AORN Journal
Volume 88, Issue 3 , Pages 347-349, September 2008

Finding the Voice of Nursing

Article Outline

 

AORN's affiliate status with the American Nurses Association (ANA) allowed me to serve as AORN's delegate to the ANA's biennial meeting in Washington, DC, this past June. Several significant resolutions that support measures to improve public health or that recognize the effects of an issue on public health were presented and approved at this meeting. Topics of the resolutions adopted include

•educational advancement for RNs,

•global climate change and human health,

•the nursing profession's response to intimate partner violence,

•health care availability for veterans and their families,

•access to oral care for the elderly,

•healthy food in health care,

•residency programs for new graduate nurses,

•protecting and strengthening Social Security,

•protecting and enhancing Medicare, and

•recognizing the impact of human trafficking.

These resolutions are examples of the social accountability that nurses, members of the largest segment of health care workers, should assume. Regrettably, nurses typically have taken a reactive, traditional approach to politics rather than adopting a proactive approach.1 Thus, our voices remain largely silent until we are forced to react to issues that directly affect our practice, leaving the power of our influence largely untapped. Our future depends on understanding why this problem exists, what can be done to reverse the trend, and how we can leverage our power.

Back to Article Outline

The Legacy of Florence Nightingale 

In an article in Advances in Nursing Science, Adeline Falk-Raphael, PhD, RN, reminds readers of the legacy of Florence Nightingale, whose vision and example are essential to the modern practice of nursing.2 Nurses are witness to human suffering and may speak with great credibility to the necessity for health care reform. Because of that intimate knowledge, Dr Falk-Raphael considers sociopolitical involvement to be a moral imperative.

Early in her career, Nightingale recognized the link between social and economic inequities and the inequities in public health care. Giving aid to soldiers in the Crimea was just a fraction of her role as a health care advocate. Workhouse reform, the use of statistics to document outcomes, the establishment of an army medical school, and sanitation reforms are initiatives attributed to her work. Jean Dunant, founder of the Red Cross and creator of the Geneva Convention, credits Nightingale as the inspiration for both.2

Other nursing leaders throughout history also have left their mark on public health advancements. Lillian Wald established nursing services in schools and rural communities. Margaret Sanger inspired the creation of the Planned Parenthood Foundation of America.2 We should take pride in the legacy of nurses serving a society they helped create.

Back to Article Outline

Leveraging Power 

Why are so many of us uninvolved today? It may be feelings of powerless that foster nurses' silence in the sociopolitical arena. The health care hierarchy traditionally places physicians in a position of esteem and influence, with nurses relegated to a subordinate role. Nightingale's success can be attributed to her understanding of both the power of her expertise and the significance of numbers for gaining recognition. She was masterful in making powerful partnerships and in reaching out to the public to achieve support. This is an important lesson for every professional nurse.

Power can have a negative connotation, especially for women; however, nothing in the political realm happens without the use of power. French and Raven3 are known for a fairly simplistic, yet effective, identification of five categories of power: expert, referent, reward, legitimate, and coercive. In an article in the Online Journal of Issues in Nursing, Sheila Abood, PhD, RN, provides information on how nurses can use each of these categories.4

•Expert power: Nurses have the credibility and public trust to speak out on health care issues. We are in a position to share our expertise with the public and with legislators to urge them to act and promote important health care reforms.

•Legitimate power: The source of legitimate power is granted through our licensure to practice nursing. This right is augmented by ANA documents such as the Code of Ethics for Nurses With Interpretive Statements5 and Nursing's Social Policy Statement of 2003.6

•Referent power: This is achieved by having other people admire and respect our knowledge. Evidence of this is seen in the 2007 Gallup Organization's survey on professional ethics and honesty in which nurses ranked in the number one position.7

•Reward power: Nurses may reward political candidates who support our health care platforms—every vote counts when someone is running for public office.

•Coercive power: This is a negative category of power that is not appropriate for use in most situations; however, we may relate this form of power to withholding support or actively opposing a position.

Back to Article Outline

Strength in Numbers 

Finally, and perhaps most importantly, is the undeniable power of numbers. AORN made nursing history by achieving affiliate status of our members in the ANA as of August 1, 2008. This move joins the voices of more than 200,000 nurses, while still allowing AORN to remain autonomous. Imagine the force of the voices if similar affiliations were to be adopted by every specialty nursing association in America! That unity could easily advance AORN's legislative agenda.

AORN must embrace the global issues of public health and speak up for health care inequities and disparities. The time is right to recognize the power of numbers and leverage our expert power to achieve lasting health care reform. It is our right, and it is our moral imperative!

Back to Article Outline

References 

  1. Des Jardin KE . Political involvement in nursing—education and empowerment . AORN J . 2001;74(4):468–475
  2. Falk-Raphael A . Speaking truth to power: nursing's legacy and moral imperative . ANS Adv Nurs Sci . 2005;28(3):212–223
  3. French and Raven's Five Forms of Power. ChangingMinds.org. http://changingminds.org/explanations/power/french_and_raven.htm. Accessed July 28, 2008.
  4. Abood S . Influencing health care in the legislative arena . Online J Issues Nurs . 2007;12(1): http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume122007/No1Jan07/tpc32_216091.aspx Accessed July 28, 2008.
  5. American Nurses Association  . Code of Ethics for Nurses With Interpretive Statements . http://nursingworld.org/ethics/code/protected_nwcoe813.htm 2005; Accessed July 28, 2008.
  6. American Nurses Association  . Nursing's Social Policy Statement . 2nd ed.. Washington, DC: American Nurses Publishing; 2003;
  7. Jones JM . Lobbyists debut at bottom of honesty and ethics list. Nurses again perceived as having highest honesty and ethical standards [news release] . Princeton, NJ: Gallup; December 10, 2007; http://www.gallup.com/poll/103123/Lobbyists-Debut-Bottom-Honesty-Ethics-List.aspx Accessed July 28, 2008.

PII: S0001-2092(08)00524-3

doi:10.1016/j.aorn.2008.08.003

AORN Journal
Volume 88, Issue 3 , Pages 347-349, September 2008

Article Tools