It was with a heavy heart that I read about the formation of another panel on nursing (July 18, p. 18). As a registered nurse, I am concerned that once again nursing has failed to make and implement its own decisions.
While I am certain Carolyne Davis will do an admirable job chairing the panel, I think there are nurses in this country who support the changes taking place in healthcare and the resulting changes needed in nursing.
I do not think the Service Employees International Union and the American Nurses Association represent the perspective of a large number of nurses. I believe there are about 5 million nurses in this country. The 205,000 from the ANA and 90,000 from the SEIU are hardly a large representation of all nurses. Unfortunately, the militant mind-set and emotionally based defensiveness are not useful in resolving the problems facing nursing.
Much of the nursing activity surrounding staffing issues is based on fear: Fear of change, fear of unknowns because of reform, and fear that what has always worked won't work anymore. There is also much anger in nursing: Anger that the culture nursing has created for itself of specialization, narrow focuses and primary RN care is no longer effective, and that there is nothing easy or painless that can replace it.
The issues aren't really about staffing or patient outcomes. Instead, the real issues are about changing nursing's culture and its role.
I believe it is up to each nurse to take the responsibility to understand what the changes in healthcare mean in his or her own institution. It's time to get past the feelings of job entitlement and an unwillingness to float or be flexible. It's time for nurses to take responsibility for their own future and develop a skill mix accordingly in an area of individual interest.
We must recognize it is up to each of us to once and for all determine the present and future priorities for nursing.
SUSAN ODEGAARD TURNER
Principal, Turner Associates
Thousand Oaks, Calif.