The National Nurse

On December 15, Rep. Eddie Bernice Johnson (TX-30) introduced HR 3679, The National Nurse Act of 2011.

The legislation, co-led by Rep. Peter King (NY-3), would elevate the existing Chief Nurse Officer of the US Public Health Service, to the National Nurse for Public Health, a new full time leadership position that can focus nationally on health promotion and disease prevention priorities.

Teri Mills, a Certified Nurse Educator at Portland Community College in Oregon and President of the National Nursing Network Organization (NNNO), introduced the idea of a National Nurse in a 2005 NY Times op/ed. Here is an excerpt from that article.

…Nurses are considered the most honest and ethical professionals, according to a recent Gallup poll. It’s the nurse whom the patient trusts to explain the treatment ordered by a doctor. It is the nurse who teaches new parents how to care for their newborn. It is the nurse who explains to the family how to comfort a dying loved one.

Now, I’m not saying that a National Nurse will become a household name immediately. But given all that’s at stake – the health of a nation – it seems to me that we should at least give nurses a try.

Here’s what I’d have the National Nurse do. She or he would highlight health care education through 15-minute weekly broadcasts that would also be available on the Internet. The emphasis would be on prevention: how to have a healthy heart; how to raise your teenagers without going crazy; how to avoid being swept into the growing tide of obesity.

The Office of the National Nurse would yield benefits in a multitude of ways. The informational programs would decrease dependence on a health care system that is not only expensive but at times inaccessible, especially for those who lack insurance or live in rural areas. Through the office, nurses could sign up for a National Nurse Corps that would organize activities to enhance health in their communities. A National Nurse would give public recognition to the valuable work that nurses perform each day; if we’re lucky, the National Nurse would help stem the nursing shortage by attracting people to the profession.

Ms. Mills is right. Physicians may drive care, but nurses are on the front line with patients delivering it. Nurses are among our most capable and under-appreciated professional resources. Patients respect and respond to them.

Against a backdrop of overwhelming chronic disease and other maladies, why not give nurses the national visibility and respect that is commensurate with the trust that patients give them. Kudos to Ms. Mills for spearheading this effort, as well as to Anne Llewellyn, former President of the Case Management Society of America and another wonderful nurse educator, for alerting me to the National Nurse.

For more information: http://nationalnurse.org. If you’re a nurse (or someone else) who wants to support this project – including help in contacting your US Representative to co-sponsor – contact teri@nationalnurse.info.

Brian Klepper, PhD, is a health care analyst and Chief Development Officer of WeCare TLC, an onsite clinic firm.

13 replies »

  1. I appealed the situation that I described above regarding the US Public Health Service to the US Special council and they accepted my case. I wonder what sort of reply I will get!
    I no longer care a fig about Nursing as a profession (something I NEVER thought I would say), but I would very much like to know what my legacy of service is…kicked out Commissioned Corps Nurse Officer, or retired Army Nurse.
    It has been 13 years now, and I am still trying to get some kind of resolution and closure to this; just imagine, Nurses get “written up” if a patient has to wait too long to have their Nurse Call Light Answered;), or a pill is an hour late!

  2. Hello Susan Sullivan,

    I re-read your entry. I hear what you are saying about an “intrinsic calling”, however, using that as a criteria to select who gets trained as a nurse, in today’s complex healthcare world is kind of like that old argument, “are leaders born, or can they be made”?

    I hope you know about that website “all nurses.com”. Issues such as this, and anything else you can think of, related to Nursing are discussed on that site.

    For myself, I hope that somehow I can get that time that the USPHS did not officially have me in their service, (but paid me and kicked me out!) counted as Army time, so that I can get at least a few bucks added to my borderline poverty level retirement.
    Other than than, I hope I never have to darken the door of a hospital again as a working nurse.

    I do have to point out, that my ordeal with the US Public Health Service was started and fueled, by Nurses, whose main objective in life is to keep their job in “management”, and NEVER have to touch a patient (ugh!) again.

