Thursday, September 26, 2013

Nurse Empowerment: "Now" Is Always The Time

Nurses have a long history of being significantly disempowered. Historically, nurses served as "handmaidens" to all-mighty physicians, running at doctors' beck and call. The role of the nurse has changed over the years, but we nurses still need to feel empowered to fulfill the promise of our profession.

During the twentieth century, many important factors served to empower nurses (the majority of whom were women) to come into their own. The rise of feminism in the 1960s was a crucial salvo that began to break down societal barriers for women. The subsequent emergence of so-called "Third-Wave Feminism" in the latter decades of the twentieth century was a more recent manifestation of women seizing the cultural power that was their natural birthright (but often out of reach due to long-standing patriarchal structures.)

Nursing Science, Literature and Research

Another manifestation of nursing's rise to its own empowerment came in the form of a growing body of nursing science, research and literature. With nurses conducting their own research and creating a body of solid scientific and academic literature from which to draw inspiration for further development, nursing moved from being simply an "art of caring" to a science, complete with our own codification of nursing diagnoses and rigorous reflection on our collective practices as clinicians.

The nursing process itself is an example of how nursing behaviors in the clinical setting were transformed from a simple task-oriented vocation to a scientifically grounded profession with its own growing body of self-reflective knowledge.

The Changing Calculation

Now that the Census Bureau has indicated that 9.6% of Registered Nurses are male, the calculation of what it means to be an empowered nurse has changed. When women made up 98 or 99% of the profession, women's empowerment was central to the empowerment of nurses as a whole. And while the empowerment of female nurses is still absolutely crucial, the notion of empowering nurses now must take into consideration the growing percentage of nurses who are men.

If the profession was still close to being 100% female, women's concerns would essentially be the only issues at play. But with men now having a stake in the growth of nursing as both an art and a science, the question of how to empower nurses has undergone an interesting and important sea change.

Gender Still Matters

Even with the growing number of men within the nursing profession--or perhaps because of it--we do need to continue to pay attention to issues of gender and gender equality. With American women still earning 70 to 80 cents on the dollar as compared to American men across the board, pay equity among male and female nurses is likely to need ongoing attention.

Additionally, there are some who hold the opinion that men who work as nurses are able to more readily rise up the ladder of power within the profession by assuming roles as directors, managers and administrators. This phenomenon also bears examination.

As men gain a greater and greater foothold within the nursing profession, it's important for us to keep our finger on the pulse in terms of how gender bias may favor male nurses, especially in terms of earning power, responsibility and upward career mobility.

Moving Beyond Gender

While still making sure we pay attention to gender inequality amongst nurses, we also need to be conscious of ways in which we can move beyond gender, especially when considering the empowerment of nurses as a collective body.

Whether a nurse is male or female, he or she still works within a hierarchical structure that places nurses in frequently subservient positions below physicians, even when those nurses have degrees in advanced practice.

Advanced Practice Nurses of any gender are susceptible to the machinations of the AMA and other physician groups who are attempting to use their massive influence, money and power to undermine APNs' desire for increased autonomy. Nurses need to feel individually and collectively empowered to push back against the unwarranted and defensive posturing of these physician groups that obviously feel threatened by nurses assuming increasingly independent roles.

Nursing Will Continue to Change and Grow

With the rise of APNs, nurse entrepreneurs, and nurses breaking out of the box of simply working at the bedside in a hospital setting, we can see that the nursing profession will continue to change and grow. As APNs gain increasing autonomy in many American states, other nurses will feel empowered to push for further independence and autonomy as well.

Furthermore, as nurses realize their relative importance vis-a-vis the aging population and its enormous needs for professional caregivers, our profession will shoulder an increasing burden when it comes to caring for these elders. Additionally, the astronomical decrease in physicians willing to specialize in primary care and gerontology (preferring, instead, much more lucrative medical specialties), very capable and competent APNs will no doubt fill the gap for aging Americans in need of quality primary care.

We Are Legion

Nurses, as the largest segment of the healthcare workforce, are still the backbone of the healthcare infrastructure. This will not change, and it's likely that we will make up an even larger percentage of the healthcare workforce in the decades to come.

We nurses need to seize our power in various ways both great and small. Our push for increased autonomy as APNs is important, even while it's also crucial for nurses of any stripe to fully believe in our importance as that veritable backbone of the entire healthcare system. We can advocate for our APN colleagues, push for legislation that improves student loan forgiveness for nurses, and fight against administrative and corporate powers that attempt to increase our workloads while disempowering our unions.

We nurses can advocate for patient safety, push back against mandatory overtime and chronic understaffing, and we can even force our workplaces to adopt environmental practices that more seriously consider the long-term well-being and survival of our planet.

We Are Trusted

Nurses are consistently the most trusted professionals in the United States, and most Americans also agree that we're considered the most honest of all professions. There's a reason that our fellow Americans trust us with their lives, and we can continue to earn that trust by increasing our influence over both policy and practice.

Empowerment truly comes from within, and if we trust ourselves as much as the public appears to trust us, the power of nurses to influence medical practice, legislation, environmental practices and the broader cultural conversation about healthcare will grow along with our profession.

I personally feel very empowered as a nurse, and I encourage my nurse colleagues to embrace their own empowerment, realizing the potential of what we can accomplish, singularly and collectively.


This blog post was written to be included in the next edition of the new Scrubs Magazine Nursing Blog Carnival, which will be hosted by various nurse bloggers and published on a regular basis.

Thanks to Scrubs and Brittney Wilson, The Nerdy Nurse, for including me. 

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