to serving marginalized communities—and inspiring his students to do the same. Jonas does several mission trips every year with his students or his faith community.

In 2010, following the catastrophic earthquake in Haiti, Jonas facilitated a hand washing initiative. Jonas and his students visited D.C. area hotels and collected the complimentary bars of soap left behind after guests checked out. They found a vendor to disinfect and repackage the soap. The class then delivered the soap to communities in Haiti where hygiene products were scarce.

“Sanitation is the first basic element to prevent infection,” Jonas said. “I’ve always been committed to looking for the little things that can help. This was practical and feasible, and it helped.”

Jonas is proof positive that little things quickly become big things in capable hands. Jonas is not just competent; he is gifted. And he is always willing to share his gift. “This is a calling, not a job,” he concluded of the nursing profession. “It’s a mission. It’s the whole purpose of my existence.”

Hearing and Healing

Photo Credit: Reflections of Zion Imagery ©

Sarah Rose, a registered nurse unit supervisor at Inova Alexandria Hospital, is committed to listening—and really hearing—patients and frontline nurses.

Sarah Rose, RN

Sarah Rose is a good listener. As a registered nurse unit supervisor at Inova Alexandria Hospital, Sarah makes sure that patients’ voices are heard and respected. She also ensures that the nurses who work at patients’ bedsides have a voice in shaping health-care policies and practices.

As a child, Sarah wanted to be a veterinarian. She loved animals, so it seemed like an obvious career choice. Her parents had other ideas. One summer, they convinced Sarah to volunteer at a local hospital. She was able to directly interact with nurses and patients on a daily basis. A new nurse was born.

“I always had a calling to help others, and this junior volunteer program allowed me to see how much nurses were helping,” Sarah recalled. “That started me down the path to become a nurse.”

When Sarah joined the staff at Inova Alexandria, it didn’t take long for her patients and co-workers to recognize her aptitude for caring. She received the hospital’s Nursing Excellence award in 2015, 2016 and 2019.  

Most recently, Sarah was recognized for her efforts to promote shared governance. Shared governance empowers nurses at the bedside to work with leadership to formulate policies and to express concerns drawn from their day-to-day interactions with patients.

After just two years as a staff nurse with Inova Alexandria, Sarah was promoted to unit supervisor in October 2016. Her unit provides step-down care for patients with serious cardiac issues.

“I strive to lead by example,” Sarah says of her role as supervisor. “I want to show new nurses that we can take the time to make personal connections with patients—to use the patients’ names and engage in small talk. Those simple connections make a big difference.”

Even when faced with difficult patients, Sarah remains dedicated to listening first. “It’s not just about letting them speak and then not hearing what they are saying,” she said. “You have to acknowledge what they are feeling. You acknowledge their concerns and then you explain what you’re able to do to help with the best possible outcome.”

Sarah listens. She pays attention. And she connects. By really hearing her patients and her staff, Sarah Rose is helping improve lives and enhance her profession. Sarah’s hearing promotes healing.  

Media In-Depth Look at Nurses

Sandy and Harry Summers review in their June 2020 The Truth About Nursing Blog a story that appeared in the Washington Post. I am always happy to see another example of the media covering nurses and nursing issues. And this time the authors talk about “what nurses actually do!”

However, it’s sad that it has taken a pandemic to call attention to the nursing profession.

The Summers, as usual, have done an exceptional job in their textual criticism of the essay. 

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Saving us from ourselves

by Sandy and Harry Summers

Washington Post report on nursing in Covid era offers unusually deep look at profession

A long April 2020 piece in the Post had information from a diverse group of nurses. Of course, they were able to explain how it feels to be a nurse in the Covid-19 era—a common press theme now. But they also described the nature of the profession, what nurses actually do for patients, and nurses’ protests about inadequate PPE.