    These are the people who run the show in Nursing these days, and their motivator is NOT “caring” (a subjective concept that nobody can actually define anyway). When big money says “jump”, their only reply is “how high”. Their are still wonderful people working in the health care field, in all disciplines, who go to work every day, and do their very best with what they have to work with, but it is hard to keep a human focus in an ‘industry’ that moves more money in the biggest economy in the world than Wars used to.

    I am not degenerating Management. Good Management is very important to maximizing work output in a pleasant work environment.

    In my experience, however, Nursing has got a long, long way to go in the ‘management’ department. As you point our, we Nurses used to be able to run our Wards and accomplish our patient care mission, in the days before “corporate healthcare”. What happened?

    Well, among many other developments, Nurses got sold out by Nurses. Look at this stupid “primary care Nurse” stuff, and how Nursing jumped on this bandwagon, because it was marketed to their egos. This is just a ploy to make Nurses individually accountable, so Professional liability insurance can be sold to individual Nurses, and individual Nurses can be sued.

    Does anybody really think that patients are better off with only ONE nurse looking in on them per shift, rather than two or three, like in the old days? How much “patient care” gets done with ONE CNA for 25 to 30 Patients. Do the Math. How many minutes are in a shift. How many minutes can ONE Nurse, or CNA, spend with each patient. What if the nurse, or CNA, has to go to the bathroom more than once in the morning, and once in the afternoon? What if that ONE Nurse, or CNA is not having a good day? It happens to everybody. What if that ONE Nurse, or CNA was called to come in by an agency, and had to drive 100 miles with no sleep to get to this job, in a facility they have NEVER been in before?

    What about “Unit cameraderie and cohesion”? We used to have that, also. Now, people on Nursing Units spend eight to twelve hours working with people they have never see before in their lives. Management produces bodies to fill shifts, based on the fact that they are “licensed”, or “certified” and sell that quality to the general public. As if all the ‘certifications’ in the world, or all the ‘caring’ in the world, can make up for unfilled water pitchers, or patients who are not looked in on, because, the bottom line is that the “blanks” are checked on the newest, most up to date computer system. THIS is the criteria that “management” uses to “prove” that they have “met goals”, in today’s health care world.

    I don’t want to go on, because, frankly, I don’t care what the Nursing so-called ‘Profession” does anymore. I hope I get my case settled. I hope I get a few dollars more for all those years I put in, but, if you want to hear Nurses ‘sound off’ like I just did, go on “all nurses.com”. you will read plenty of it. I used to like to read the comments on that site, but I have come to the conclusion that this venting is just another ploy to keep us talking, so that nothing gets done to change anything.

    To me, being a Nurse in this day and age is being a technocrat participating in “love for sale”. It is kind of like being a hooker, but without the sex. Our ‘Madams’, our “Nurse Managers” work for the Pimps, the Corporate health care bosses.
    No Nurse is going to out think an MBA working for a multi-billion dollar industry, when it comes to business strategies. The Docs had to learn this bitter lesson, and now we Nurses are leaning it also.

    You are so right about one thing. The decision has to be made about what health care actually is. Is health care a “privilege” to be bought, and sold, or is health care a “right” of people in a society.

    When, and if, this decision is ever made, another can of Philosophical worms will be opened up to chew on,…. and so it goes……For myself, I kind of miss having a job, but it is pretty clear to me that “old crows”, and especially “old crows” with independent view points, are NOT welcome in the Nursing world of today.

    I wish you the best of luck in your exploration of “what went wrong”, and “how can we get better”, or get back what we had.

