Reflections for our nation’s nurses

It is my sincere hope all of you have enjoyed National Nurses Week 2014. As the week draws to a close, I’d like to offer some reflections …

Next year I celebrate my 30th anniversary as a Registered Nurse. If you had told me as a 20-year-old RN (a new grad walking the wards on the night shift) that I would be working on issues such as patient safety, the environment of care, quality measurement, health IT and the patient and caregiver experience – here  in our nation’s capital – I  never would have believed it!

I am proud, and amazed, when I think about the choices that have made it possible for so many nurses like me to participate in the extraordinary developments in health care enabled by health IT, including the flexibility and omnipresence of digital data and the enhanced distribution of knowledge via the internet.  Nurses from all settings and practice areas have the power of our reach to share our stories, educate our neighbors and work to close the gaps in the health care system. Believe in yourselves and know that you make a difference. Your experiences matter.

Last year, the world of nursing lost a brilliant nursing advocate, leader and thinker who made a difference herself: Donna Diers, PhD, RN, FAAN. I was very lucky to have Donna as my academic advisor, mentor, and friend.  Donna had a long, brilliant, and diverse career in nursing. She defined nursing this way:

“Nursing is two things: the care of the sick (or potentially sick) and 
the tending of the entire environment within which care happens.”

With our skills and our wisdom as clinicians, caregivers, patient advocates, parents, and members of the community we influence the health care environment more broadly and powerfully than you might think. The federal and state governments seek input from you in every one of your roles.

This is a critical time in health care and nursing. We are moving into an era of change with much promise, especially with health IT: mobile, telehealth, data sharing, improved interdisciplinary collaboration, and increasing electronic health record (EHR) adoption, much of which will help to enable enhanced care coordination.

Yet some of the very things we know are advancing care can also pose new threats to patient safety and the quality of care.  As the proximal care provider, you as the nurse are uniquely qualified to recognize the advantages and disadvantages of these changes. With our experience comes the responsibility to attend to the consequences of health IT. The amount of data can be overwhelming and difficult to comprehend. That’s when the vigilance and expertise of nurses both in the design of health IT tools and at the point of care for patients will be essential. As Donna said, your involvement in this dynamic environment is welcomed and needed.

Throughout this week, the ONC Buzz blog featured the diverse roles of nurses across a wide array of career settings: government, health IT, school nursing. What all these roles have in common is that nurses are leaders, nurses are trusted, and nurses are role models – and at 3.1 million strong – almost everyone knows a nurse! (So if you are not a nurse, I know you know one, so please forward this post on to him or her!)

I encourage you to reflect on your sphere of influence and how it is that you inspire those around you to adopt practices that support better health, better health care and help to control the cost of care for all Americans.  To all of the nurses “Leading the Way” it is my privilege to serve you here in Washington D.C. I am humbled, I am grateful, and I am so very proud to be a nurse.



  1. Ross Koppel, PhD FACMI says:

    Nice post; a warm balance of the personal and the professional obligations. I would have appreciated examples of how nurse vigilence has benefited and will beneift improvements in HIT. The role of Nurses in informatics has become major, and is a significant opportunity to contibute. We need input from nurses on the presentation of lab reports, on medication lists, on problem lists and on the bloat of progress notes and nursing notes due to the copy and paste, which is now metastatic. We need nurses to help with all of these issues; they are uniquely positioned to help!

    Congratulations. It’s a good time to be a nurse. HIT needs you!

  2. Judith Kunisch says:

    The Institute of Medicine, Robert Wood Johnson Foundation, and AARP joined together to design and implement recommendations for the nation’s Future of Nursing. Critical to both the present and future is the use of nursing data to improve our health care delivery system.

  3. Kathleen Rossie says:

    It is time to hear from a new generation of nurses – (the average age is 48 and it sounds like you must be in your 50’s) who grew up tech savvy and aren’t afraid of change or who worry that “some of the very things we know are advancing care can also pose new threats to patient safety and the quality of care”

    Most of us who work in health care adores nurses but it is always the nursing staff that are the most resistant to changes during and EHR implementation who hold onto old outdated male/power based models of care.

    It is odd that ONC has so many nurses on staff and yet there aren’t any nursing advisory groups? It is time to hear from the next generation of nurses (vs our Mom’s era).

    • Darryl W. Roberts, PhD, MS, RN says:

      I agree that we should hear from a new generation of nurses. For too long, older nurses told my generation that we were too young to know anything. Now, your generation is telling us that we are too old. I find both to be offensive. When I was in my twenties and early thirties, I knew about patient care and informatics from a pragmatic, busy, and youthful perspective. Today, at the mean age of a nurse, I have a wiser and more rounded perspective that draws on more than just my own experiences. I don’t come from “old outdated male/power based models of care.” In my first nursing school, there was not a men’s room in the building, so I had to hike across the street to the hospital, but still be back in time for class to start. That is not exactly “male-based”.

      Anyone that wants a voice ought to have the opportunity to share their perspectives. That is why there are calls for papers in journals and calls for abstracts in conferences and symposia. We want to hear from you. Get out there and stand in front of an audience to share your views. Apply for a role in one of the Federal Advisory Committees at ONC or to become an officer or contributor to HIMSS or AMIA.

      I appreciate your youthful arrogance, but I think it ought to be tempered with some respect for those who blazed the trails for you. Donna Diers, Nancy Staggers, and Judy Ozbolt blazed the trails from paper to hybrid. Ellen Makar and Patty Sengstack are blazing the trail from hybrid to electronic. If you honor your history, you might blaze the next trail. I wish you very well in all of your future endeavors. Make your Mom proud.

  4. Crystal Rojas says:

    I enjoyed reading about your mentor and friend. I agree with her comment about tending to the entire environment. It is incredibly important for us as nurses to stay connected, and to jointly tend to the environment of care. Things are changing quickly, and we can learn important concepts from all generations of nurses. Each facet provides valuable input on the vast benefits and unintended consequences of Health IT. I can see that you actively keep your finger on the pulse by connecting with nurses at all levels of experience and position. Congratulations on your 30th year, and thank you for your contribution to the profession!

    Crystal Rojas

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