The Truth About Nursing

The Registered Nurses Association of Ontario (RNAO) has told the media that London Health Sciences Centre fired chief nursing officer Vanessa Burkoski, RN, MScN, NP, DHA, because of her role as president of RNAO, which had recently issued a report criticizing denursification at the province’s hospitals. The June 2016 article "An Ontario nursing group contends Vanessa Burkoski was fired to silence her about changes affecting patient safety,” includes an account by Dr. Burkoski in which the large hospital's CEO Murray Glendining repeatedly offered her a cash settlement to resign quietly, which she declined to do.  In the article, RNAO chief executive Doris Grinspun reportedly says that the “boss of London’s largest hospital has sacked his chief nurse to stop her from speaking out against changes that put patients across Ontario in harm’s  way.” The article explains that according to Grinspun, Glendining fired Burkoski not for her work at the hospital, “where she received stellar reviews,” but because she was the RNAO president in May 2016 when it “produced a report that exposed how Ontario hospitals had harmed patients by replacing registered nurses with cheaper and less educated health care workers.” Grinspun says that other Ontario hospital leaders have tried to silence chief nurses who raised this kind of concern, and “patients suffer the consequences because chief nurses are the safety valves.” The Windsor Star quotes Burkoski as saying that no other RNAO President has ever been fired for serving in that role in its 90-year history. “As CNEs (chief nurse executives) we can’t become shrinking violets when our bosses intimidate us or threaten us, because it’s dangerous for patient care and patient outcomes,” she reportedly said.  Please encourage Ontario Health Minister Eric Hoskins to investigate this apparent termination and its effect on patient safety.

On September 14, 2016, soccer star Abby Wambach discussed Title IX on National Public Radio's Fresh Air. Ms. Wambach asserted that the historic legislation was not intended mainly to strengthen women's sports, but instead "there was a ton of women who wanted to become doctors, they didn't want to just be a nurse.” Neither Wambach nor Fresh Air host Terry Gross gave any indication that they disagreed with the assumptions underlying that description: that medicine is a much more important, substantial profession than nursing, and so any ambitious modern female would naturally choose to be a physician rather than a nurse. Even if this was in fact the way Title IX supporters thought, presenting such views with no apparent distance tends to reinforce them because they are still so commonly held. By contrast, Wambach does not describe ignorant views of gender equality without any indication of whether she agrees--instead, she expresses strong disagreement. We realize many feminists assume that jobs to which women were traditionally confined must be less valuable and desirable than the ones dominated by men, and nowhere is this more striking than with nursing and medicine. But as applied to nursing, these views are very damaging, because they contribute to the undervaluation and underfunding of the profession that is costing lives worldwide. Nurses are autonomous professionals who use (or try to use) their college science degrees to save lives and improve outcomes in a wide range of settings. Nursing is just as important as medicine. In fact, many nurses are "doctors"--of nursing. Of course women should be able to pursue any field they wish on an equal basis. But the failure to recognize the value of the traditionally female field of nursing is especially ironic in a discussion of gender equality. And NPR's Fresh Air claims to reach more than 5 million listeners weekly.  Please join us in urging Abby Wambach, Terry Gross, and NPR to clarify whether they agree with the uninformed views about nursing that the September 14 comments reflect, and if not, to take steps to address the damage caused by the unquestioned presentation of those views to Fresh Air's listeners. Thank you!

On June 1, 2016, Fox News posted a video report headlined "Vets may have to settle for a visit with the nurse at the VA," which featured statements about a proposed rule change by the Department of Veterans Affairs (VA) that would "allow highly trained nurses to act as doctors, and even administer anesthesia without a doctor's supervision."  The video report was apparently sparked by a June 1 press conference at which physician anesthesiologist groups voiced their objections to the rule. The report gave these physicians free rein to espouse their unsupported views, with no nursing response beyond a limited segment featuring a nurse practitioner (NP) assuring viewers somewhat vaguely that NPs do have clinical experience. The piece failed to convey that advanced practice nurses like NPs are graduate-educated health professionals with independent licenses and an autonomous nursing practice model, which is broader and more holistic than the medical model. There was no response from any nursing group. Fox News ignored the powerful rebuttal of the physicians’ arguments by the American Association of Nurse Anesthetists (AANA) that was issued on the same day as the anesthesiologists' press conference. Fox failed to convey that certified registered nurse anesthetists (CRNAs) have years of education specifically aimed at this work, which they have been doing safely for decades--they are not suddenly being asked to give anesthesia after learning about it in an extra night class or two. The AANA referred to the latest study showing that physician "supervision" of nurse anesthetists makes no difference to patient safety and is therefore unnecessary. We urge Fox News to apologize for its unbalanced report, including the insulting suggestions that patients would be "settling" and that the nurses would be "act[ing] as doctors." We also expect Fox News to make amends for this report by running a followup video report with AANA president Juan Quintana, RN, DNP, CRNA, himself a military veteran, to allow nurses the opportunity to defend themselves from these attacks and let the public know about the research that shows they are safe, effective science professionals.

Memorial Heights Emergency Center in Houston posted a billboard portraying nurses as eye candy in its quest to lure patients to its outpatient facility--one owned by physician Akash Bhagat, who thinks so little of nurses as professionals that he boasted on a radio program that his facility refused to hire nurse practitioners because they are trained "at a different level." 

  In the episode of Disney's Lab Rats broadcast on August 5, 2013 (“Bionic Showdown”), inventor Donald Davenport mocks his brother Doug by noting that Doug has turned into “Dr. Evil,” “or should I say Nurse Practitioner Evil, since you flunked out of med school!” That is a baseless and damaging message about nurse practitioners because research shows that even jokes affect what people think and that advanced practice nurses provide care that is at least as good as physician care.

People have the right to show the public the kind of conduct we see on Scrubbing In. But when that conduct is so closely associated with nursing, it can be troubling, because of the profession's poor image. Nursing has endured decades of negative media images, including the enduring ideas that nurses are unskilled and sexually available. These stereotypes form the foundation of the disrespect and underfunding that has led to the global nursing shortage, which kills millions of people every year. And because of nursing's poor image, it matters which nurses are chosen to appear on a show like Scrubbing In and what they are seen to be doing on the show. We cannot assume that the public, particularly the impressionable young MTV demographic, will know that there are millions of highly qualified professional nurses out there regardless of what appears on this show. So the show is a public health problem.