President's Note-Bold Voices Make Sure
Our Story Is Heard
By Connie Barden, RN, MSN, CCNS, CCRN
Following are excerpts from the closing
ceremony address delivered by 2002-03 AACN President Connie Barden, RN, MSN,
CCNS, CCRN, at AACN's National Teaching Institute and Critical Care Exposition
in May 2002 in Atlanta, Ga. Barden's theme for the year is "Bold Voices-Fearless
The time has come to use our voices to
steer healthcare in the direction it must go-not only for nurses, physicians and
other healthcare team members, but also for patients and families who are
quickly losing trust in our ability to provide them with safe, compassionate and
For me as president of AACN this year, this
means ensuring that AACN uses its voice as the undisputed leader for critical
care nursing where it has the greatest impact on our ability to practice fully
and safely and to deliver the best care to our patients. AACN will speak out on
issues that affect critical care nursing practice and patient care, just as we
have done by taking the stand that mandatory overtime is neither safe nor in the
best interest of nurses or patients. Many other issues demand our attention,
including those related to our clinical practice and to our workplaces. We will
use our voice as the undisputed leader to influence these issues.
We must be certain that our colleagues know
how vital nurses are to patient outcomes and why hospitals cannot afford to let
nursing care be anything but the best.
This may mean talking with your manager, a
colleague, a physician or even a reporter about issues that are important to
nurses in your area. You may be tempted to step back and hope that someone else
will handle an issue, but we must speak up and stop waiting for others to
respond to our issues and dictate our fate. Our voice must be bold, clear and
fearless, even when using it makes us uneasy or uncomfortable.
What is a "bold" voice? It isn't a blaming
voice or a whining voice. It doesn't argue about who is right or wrong or about
whose fault it is that we are faced with challenges. A bold voice moves past
complaints to look for solutions. And, solutions will be found if we work with
others and take the time, give the thought and have the patience to create the
changes that need to occur.
Tell Our Story
Where and how can we use voice to alter
anything in healthcare today? We can start by telling people what we do-regular
people like neighbors, family, church members, friends, administrators,
legislators and anyone else who thinks that nurses are simply nice people who do
what doctors tell them, but never think or make decisions on their own.
They must know who we are and what we do.
We save lives. We rescue patients. We act on behalf of others when they cannot
act for themselves. We give treatments, monitor their effect, interpret data and
direct care. And, because of our skills and knowledge about medicine, science
and nursing practice, we prevent patients from having all kinds of complications
and bad outcomes.
Until we give people the information they
need to understand the importance of what we do, we cannot expect them to value
it. And, until they value it, they cannot grasp the notion that the system will
fail if there are not enough nurses around to take care of patients.
Deliver Our Messages
We must also become better at articulating
what it is we need to provide excellent patient care. Too often, our response
when asked what we need is to simply reply, "More nurses." Although we all agree
that the nursing shortage will continue to have a huge impact on how we
practice, there are other messages that we must deliver:
� To young people: Think about becoming a
nurse! It's an exciting and challenging career. You can work almost anywhere-on
a ship, on a plane, in a hospital or in a school.
� To nursing students: We welcome you to
the bedside. We will mentor you and do our part to make you successful.
� To employers: We want to deliver the best
possible care, and we want you to ensure that there are sufficient numbers of
nurses and resources to allow us to do so. We will listen. We will learn with
We will serve on committees. And, we will
tell you what we need to deliver good patient care. We will work hard, but we
must be compensated appropriately for what we do. If we are to entice nurses to
make a life-long career of this work, our salaries must reflect the fact that
nurses are the backbone of the healthcare system.
� To legislators: We need your help. After
all, we voted you in! You are in a position to enact laws to expedite nurses
getting financial support for school, being able to move easily from state to
state and being capable of functioning fully within the scope of their practice.
You are also the ones who must make sure that healthcare is adequately funded so
that hospitals can afford the resources they need-including adequate numbers of
nurses-to provide care to our patients.
� To physicians: You are our number-one
strategic partner in solving this crisis. We must work together-respectfully,
collaboratively and continuously-to care for our patients and for the future of
healthcare. No one knows better than you, our colleagues, that your work cannot
be done without nurses.
Find the Courage; Find Your Purpose
What will allow and motivate us-you, me and
AACN-to find the courage to be bold and use our voices in ways we have never
used them? The inspiration that can give us courage and move us to be more than
we think we can be is our sense of purpose. That which is so compelling and
powerful that we become stronger, more determined and committed because we
believe so much in its validity.
For me, this is where the buck stops. If
our profession is in danger, our patients are in danger, and that is where I
draw the line. AACN's vision of a healthcare system driven by the needs of
patients and families cannot become a reality unless we begin to use our voices
to make nursing known; to educate others about how our care changes patient
outcomes and safety; and to be fearless in speaking about the realities of what
we do and what the actual needs of nurses and patients are. Keeping patients out
of danger requires that there be enough skilled, committed, well-paid and
supported nurses. This purpose can carry us past our fears to use the bold
voices needed to mold the future.
Join AACN and me as we begin this year
using bold voices-fearless and essential voices that will shift the future of
healthcare for us and for our patients.
Families Must Also Respect Nurses
Re: Viewpoint: Getting to Best Practice on
Visiting Time (AACN News, May 2002):
As healthcare providers, we try to build
trust and respect with every patient. But to be told that this is our job, when
faced with threats of harm or lawsuits and other issues, I have to respond that
families must instead earn my respect and trust.
As a critical care nurse with an MSN and 10
years of critical care experience, I understand that visitation is important to
patient care and outcomes. In fact, I worked in a facility where open visitation
worked well. However, the families respected the nurse's judgment and when asked
to leave did so.
Now when we have a code and ask families to
leave, it rarely happens. While working in the hospital, I have been threatened
with bodily harm, dodged a punch, and told we would be sued. A family member
actually struck one nurse. Dealing with intoxicated family members is becoming a
constant. I could go on.
It's one thing to provide support, answer
questions and address concerns, even with "overbearing" families, but a totally
different issue when faced with these types of situations. I'm sure my facility
is not the only one where issues like these arise. These problems take our focus
away from what we are here to do, care for the patient.
I feel the authors should acknowledge that
these issues are occurring, and that there must be some respect given to
JoAnn Green, RN, MSN, CCRN