Responses to the 2013 Question of the Year
Dr. Sochalski is associate professor, The University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania.
Mr. Melendez-Torres is departmental lecturer in evidence-based social intervention, Centre for Evidence-Based Intervention, and DPhil candidate, University of Oxford, Oxford, United Kingdom.
Correspondence should be addressed to Dr. Sochalski, School of Nursing, University of Pennsylvania, Philadelphia, PA 19104; e-mail: firstname.lastname@example.org.
We thought the biggest challenge we would face when drafting our answer to the question “What is a nurse?” would be limiting the volume of our thinking on the subject to 750 words. To our surprise, the real challenge was to set aside our collective wisdom—combining the experiences of one who trained almost four decades ago with someone new to the workforce—and start anew to answer the question. To guide this unconventional quest, we consulted an unconventional resource: Gaarder’s Sophie’s World,1 the philosophical quest of a 14-year old Norwegian girl to answer the question “Who are you?”
We began by examining the question itself. Its framing denoted “nurse” as a noun. If, however, a nurse is “someone who …,” then its proper form would be a verb—to nurse—or, to reframe the question, “What is nursing?” Exploring the etymology of “nurse” revealed derivation from “nourish”—someone who nourishes, enlisting food and/or other resources as necessary for growth, health, and good condition. Gretter’s 1893 Nightingale Pledge2 called on the nurse “to devote myself to the welfare of those committed to my care,” connoting an intrinsic and extrinsic commitment, a vocation, to provide for those in need. Her 1935 modification to the pledge exhorted nurses to be “missioners of health” dedicated to the advancement of human welfare, expanding nursing’s commitment to persons in all states of health and illness. This commitment to patient and public welfare underscores a critical dimension of nursing—that of advocacy. Nurses advocate vigorously to promote the health of the individuals, families, and communities entrusted in their care and inform each of the threats therein.
We uncovered a diverse range of definitions of nurses and nursing during this journey, from pedantic to existential, but they can all be located within a single framework: to nurse is to apply the knowledge and principles of nursing care to put and keep individuals, families, and communities on the path of optimal health. In other words, to try to keep Humpty Dumpty from falling off the wall, but to put him back together again if and when he did fall. Those entitled—indeed, privileged—to become nurses embody the highest ideals of professionalism: promoting holistic, humanistic care, advocating for the health of each patient, and working to build a system that makes it possible. Nurses do this through roles that are understandably varied and continually evolving, adapting to the varied circumstances under which individuals and families “live their health.” These roles, it goes without saying, are interprofessionally entwined—good outcomes depend on interprofessionalism, and professionalism dictates such care. Nurses’ centrality to health care places them at the hub of health care delivery, coordinating the inputs of all health care providers and aligning them with the needs of individuals and their families.
While working on this treatise, we posed the Question of the Year to a range of people—family, friends, strangers standing in the grocery line, and morning commuters waiting for the subway. While the words varied, the theme was consistent: A nurse is the person who has your back, the one in whom you can confide, who actively listens and hears you, who decodes incoming information and improves its signal-to-noise ratio. The American Nurses Association3 says nurses protect, promote, and optimize health and abilities. To the public, that means the nurse gets you across the finish line, wherever that might be.
1. Gaarder J Sophie’s World: A Novel About the History of Philosophy. 1994 New York, NY Farrar, Straus, Giroux
2. Munson HW, Gretter Lystra E. Am J Nurs. 1949;49:344–348