  3. Hello Susan Sullivan,

    Thank you for your reply.
    The story I included here was a very shortened version, by necessity, to fit it in this space.
    Another thing that happened to me, after I contacted the Division of Commissioned Personnel (DCP), to start the Board process, was “anonymous” phone calls. These came from a woman who knew my name, and the facts of my case. She said, “Jackie, you don’t want to know who this is, but you need to know that there are people up here who support you…..” She was nice, but I am not stupid enough to think that anyone supports me, as ME. It is possible that my case fits in with whatever their political agenda is…., Anyway, in my frightened and confused state, back in those early days, these phone calls only frightened me more.

    Another time I spoke with a woman in the DCP who said to me,”Jackie a CPT——–, has taken files of your case home and wants to speak with you about them, let me give you my home phone number”, when I didn’t reply right away she practically hissed, “let me give you my home phone number…”. I was quite taken aback by this. I finally told her, “Ma am, I don’t WANT your home phone number, all I want is to know what I can do to get an open and fair resolution of this case…”

    This is still my position. I don’t want to get involved in any clandestine scheming or plotting; all I want is a fair hearing by people who are honest and actually know healthcare rules and regulations.

    My case is a matter of Public Record. It is case # 225-00 US Public Health Service Board for Correction of Records.
    Now, whether or not files related to my case are complete, wherever they are kept, I doubt that, not if Denise Canton, R. Michal Davidson, or Cheryl Chapman, or whatever that guys name is who is the new “Adverse Actions officer” have anyway to gain access to them.

    I wonder why you would want to speak with me? Did you get screw*d by these people too? I am sure there are many, many of us Nurses who got the hose job from these crooks.

    I am not adverse to speaking with you, I just don’t want to get dragged into any sort of cloak and dagger stuff that involves these dangerous people.
    If I can help you in some way, I would be happy to do this.

  4. Status Unknown I would like to talk more with you about your situation… how can we connect?

  5. I am a 3rd generation RN and I am now retired… and there have been many changes in nursing during my family’s history with nursing… A key factor is the changes in healthcare.. the point at which it became viewed as a profit making “business” with stockholders and was no longer viewed as a non-proprietary community “service” things began to change…( I remember when it was unprofessional, actually it was considered unethical, for a hospital or a doctor to “advertise.”)
    Most who really enjoy and stay in nursing need to have some intrinsic calling…ie, a desire to assist those who need care and support. I have some concerns about the “accelerated” programs that take college grads who have not found jobs in their field and make them BSNs in a year or 18 months…the motivation is different…more likely to be “job security” as opposed to a basic desire/calling to be a hands-on care provider and nurse. That fact coupled with the increasing profit factor in health care might result in many persons with very different motivation doing nursing in the future.

  6. True, nurses are on the front line and yet they are the ones who don’t get as much credit as they deserve. We’ve all been patients at some point in our lives. We know how it feels to be in need of care and attention and actually get it from someone.

  7. I was a nurse in the USPHS Commissioned Corps.
    I was ‘kicked out’ of the Corps, because I complained that we nurses at a little Indian Health Service hospital were compelled to ‘practice medicine without a license’. (Our Nurse Protocols were titled “Practicing the Art of Medicine”, lol). Rather than go to a Medical Center 22 blocks away, after hour, weekend, and holiday patients presented to our little hospital/clinic. Most of these just wanted a ‘sick slip’ for work. Regardless, we nurses were required to use the ‘Protocols’ to treat these patients.

    The doctors, who all had a full day of clinic the following day, were only to be called as a last resort. We nurses carried around the key to the Pharmacy and gave out whatever meds we “prescribed”. The physician who was ‘ostensibly’ “on call” signed our ER treatment form the next day.
    Those patients with third party insurance were billed as if they had been treated by a physician.
    One of the USPHS ‘managers’ came to ‘investigate’ the situation after I sent the Protocols to my State Board of Nursing. Her ‘investigation’ never involved talking to me! lol. She just recommended that I be kicked out of the Corps, despite having been a Commissioned Officer for 12 years, (in the USPHS Corps and the Army Nurse Corps). I had had my most recent ‘excellent’ evaluation at this place 16 weeks prior to being kicked out.

