During a time when Americans' confidence in many U.S. institutions has declined, the public's trust in nurses remains unmatched.
For the 14th year in a row, the public rated nursing as the most honest and ethical profession in America, with an 85 percent rating, according to a recently released Gallup survey. Nurses have claimed the top spot since 1999, the first year they were included in the survey, with the exception of 2001, when firefighters were voted No. 1 following the attacks on September 11.
While the U.S. health care system struggles to retain the public's confidence, with only 37 percent of respondents saying they have a "great deal" or a "quite a lot" of confidence in the system according to findings from a June 2015 Gallup poll, the evidence is clear that nurses have the respect of Americans. As lawmakers and other policymakers work to enable better quality, safety and cost-effectiveness of health care, the actions of nurses have resulted in reduced hospital-acquired infections and falls. To ensure that progress continues, it is imperative that nurses, who are caregivers, administrators, innovators and policymakers, occupy more prominent roles in the discussion and in leading change.
The Gallup survey paints a positive portrait of how nurses are perceived compared to other professions. For example, the public gave a 56 percent rating for police officers, 21 percent rating for lawyers and a 17 percent rating for business executives, among many professions represented in the survey.
These numbers are important because they contextualize and complement findings that show that patients benefit when nurses are leading and working to the full scope of their education. A 2014 study funded by the National Institutes of Health found that patients with heart disease were almost 50 percent more likely to receive optimal care when their care was coordinated by teams led by nurses. Nurse-led teams not only ensured that patients received all recommended care in the hospital, but also identified helpful community resources and served as a liaison with families and care providers after patients were discharged from the hospital.
There are a number of steps that can and should be taken by Washington and health care institutions to optimize the value of nursing:
- Modernize health care payment systems, starting with the Medicare program, to incentivize the use of care coordination teams in medical settings, including those managed by nurses and not just physicians.
- Enable a full scope of practice for advanced practice registered nurses (APRNs), so they can perform a broad range of primary care functions at a lower cost, which will be critical to easing the nation's health care workforce shortage. Currently, only 21 states and the District of Columbia offer APRNs full practice authority.
- Establish more nurses on the boards of hospitals, health systems and health-related boards to help improve the health of patients and communities. The Nurses on Boards Coalition is working to place 10,000 nurses on corporate and non-profit health-related boards of directors by 2020. Unfortunately, since 2011, the number of nurses serving on hospital and health system boards has decreased from six percent to five percent.
- Implement common-sense reforms to protect nurses from injuries on the job. Registered nurses rank fifth of all occupations in the number of cases of musculoskeletal injuries resulting in missed work days due to lifting patients and performing other essential tasks. Improving the work environment for nurses helps to keep them healthy and able to contribute fully to the delivery of high quality patient care.
There is much truth in the rhetoric that America has the best health care system in the world. In terms of technological innovation and the commitment we bring to every patient, I believe health care in the United States is second to none. Nurses should be engaged to advance innovations that enhance care and reduce costs. Without nursing's voice, leadership decisions are incomplete or incompetent to address the needs of the public. Health care organizations and communities are wise to tap the expertise of the health care professionals who Americans trust the most.