April 28, 2020 – Today the Washington Post had a good story by Dan Zak and Monica Hesse headlined “Nurses are trying to save us from the virus, and from ourselves.” That last part signals that this won’t be just a standard “nurse-hero” piece about how difficult it is to care for Covid-19 patients. Instead, the article manages to provide a surprisingly in-depth look at the nursing profession, from its historical roots to its key roles in patient surveillance and advocacy, including why many nurses are now protesting about shortages of personal protective equipment (PPE). One highlight of the piece is a capsule description of what direct care nurses do by Laurie Combe, the president of the National Association of School Nurses. Combe talks about the subtle but critical assessments and the vital psychosocial care nurses provide. The piece also discusses some of Florence Nightingale’s work to revolutionize care settings and improve survival rates in the 19th Century. And it describes nurses’ protest activities during the current pandemic, particularly efforts by members of National Nurses United to push for the federal government and hospitals to ensure that nurses have adequate PPE. One nurse protester mocks the “hero” narrative nurses often hear now as just “gaslighting” when it’s accompanied by a failure to provide them with PPE. These elements point to nurses’ key patient advocacy role, although the article does not make that link specifically. And the report is not perfect, as a few elements tend to support the incorrect notion that nurses are virtuous adjuncts of physicians, rather than autonomous professionals whose focus is serving patients. But overall the piece gives a vivid sense of what nursing is about and the situation of nurses trying to care for Covid-19 patients now. We thank those responsible.

Strong and smart

The Post report does start by discussing the demands of Covid care. It explains how hard it is to provide expert and empathetic care for 12 or more hours while wearing burdensome PPE in an under-resourced setting while “confronting the most frightening pandemic in 100 years.”  

But then the piece backs up and asks what nurses really do. Apparently they are “the glue” and the “link between patient and doctor,” and their profession is consistently rated the “most honest and ethical” in Gallup surveys. Those descriptions are all somewhat problematic—the familiar polling point because it often masks a lack of true respect for nurses’ skills, and the earlier descriptions because they present nurses as adjuncts to physicians, which they are not. Nursing is an autonomous profession that exists to serve patients, not physicians. The reporters do say that nurses don’t want to be called heroes, but for the public to stay home and stay alive. And then they turn it over to a nurse expert, who picks up on the standard “most trusted” message the piece has just presented.

“But I don’t think that means people really understand what nurses do,” says Laurie Combe, president of the National Association of School Nurses. It’s a complex job, requiring knowledge of both biochemistry and psychology, in myriad environments. Nurses are helping your fourth-grader learn to track her insulin levels at school, and they are putting pressure on a gunshot wound at 2 a.m. while noting that the victim has no pulse. They are monitoring both your heart rate and your spirit. When they touch your arm, in what would appear to be a simple gesture of friendliness, they are also testing if you’re hot, swollen, dehydrated, tremoring. “I can observe what is on your bedside table that you’re reading — if I can talk with you about that, I can strengthen our connection to build trust,” says Combe, who has been a nurse in the Houston area for 45 years. “I can see who’s in your room visiting, what the interaction looks like, and see whether that’s a trusted person or not, so I know what I can talk about during that visit.”

This is one of the best capsule descriptions of nursing that we have seen in almost two decades of doing this work. Ten stars for Laurie Combe! She identifies the problem with the angel narrative, and then she addresses it, with a short, compelling description of how nurses help people in ways few even realize are happening. 

The piece moves on to note that the coronavirus has changed what nurses do, as they may be working in unfamiliar units under extreme conditions without adequate PPE, “facilitating virtual goodbyes with dying family members” and “organizing protests against hospitals and the White House.” Some are running Covid testing sites, and the article profiles Brenda Lagares, who had been a “night nurse” in New York City before being recruiting to be a “sampling nurse” at a drive-through testing site in Bear Mountain, NY. She tests motorists after having “been given 15 minutes of training to potentially save their lives.” These descriptions do not convey a very full picture of nursing education or expertise. Fortunately, Lagares gets to explain what she does for patients even in the fast-paced and limited drive-through setting. She describes how, even encumbered by PPE, she can read patients’ emotional state (by examining their eyes) and provide reassurance (with explanation, encouragement, a wave and a thumbs up). The article also talks to another nurse at a test site, in Orlando, FL. Sasha DeCesare went to nursing school in Venezuela. DeCesare believes it’s great to be a nurse in the U.S. because (in the report’s words) “it’s a female-dominated profession, filled with strong and smart women.” But now she has worked 22 days straight, and sleeps in a hotel to protect her family from infection.

