Saturday, September 20, 2008

The Office of the National Nurse

(Note: This is my seventh post under the auspices of the nurse blogger scholarship which I recently received from Value Care, Value Nurses.)

Unbeknownst to many Americans, a grassroots campaign to create an Office of the National Nurse has been underway for several years. While many in the nursing community recognize that the Surgeon General plays an important role in managing and overseeing the health and health education of the nation, it is also recognized that nurses are woefully underrepresented when it comes to our national priorities vis-a-vis healthcare and prevention.

With a global nursing shortage in full swing at this pivotal historical time, we still see that neither presidential candidate in the current race fully acknowledges (or plans to adequately address) the shortage and its potentially devastating effects on the health and healthcare of the country. Many involved in the campaign to create an Office of the National Nurse feel that the office "would strengthen efforts by nurses in every community to assist in initiating a nationwide shift to prevention to yield improved health outcomes" nationwide.

Since 1871, the Surgeon General of the United States---the nation's "chief health educator"---has overseen and guided the health of Americans. Charged with overseeing the U.S. Public Health Service, the Surgeon General is appointed by the President and approved by Congress for a four-year term. According to the official website of the Surgeon General, this individual's duties include, but are not limited, to:

  • Protect and advance the health of the Nation through educating the public, advocating for effective disease prevention and health promotion programs and activities, and, providing a highly recognized symbol of national commitment to protecting and improving the public's health
  • Articulate scientifically based health policy analysis and advice to the President and the Secretary of Health and Human Services (HHS) on the full range of critical public health, medical, and health system issues facing the nation
  • Provide leadership in promoting special Departmental health initiatives, e.g., tobacco and HIV prevention efforts, with other governmental and non-governmental entities, both domestically and internationally
  • Administer the U.S. Public Health Service (PHS) Commissioned Corps, which is a uniquely expert, diverse, flexible, and committed career force of public health professionals who can respond to both current and long-term health needs of the Nation
  • Provide leadership and management oversight for PHS Commissioned Corps involvement in Departmental emergency preparedness and response activities
  • Elevate the quality of public health practice in the professional disciplines through the advancement of appropriate standards and research priorities, and
  • Fulfill statutory and customary departmental representational functions on a wide variety of federal boards and governing bodies of non-Federal health organizations, including the Board of Regents of the Uniformed Services University of the Health Sciences, the National Library of Medicine, the Armed Forces Institute of Pathology, the Association of Military Surgeons of the United States, and the American Medical Association.
From a nurse's perspective, what is missing from the Surgeon General's overall equation is the more robust input of a nurse who would serve more as an equal to the Surgeon General in terms of his or her ability to effect and implement healthcare policy in the interest of the American people. At this time, the U.S. Public Health Chief Nurse Officer (CNO) serves as Assistant Surgeon General, representing the Surgeon General's interests and opinions, and otherwise working in a subjugated role that the medical community might deem fit for a nurse.

The goal of the organizations and individuals behind the drive for an Office of the National Nurse is "to elevate and enhance the Office of the PHS Chief Nurse to bring more visibility to the critical role nursing occupies in promoting, protecting, and advancing the nation's health."

The proposed role of the National Nurse would be to:
  • Assist in the initiation of a nationwide cultural shift to prevention.
  • Bolster efforts to focus the public on healthy living.
  • Intensify roles for nurses, including students and retirees, in community health promotion.
  • Provide greater support to the Surgeon General in calling for improvements in health literacy and reduction in health disparities.
  • Encourage all nurses to spread prevention messages in their communities.
  • Encourage participation of nurses in Medical Reserve Corps (MRC) units.
  • Provide leadership to network with existing volunteer health promotion efforts.
  • Strengthen linkages with providers, nursing programs, and public health leadership.
  • Serve as a visible national spokesperson for professional nursing.
  • Increase public awareness of nursing roles and contributions.
  • Enhance nursing recruitment and education throughout all communities.
  • Support and justify additional funding for nursing education, research and service.
The National Nurse would work to slow the growth of preventable diseases; promote health awareness, increase health literacy, and reduce health disparities; promote health careers and increased resources; enhance visibility and public recognition of nursing.

It is the opinion of many involved in the call for the establishment of the Office of the National Nurse that it is time for nursing to have a seat at the nation's healthcare table. While some might argue that the aforementioned Chief Nurse Officer of the U.S. Department of Public Health already adequately fulfills that role, most still see that role as one of subservience to the Surgeon General rather than one of professional equality. Just as nurses are rarely consulted by the media for their expert opinions vis-a-vis the various challenges faced by the nation and its beleaguered healthcare system, the government also fails to fully utilize nursing's unique and crucial input to the fullest extent possible, in the interest of the health and well-being of the American people.

The establishment of the Office of the National Nurse would set a new standard for a more accurate and realistic recognition of nursing's importance to health and healthcare in the United States. If the federal government enthusiastically and publicly embraced nursing, making its crucial contributions crystal clear, perhaps the public, the media and the private sector would all then have a greater understanding of, and appreciation for, the multitudinous ways in which nursing impacts the health of millions of Americans.

Most importantly, however, the establishment of this office would certainly bring an important voice even more strongly to the ongoing conversation about health and health care in America. A National Nurse could, in effect, deliver a unified message of preventive health at a time when millions of Americans---including millions of children---live without health insurance or access to regular primary care. At a time of crisis and uncertainty vis-a-vis the health of the country, the Office of the National Nurse could very well be a welcome, stabilizing and empowering voice of reason and prevention.

I fully support the drive to establish such an office, and hold out hope that a new administration will recognize nursing's contributions to the health of the nation, and give thoughtful consideration to an idea whose time has come.


Mother Jones RN said...

Hi Keith:

Thank you for this inspiring post. Every American deserves a nurse!


Keith "Nurse Keith" Carlson, RN, BSN, NC-BC said...

Thanks, MJ.

Anonymous said...

May I have permission to share this blog in my next newsletter and on my blog -- giving full credit to you?

Keith "Nurse Keith" Carlson, RN, BSN, NC-BC said...


Yes you may. Please send me a link to wherever it is reproduced!



Anonymous said...


My blog is "

When the newsletter is ready I will send you one if I have your e-mail address.

Anonymous said...


This is an awesome post, and we would like to send it to others who are requesting information about the Office of the National Nurse initiative so they can put it in their newsletters as well.

Would you mind emailing me at ?


Unknown said...

# In olden days,it was "doctors orders", and nurses were trained by them to help in the work, and Dame Flo N served the wounded. At home it was always a sick nurse at hand.With changing times now doctors are delegating more and more responsibilities to Nurses, Orderlies, and such other para-medical workers, who are skilled in their work to the PhD level.And it will be happily welcomed by one and all, if more importance is sought by the paramedicals and nurses, by creating Nursing and all other Chiefs at the national level. BUT I STILL MAINTAIN THAT THE WORD "NURSE" SHOULD BE PRESERVED FOR THE KIND GIRL/person WHO TAKES CARE OF THE SICK AND NEEDY AT THE BEDSIDE IN HOME OR HOSPITAL OR FIELD.# After the necessary training and qualification the nurse and all workers in health care can be given increased rank titles, even upto "Dr".We fully know that we take care of barely 16% of the ill,And there are many others equally important in the service to humanity.