In the 21st century, professional nurses aren’t just handmaidens to doctors.
In fact, nurses are more autonomous than ever in many areas of practice. We have the ability to set the agenda, make our voices heard, and act as change agents when change is called for.
Nurses can be the instigators of change. We are disrupters.
The Nurse as a Disrupter
The concept of disruption is being used a lot in the business world these days. Air BnB has disrupted the hospitality industry; Uber and Lift have disrupted taxis and transportation.
Many industries and professions are being disrupted in very positive ways, but medicine and nursing can often feel like slow ships that are difficult to turn. This is where nurses come in.
When a nurse notices that a common practice is no longer working, she or he can disrupt that paradigm by speaking up and offering a new solution.
If bullying and incivility are rampant in a workplace, nurses can stand up and instigate change. If the majority of nurses within a single unit or an entire facility decide that enough is enough, they can disrupt the bullying culture and demand that new norms and standards of behaviour are adopted and bullies be terminated.
When nursing is shut out of the decision-making process, nurses can raise their voices and insist on having a seat at the table with the physicians, leaders, and executives who have blocked them from being present.
In any situation where nurses need to be heard, nurse disrupters can make it happen.
The Nurse as an Agent of Change
When Florence Nightingale went to the Crimea and saw how wounded soldiers were dying from preventable complications, she didn’t sit back and accept an unacceptable situation. She used applied statistics and nursing know-how to turn that reality around.
Nurses are the largest workforce within the healthcare industry and we spend more time with patients than any other providers. We’re the ‘boots on the ground’ and when we see the need for change, it’s our right and responsibility to agitate for change.
Champions of Change
Sitting on our laurels is not what nursing is all about. Nursing has become a profession steeped in evidence-based practice, nursing science, and common sense.
We nurses have a natural desire to do the right thing by our patients and communities, and we’re in the position to instigate change, even when the powers-that-be may appear aligned against us.
In the United States, nurse practitioners and advanced practice nurses are slowly and steadily gaining increased autonomy across the country. In approximately half of the 50 states in the US, NPs now have complete independence from physicians (Maryville University 2015).
Even the United States Veterans Administration – a government agency charged with providing comprehensive medical care to veterans of the armed forces – has granted NPs fully independent practice. These changes didn’t happen without a reason; nurses fought for these changes at the legislative level, despite vehement physician opposition.
Florence was Right
Florence Nightingale was not a fading Victorian violet who avoided a fight. Rather, she was a disrupter, a change agent, a nurse who used her mind and heart to initiate change in the interest of the health and wellbeing of those she felt called to serve.
Thoughtful disruption of the status quo is nursing’s birthright. Nurses, when silence is equal to complicity, the only thing to do is speak up. Are you ready?
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- Maryville University 2015, ‘The States that Allow Nurse Practitioner Autonomy’, Maryville University,http://onlinenursingdegrees.maryville.edu/the-states-that-allow-nurse-practitioner-autonomy/ 23 June, viewed 6 June 2017,
- Summers, S 2010, ‘The image of nursing: The handmaiden’, Nursing Times, 7 October, viewed 6 June 2017, https://www.nursingtimes.net/roles/nurse-managers/the-image-of-nursing-the-handmaiden/5020163.article
Keith Carlson, RN, BSN, NC-BC, is a holistic career coach for nurses, award-winning nurse blogger, writer, podcaster, speaker, author, and popular career columnist. With two decades of nursing experience, Keith deeply understands the issues faced by 21st-century nurses. Keith’s two podcasts, RNFM Radio and The Nurse Keith Show, offer inspiration and practical support to nurses seeking to create meaningful, satisfying lives and careers. Keith’s message of savvy career management and professional satisfaction reaches tens of thousands of nurses worldwide. Keith can be found on many social media platforms---including Facebook, Twitter, Pinterest, LinkedIn, and Instagram---as well as at www.nursekeith.com and Digital Doorway.