April / May 2009

The Economic Value of Nursing

Donna P. Jernigan, MS BSN RN CNA-BC CRRN

In November 2008 nursing leaders from the Nursing Organizations Alliance (NOA) met with Rebecca M. Patton, MSN RN CNOR, president of the American Nurses Association (ANA). The discussion centered on the critical role nurses play in driving the value and quality of health care. Although we came from many specialties, we committed to communicate the economic value of nursing to our members. Our value is more important than ever in these tough economic times. With the new White House Administration placing health care near the top of its agenda, registered nurses (RN) have an incredible opportunity to help shape a safe, quality, and cost-effective healthcare system. The following are the key points about nursing values every nurse should share with others.
    The public trusts nurses. In the annual Gallup Poll on Honesty and Ethical Standards within a Range of Professions, nurses repeatedly ranked as the most trustworthy. The national Harris Polls yield similar results. It’s with good reason. The public knows that we will look after their best interests and the best interests of their loved ones. The RN’s professional Code of Ethics clearly states that the “primary commitment is to the patient.” Our mission is to keep patients safe and provide them with the best care possible.
    Nurses are there for patients. The public doesn’t always think about RNs’ solid educational backgrounds, Code of Ethics, or commitment to developing and following standards of care. However, the public does know that we respond when they’re afraid or in pain, answer their call lights 24-7, and take the time to listen and answer their questions honestly and completely. Nurses are the first responders in times of crisis—whether it’s helping at the scene of a car accident or providing care during a hurricane. We are often the ones who neighbors and family members turn to for advice and recommendations. We are in the communities, hospitals, clinics, schools, and workplaces—we are everywhere.
    Nurses recognize that patients are more than a set of symptoms that need to be treated. As RNs, we are taught to look at our patients as a whole person with physical, spiritual, emotional, and psychosocial needs. We will listen to patients, advocate for them, give them the information they need to make informed decisions, and support them in those decisions.
    Nurses help patients navigate the system and understand health needs. In times of crisis, RNs serve as interpreters of complex information by explaining diagnostic tests, treatments, and the complicated healthcare system. We serve as the liaison for interactions with physicians, social workers, pharmacists, other members of the healthcare team, and, sometimes, with family members. Nurses play a key role in coordinating patient care to ensure that follow-up appointments, medication needs, and other services are met during hospitalization and after the patient’s discharge. In addition, RNs provide patients with information on safety and preventive and self-care measures for healthier lives.
    No one spends more time at the patient’s bedside than a nurse. RNs have a unique perspective on the issues that are part of the current healthcare crisis. From issues of quality and safety to the domino effect of the disintegration of the mental healthcare safety net, and from the growing issues facing America’s seniors to the importance of access to primary care, nurses are on the front lines working to ensure quality health care and searching for solutions that will benefit everyone in need.
    Nurses are “puzzle solvers” and guardians. RNs have the analytical thinking and decision-making skills to look at a patient’s history, current symptoms, and body language to determine what’s needed to keep him or her on the road to recovery and health. The truth is nurses are constantly monitoring a patient’s condition to catch a potential problem before it spirals out of control. We are literally the last line of defense for patient safety. That’s why it’s crucial that there is adequate RN staffing. Scientific evidence backs this assertion: When there are more nurses on a floor, patients fare better.
    Nurses are cost-effective in tough economic times. The healthcare industry is not immune to the current economic need to cut costs. Nurses have known for a long time that having more RNs on staff can prevent complications and save lives, and a new study shows that having more nurses on staff also saves money. We also know that nurses are highly resourceful and will improvise in emergency situations or tough times while keeping patients safe. Nurses in advanced practice roles—nurse practitioners, certified nurse-midwives, certified RN anesthetists, and clinical nurse specialists—also have a proven track record of providing high-quality care while keeping costs down.
    Nurses are leaders. There is an old adage in nursing: When nurses see a need, we do something about it. In hospitals, staff nurses not only take the lead in improving the care individual patients receive, but also help shape hospital-wide policies on patient safety and quality care. RNs serve as leaders in many governmental agencies and uniformed services, managing health care in times of crisis and conflict and working to implement important public health programs such as influenza prevention. We can be found on city councils, state advisory boards, and the halls of the U.S. Congress using our healthcare knowledge and team-building skills to pass laws that will benefit the public good.
    Nurses are role models. As role models for the public, our peers, and other healthcare professionals, RNs are often held to a higher standard. Patients and their families look to us to provide unbiased, calm, competent, and ethical care. They see us as examples for how to effectively advocate for services or successfully broach difficult topics such as end-of-life care.
    Nurses have many faces. Although the public primarily thinks RNs work in schools or at the bedside in hospitals, the reach of nurses is much wider given our many areas of specialization and opportunities for advanced education. For example, sometimes nurse practitioners are the only healthcare professionals providing primary care services in remote, rural areas or in low-income, urban neighborhoods. Clinical nurse specialists develop protocols aimed at improving care for a range of patients, such as those needing geriatric care, mental health services, or rehabilitation. Some of the most cutting-edge research on issues ranging from preventing heart disease in women to alleviating physical symptoms during cancer treatment is being done by nurse researchers.
    Thank you to the NOA and the ANA for making this possible through collaboration.
    Now, go tell everyone you meet about your value to our country and to health care.