After Two Decades of Trust, It’s Time for Action

May 19, 2022 by Alec Stone MA, MPA, ONS Government Affairs Director

“It takes 20 years to be an overnight success,” classical Hollywood era star Eddie Cantor once said. For many, “instant” recognition comes after a long preparation of methodical strategy and hard work. It is the story of nurses.

Nursing is an art (https://www.aacn.org/nursing-excellence/nurse-stories/a-conversation-with-florence-nightingale): and if it is to be made an art, it requires an exclusive devotion as hard a preparation as any painter’s or sculptor’s work; for what is the having to do with dead canvas or dead marble, compared with having to do with the living body, the temple of God’s spirit? It is one of the fine arts: I had almost said, the finest of fine arts.

Florence Nightingale

In early 2022, the public once again ranked nurses at the top of Gallup Poll’s annual rating of honest and ethical U.S. occupations (https://news.gallup.com/poll/388649/military-brass-judges-among-professions-new-image-lows.aspx). ONS celebrates and reports the news every year, but this one marked a milestone: the 20th year in a row—two decades—that nurses have held the top spot.

Although several healthcare professions were clustered in the top five positions, nurses ranked above the runners-up by 14 points. It speaks to the public’s confidence that nurses are indeed the most trusted and ethical profession.

Advocates by Personality as Well as Profession

Nurses from all specialties are serving on the frontlines of the COVID-19 pandemic while bearing the weight of a preexisting national nursing workforce shortage. Yet despite historic levels of stress, trauma, and burnout, they are dedicated (https://annals-general-psychiatry.biomedcentral.com/articles/10.1186/s12991-020-00272-9) to comfort, compassion, and the transformation of patient care. Some real examples from ONS members include (https://cjon.ons.org/book/reflections-covid-19-and-cancer-care-stories-oncology-nurses):

We bear witness to sacrifices requiring amazing inner strength. Our clinical teams work and support each other emotionally. By staying focused in the face of adverse situations, we are able to radiate the feeling of hope to our patients and their loved ones. This ongoing pandemic is like a tough professor; the tests came first, but we are enriched by the lessons we learn from them.

Sobha Akkar, RN, BSN, City of Hope Medical Center, Duarte, CA

Nurses are now, more than ever, reconnected with their mission of caring for people. In Portugal in 2019, we had some struggles with our nursing profession and the recognition of our status. You can do what you love, you can be exceptional, and your patients can see it, but it is harder if you don’t feel you have the right compensation or respect. Sometimes those adversities seem to be the bigger issue, but when the pandemic came, the nurses came together and reconnected with their real purpose and vocation.

Anabela Amarelo, RN, Centro Hospitalar Vila Nova de Gaia/Espinho, Portugal

Since spring 2020, our hospital’s motto has been Together We Can, and I saw that attitude become a part of our lives as we adapted to a community effort of fighting COVID-19. I have learned that facing a large-scale calamity such as the pandemic requires cooperation, flexibility, and ongoing learning. As nurses, we find strength working together and find meaning as we care for our patients.

Edie Hochstetler, BSN, RN, OCN®, University of Iowa Health Care, Iowa City

Now Americans Must Advocate for Their Nurses

“The COVID-19 pandemic is having a significant impact on the well-being of nurses and has exacerbated long-standing issues of stress and burnout. Expecting or hoping that nurses will recover quickly or bounce back from the stress and deep trauma of the pandemic is not realistic,” Mary Jo Kreitzer, PhD, RN, FAAN, wrote (https://connect.springerpub.com/content/sgrcn/27/2/88) in 2021. Her words joined many others’ to raise awareness, but nurses need action as well as awareness.

The American Nurses Association (ANA) seized the opportunity to change workforce protections through regulatory relief. In early 2022, the ANA beseeched (https://www.nursingworld.org/news/news-releases/2021/ana-supports-efforts-to-restoreemergency-temporary-standard-protections) the Biden-Harris administration to reinstate the Occupational Safety and Health Administration’s (OSHA’s) emergency temporary standard (ETS) to protect nurses during COVID-19.

In its January 17, 2022, press release, the ANA reminded (https://www.nursingworld.org/news/news-releases/2021/ana-supports-efforts-to-restoreemergency-temporary-standard-protections) OSHA that it must release clear standards and extend the ETS to protect nurses and other healthcare personnel. “Removing protections leaves nurses and other frontline personnel unnecessarily vulnerable when they have been and continue to be the backbone of the COVID-19 response since it began nearly two years ago.”

ONS Perspective

More must be done to safeguard nurses, enhance workplace safety, invest in research, and provide education and training. With a national nursing shortage on the precipice of calamity, patient care may be in critical danger. A great deal of the reverence for nurses in public opinion polls is reflected (https://nursejournal.org/articles/the-us-nursing-shortage-state-by-state-breakdown/) in the understanding that nursing is a highly demanding occupation as well.

Many cultures have some variation on the expression “a blessing and a curse.” Perhaps that best describes today’s nursing environment. Nursing is a calling much more than a career, and very little prevents them from dedicating complete attention to their patients. But without significant change, being named the “most trusted and ethical” is just empty praise. Nurse must leverage that acclaim with decision-makers and push for the same support as other providers before we burn out the entire profession. For what would America do without its nurses?


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