Once, in introducing me to a friend, my youngest son said, “and she used to be a nurse.” My husband laughed because he knew I wouldn't let that sit: I immediately responded, “No, I'm still a nurse. Once a nurse, always a nurse.”
I still identify as a nurse, but that doesn't mean I still do nursing as my job. It's been years since I've provided care to patients; and while I think my assessment skills remain on target, I doubt that I possess the knowledge needed to safely practice nursing today. So, why do I still identify as a nurse?
I've been thinking a lot about this question and what it means in the context of our current social and political climate. As nurses, I think we would all be compassionate toward vulnerable populations, regardless of their social or legal status. After all, our Code of Ethics mandates this in Provision 1: “The nurse practices with compassion and respect for the inherent dignity, worth, and unique attributes of every person.” The code also delineates our duty to protect human rights in Provision 8, and affirms nursing's commitment to social justice in Provision 9.
This means we provide care to whoever needs it—that includes enemy combatants and prisoners of war and criminals. Nonjudgmental care has been our legacy since the days of Florence Nightingale and Clara Barton, who dispensed care to all wounded in battle. Our military nurses today follow that credo, as do our colleagues who work in prisons. Yet, I've received vitriolic e-mails and letters from nurses in response to editorials and blog posts I've written expressing such a stance regarding the recent treatment of immigrants. How can this be? How can one be a nurse and support policies that will cause irreparable harm to children? How can one be a nurse and object to providing care to vulnerable people? How can one be a nurse and refuse care because the person who needs it doesn't share the same beliefs? This isn't about politics—it's about standing up for who we claim to be as nurses.
The technical skills and knowledge needed for nursing can be learned. For some nurses, this is enough. They do nursing, but nursing isn't part of their identity. So how do we change that?
Nelda Godfrey, associate dean and professor, innovative partnerships and practice, at the University of Kansas School of Nursing, recently convened a meeting of nurses representing practice, education, research, regulatory, and other sectors to examine how to best foster the formation of a professional identity. How does one imbue nurses with the “being” part of nursing? What is it that transforms nursing students into nurses—into, as Godfrey defines it, individuals who have “a sense of oneself that is influenced by characteristics, norms, and values of the nursing discipline, resulting in an individual thinking, acting, and feeling like a nurse.”
For a day and a half, the group discussed what we know about identity formation from research (there's little about health professionals’ identity formation) and brainstormed to identify the essential elements that characterize nursing. And we heard stories about nurses whose actions embodied these key elements.
This is critical work for the profession and for those to whom we provide care. A professional identity creates a sense of belonging to a group that holds the same values; it can provide colleagues to touch base with when decision-making guidance is needed in stressful situations. For those in our care, it can foster confidence that they will be dealt with in a professional manner by someone who adheres to a code of ethical conduct.
Virginia Henderson, a nursing scholar and theorist, perhaps best known for her definition of nursing, explained her concept of what makes a nurse excellent in the October 1969 issue of AJN. In her article, “Excellence in Nursing,” she discussed what attributes nurses needed to possess, noting, “It seems hardly possible to me that an excellent nurse can be at the same time an indifferent or socially inexperienced citizen.”
Her statement rings true today. Having a professional identity, knowing what it means to be a nurse, and practicing by our ethical code, can unite us and help us look beyond politics to work together for a better world for everyone. There's no better time for us to cultivate that professional identity than now.