    Now I knew that I had to fight the false charges against me. I did not know what to do, until I discovered the USPHS ‘Board for Correction of Records’. It took me three years, but I won my case before the ‘Board’. The decision in my favor was ‘non-concurred with by a man who, I passed himself off as a direct designee of the Secretary of Health and Human Services. (I don’t know if that was true, the USPHS management world is a murky, distorted place.)

    Within weeks of receiving this ‘non-concurrence, the US Army called me up to Operation Iraqi Freedom. (“Ma’am, nobody in this unit knows who your are, but you have 24 hours to report to duty”.)
    Now, how could a kicked out Commissioned Corps Officer be called up by the US Army? I believe, after turning this around, and around in my head, that the Commissioned Corps never got a release from the Army for my Commission.
    I went on to have a happy, and successful stint with the the Active Army Reserve, until age forced me out.
    Now, I am left with trying to determine how much time in service I actually have. The Army has no record of that time in the USPHS,
    I have been trying to solve all this for eleven long, long years.
    How did I get so scre**d? The Commissioned Corps Nursing Management is composed, to a great extent, of persons who got Management jobs because they meet the ‘Ethnic Preference’ required to be selected for any sort of management job in the Indian Health Service. It is not possible for a ‘Service’ to select and promote someone who has not served in a management position, but it is not possible for a ‘non-preference’ Nurse to get a Management position.
    Talk about a catch 22. No wonder we can’t deal with the Tribal problems we encountered in Afghanistan, we can’t figure out how to handle them here in our own country!

    I do want to say a kind word about Chief Nurse Romano. She at least did me the courtesy to listen to my story, after she got into office, but of course, she wants to keep a job and get a Retirement, just like anyone else. She cannot “rock the boat” and expect to get any of that.
    As for my dealings with the rest of those (expletive deleted) Commissioned Corps upper echelon do-nothings, I guess you can imagine what I would like to say about the lot of them.

    By the way, the first thing I received, in a USPHS envelope when I submitted my request for consideration by the USPHS ‘Board’?
    Seven spent 9mm bullet casings.
    I am not making any of this up.
    So much for Ethics and the USPHS Commissioned Corps.
    Please, please, please, DON’T give them ANY MORE positions or funding.
    The best thing the Country can do with this group, in this time of budget constraints and, especially, Military Cuts, is GET RID OF THE USPHS COMMISSIONED CORPS. Send the Officers currently serving to the Military Branch of their choice, (assuming they can get through Office Basic AND pass the PT Test, ha, ha)
    Believe me, I have been Military and I have been Commissioned Corps. The two have NOTHING in common. A Comissioned Corps Officer is a civilian one day, and a Commissioned Officer the next day. NO Basic training of ANY kind. This means they are non-deploy-able.
    The USPHS Commissioned Corps is a drain on the resources of the United States
    If any organization wants a Nurse, Physician, or other Medical person in a
    Uniform, TDY a Military person to do the job. At least, that way, we will ALL get our moneys worth, and the Military will get additional training opportunities.
    Thank you for reading this far.

  8. I take care of my lawn myself. You can get rid of the surgeon general, too

  9. Well, point taken. The ones I have worked with come from the older cohort, so my view is biased by the acumen I have encountered.

  10. “This is beyond dispute.”

    Given the new nurse graduates my 30 + year nurse wife has had to work with I’m not so sure I’d say “beyond dispute”. There are now something like three generations of nurses working together, each with different attitudes to their professional responsibilities. I would not be putting my faith in nursing based on the traditional nurse image we all like to believe is in all nurses.

  11. ” Physicians may drive care, but nurses are on the front line with patients delivering it. Nurses are among our most capable and under-appreciated professional resources. Patients respect and respond to them.”

    This is beyond dispute. I’ve been working with and around nurses episodically since 1993. They are the linchpins.