The piece has some history. This starts with Nightingale’s work for soldiers in the 1850s Crimean War, which the article explains in some detail. It involved better hygiene, ventilation, nutrition, and fundraising. As the piece explains, “the death rate for admitted patients fell by more than half. [Nightingale] wasn’t only a caretaker. She was a revolutionary.” And she wrote Notes on Nursing, which “became a bible for modern care.” The piece quotes Barbra Mann Wall, director of the Eleanor Crowder Bjoring Center for Nursing Historical Inquiry at the University of Virginia, on the diversity of early nurses in the United States. (The piece might have noted that Mann Wall is herself a prominent UVA nursing professor with a PhD.) Apparently relying on Mann Wall, the piece describes the growth of nursing during and after the Civil War, as well as the development of nursing education from a two-year apprenticeship based mostly on skills — wound care, bedsores prevention — to a four-year program equally based on science. … Eventually, nursing would encompass a range of specialties and career paths; a nurse anesthetist might make $175,000 a year, while a nursing assistant might make $14 an hour.

Not surprisingly, the piece pauses at the 1918 flu pandemic. Apparently relying again on Mann Wall, it notes that the best treatment available then was “rest, hydration, hygiene — the pillars on which Nightingale had built her practice.” And it quotes then-health commissioner of Philadelphia Wilmer Krusen on what was needed in that epidemic, given that beds and physicians were in sufficient supply: “Nurses, more nurses and yet more nurses.” That is a timely comment today, when much of the early media on Covid-19 focused on beds and ventilators, ignoring the nurses who would be needed to care for the patients using that equipment. 

Gaslighting

And the article has a substantial amount of material on the protests, i.e., the patient advocacy. The reporters explain:

People keep saying that nurses are on the front lines, but they are actually behind enemylines, surrounded on all sides. They are trying to save us, and save us from ourselves. Nurses are protesting protesters, standing in their scrubs and masks to glare at “freedom-loving” citizens who spew insults as they rally for the economy to reopen. Nurses are taking to social media to convey the extremity of their situations: They talk about war zones, about titrating a dozen IV drips while troubleshooting fluky ventilators, all without reliable stockpiles of supplies.

The piece relies fairly heavily on Elizabeth Lalasz, a Chicago union steward for National Nurses United (NNU). Lalasz herself was out of the clinical setting for 18 days with Covid-19, which she says she got because of inadequate PPE; she calls the nurses “cannon fodder.” The report explains that Lalasz became a nurse in her 40s, after watching an oncology nurse caring for her dying father advocate successfully for him “against a phalanx of male superiors” to go home to die, 35 years ago. Presumably that means a group of physicians; of course, they were not “superiors,” but surely they had far more power, so that sounds like some impressive advocacy. 

And Lalasz does some advocacy too, pointing to the dysfunctional U.S. health care system, which even before Covid-19 “left front-line workers feeling burned out, with high rates of attrition and suicide.” The reporters also talk to nurses at the California hospital that suspended 10 nurses for refusing to care for Covid-19 patients without an N95 mask. One of the suspended nurses, Jack Cline, explains why the surgical masks are inadequate, regardless of CDC guidelines saying otherwise. The piece also describes the recent White House protest by NNU members seeking more PPE for health workers—over 230,000 of whom have been infected with the virus, and 600 nurses have died from it. One protesting nurse was Charles Dalrymple, who spends hours caring for Covid-19 patients in negative-pressure rooms, in some cases helping them say goodbye to family through virtual means. He held a sign saying “20 SECONDS WON’T SCRUB THE BLOOD OFF YOUR HANDS,” with “HERO” in quotes. Why the quotes? Dalrymple said:

I feel that it’s being used to placate us — gaslighting this entire situation. A ‘we signed up for this’ kind of thing. But we didn’t. We didn’t sign up to go into a room without proper gear. . . . They can’t be throwing this word around just to make it seem like, ‘Oh, it’s okay that they’re dying. It’s because they’re heroes.’

Right. Nurses have always faced the virtuous-angel narrative, in which they get lip service but are expected to endure abuse and resource shortages without complaint. But now, the “hero” narrative seems to be functioning in a somewhat similar way for everyone on the Covid-19 front lines. If we call them heroes enough, and have the Blue Angels fly overhead to say thanks, then apparently it’s OK that we are still not giving them the PPE, tests, and other supplies they need. 

On the whole, because of the detail about what nurses actually do, the material about the history of nursing, and the reporting on nursing advocacy—particularly the PPE protests—the piece is an unusually valuable one in the Covid-19 category. We thank those responsible.

See the article by Dan Zak and Monica Hesse “Nurses are trying to save us from the virus, and from ourselves,” posted on April 28, 2020 on the Washington Post website.

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