Lillian Gonzalez, BSN, RN


Topics in Advanced Practice Nursing eJournal. 2006;6(1) 

The rising cost of healthcare, inaccessibility of providers, and lack of health insurance are perhaps the 3 main issues negatively affecting our nation's health. That is why the time is overdue for the nursing profession to lead the country to better health.

A December 15, 2005, ABC News story reported: "In 2003, the country spent $1.7 trillion on health care. That's up 500% since 1980." Additionally, they reported that approximately 46.5 million Americans lack health insurance.[1] The lack of health insurance can be a devastating blow to families caught up in a costly system of healthcare. And yet, time and again, nurses witness that costly tests and longer hospital stays do little to improve outcomes or patient satisfaction. In fact, the Dartmouth Atlas of Healthcare confirmed this when they issued a press release on November 16, 2005, announcing their research findings: "New Study Shows Medicare Pays Some California Hospitals Four Times More Than Others, Without Improving Results or Patient Satisfaction."[2]

Adding to the high cost of healthcare is the looming threat to baby boomers and others that as they continue to age there will be fewer providers to address their healthcare needs. And physicians across the country are closing doors to their patients claiming liability insurance problems.

As politicians on the left, right, and in the middle struggle to answer questions such as whether healthcare is a right or a privilege, there is one clear consensus: it is much more cost effective to prevent healthcare problems than it is to treat them.

The nursing community understands the merits of prevention and needs to take assertive action now. From the time Florence Nightingale instituted isolation wards to prevent contamination,[3] nurses have been ingrained to hone in on prevention. Individuals cannot take ownership of their health unless they understand what is at stake. Nurses have been in the best position and have had vast experience translating technical jargon to patients.

In hospital settings, nurses spend the most time with patients and have learned to be expert communicators with patients and members of other disciplines to facilitate positive outcomes. That is why today nurses have a golden opportunity to demonstrate on a national scale that our knowledge of prevention combined with our teaching skills is the key to saving our nation's health.

One means to do this is by establishing an Office of the National Nurse -- an idea conceived by Teri Mills, a nurse practitioner and nurse educator in Oregon. Her idea received national attention when, on May 20, 2005, her op-ed was published in The New York Times.[4]

Mills has since developed a Web site, The National Nurse, to enlighten the public about the National Nurse concept and to report the status of its progress. In essence, the office would: (1) involve all Americans in preventive health practices; (2) complement health services already in place; (3) establish volunteer national nurse teams to deliver nursing assistance and education to communities in crisis; and (4) give the nursing profession the national attention it needs to solve the current shortage of nurses.

Mills' vision includes 3 key components to the proposal: an Office of the National Nurse, a federal position within a healthcare agency; state coordinators headed by a nurse leader; and teams made up of volunteer nurses at the community level. The National Nurse would represent nursing at the public policy table and focus on the nurse's role in the delivery of the national health agenda. The National Nurse would provide leadership and guidance for the coordination of state team activities. The state coordinator brings the national educational messages to the state, where teams of nurses are developed to deliver quarterly educational programs and services.

Mills has received support from colleagues, nursing students, writers, and members of Congress. In particular, one registered nurse congresswoman took notice. Lois Capps, US Representative for California's 23rd Congressional District, said in an official statement:

I am very supportive of efforts to create a national nurse position and am currently working on legislation to do so. I am pleased to see this idea is generating public support. This type of grassroots advocacy will be essential once we have a bill to introduce to Congress.

Much more grassroots help is needed. Please visit the National Nurse Web site. Inspire the team by sharing your views, offering suggestions, and signing up for email news alerts. It is time for society to recognize that nurses have a scope of practice separate from but complementary to those of physicians and other healthcare disciplines and that nurses are healthcare experts who save lives. May our generation of nurses be the generation that made the Office of the National Nurse a reality for future generations!


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.