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“To Maintain and Elevate the Standard of Nursing” - Commencement Address by Senator Richard T. Moore at the Massachusetts College of Pharmacy and Health Sciences May 12, 2007, Mechanics Hall, Worcester, Mass.Today, as members of this first ever nursing class of the Massachusetts College of Pharmacy and Health Sciences, you are making history! You are the first nurses to benefit from this school’s commitment to caring, its superb faculty, state-of-the-art facilities and innovative programs. The coveted diplomas that each of you are about to receive, together with your registered nursing license, are now the keys to a healthier future for those who will be in your care! For many years, new nurses subscribed to what is known as, “The Florence Nightingale Pledge,” established in honor of one of history’s great heroines. Most significant among the key maxims of that pledge is the promise “to maintain and elevate the standard of nursing.” It’s a noble professional goal, but even the best and brightest nurses are constantly challenged to live up to this high ideal. Although it may seem far distant to you now, at some future date, you will look back on your nursing career and ask yourself, did I maintain and elevate the standard of nursing? Did I make a genuine difference for my profession and, more important, for my patients? In the few minutes before you officially become nursing graduates, let me share some thoughts that might help you to answer these fundamental questions with a resounding yes! First, despite the well-deserved feelings of satisfaction, and perhaps relief, that you are experiencing at this moment, graduation does not mean that your learning is over, or that you now have all the answers even after completing this innovative, accelerated post-baccalaureate program! There’s a reason that this ceremony is called a “Commencement” – because it implies…a new beginning. There is more to learn if you are always to deliver patient-centered care! Second, you now represent the nursing profession – the profession that is annually ranked in public opinion polls as the most trusted. No one is more suited than you to be a role model for others seeking a truly meaningful career in nursing! Third, nurses work synergistically with other health professionals to provide patient centered care. Always remember to treat your colleagues in health care as you’d like to be treated by them, even when they don’t treat you the way you want, and have a right, to be treated! Fourth, health care – including the nursing profession – is changing in scope of practice, responsibility, technology and team work. Be among the agents of change in the nursing profession for, as St. Dominic once said, “It is better to be a hammer than an anvil.” Finally, even though you may not see yourself as an “angel,” to your patients and their families, you are! Never let them down! Let’s look a little closer at each of these five concepts. 1. Nursing, more than many other professions, requires lifelong learning. In nursing and medicine, more than any other profession, you will continue learning throughout your career as health care constantly evolves. Medical knowledge is now doubling every eight years. Expect it to be doubling every two years by 2010 -- with the result that medical professionals will be struggling to an even greater degree to keep up than they are today. Nurses of the future must have and maintain competencies in the areas of quality improvement, teamwork and collaboration, evidence-based practice, patient-centered care, safety, professionalism, informatics, systems-based practice, and nursing knowledge. Increasing your knowledge in these competencies combined with positive attitude and growing skill will allow you to move from novice to expert during your career – thus, honoring the Florence Nightingale credo “to maintain and elevate the standard of nursing.” 2. Nursing is a special calling. Starting today, nursing needs you to represent and promote the profession. There is a shortage of people with the desire, commitment and caring skills that it takes to be a nurse. As you graduate today, you are making an individual and collective step toward easing this current and growing shortage responding to the needs of society. Fortunately, more young people are selecting nursing as a profession today than was the case only a few years ago. In the last 5 years, the Massachusetts has seen a 26% increase in the number of nursing graduates and a 45% increase in nursing-student enrollments. Yet, we still have a shortage of nurses, and as the population of “baby boomers” transitions to senior citizens, the need will grow. Our society needs you to remain in nursing and to encourage others to enter your honored profession. You will need to continue to utilize technology and support personnel in order to use your education, experience and skills to best serve the needs of more patients without becoming spread too thin, stressed, and exhausted. While you might not be ready, just now, to think about graduate education and becoming a nursing professor; -- and some of you should -- you can still help to ease the nursing shortage if you recruit more nurses by your caring example and encouragement. You can influence, inspire, and share your expertise with the nurses of tomorrow. 3. Nursing is at its best when it’s collegial rather than competitive. Nursing professionals act within legal, ethical, and regulatory frameworks demonstrating concern for others, valuing the profession of nursing, and functioning effectively within teams based on mutual respect and shared decision making focused on the best interests of the patients. It’s possible that you’ll find that some of your new nursing colleagues and some other medical professionals may seem less than welcoming as you begin or continue your nursing responsibilities. The truth is some nurses are hurting each other. Long hours, difficult physicians, and the emotional demands of the job can take their toll and cause nurses of all ages to act hostile toward one another. Researchers report that verbal abuse among nurses contributes to up to 24% of staff turnover. To make matters worse, studies indicate that approximately 60% of newly registered nurses leave their first position within six months because of some form of horizontal hostility. With the nursing shortage and high turnover rates affecting nearly every facility, it is imperative that each new nurse work to put an end to this attitude! Think, once again, about that phrase in “the Florence Nightingale Pledge,” “to maintain and elevate the standard of nursing.” If you find hostility from colleagues, learn to deal with it. Nurse and author, Karen Bartholemew, RN, has written a book entitled, Ending Nurse-to-Nurse Hostility: Why Nurses Eat Their Young and Each Other, that’s full of helpful suggestions. Don’t let anyone drive you away from what you’ve worked so hard to achieve; and don’t be among those who perpetuate the hostility as you attain seniority in service. 4. Nursing is changing. Don’t resist change, lead it! For too long, the health care number crunchers have failed to recognize the healing power of nursing. Incredibly, nursing care has, traditionally, been lumped together in hospital bills as, “room and board.” Yet, as you all know, the acuity of each patient requires different levels of nursing intensity. Delivery of patient-centered care has to be based on respect for the patient’s preference, values, and needs. Sicker patients require more nursing time and benefit from the care of nurses with more experience and education. Professor John Welton of the Medical University of South Carolina’s Nursing School has proposed that hospitals utilize what he calls; “nursing intensity billing” based on the services and skill level of nurses and the care needs of each patient. If hospitals and other health care providers properly valued nursing services in this new paradigm, adequate reimbursement for identified nursing would become a revenue center rather than a cost center. Nursing also relies increasingly on the concept of a patient care team and health information technology under the leadership of the Registered Nurse. Proposals for specific nurse to patient ratios, which have no evidence basis in research, fail to recognize the needs of each patient, the importance of the patient care team, or the assistance that is provided through availability and proper use of health information technology such as e-prescribing and the electronic health record. As you enter this new phase of your nursing career, don’t be afraid to question policies that are not based on scientific evidence. Enthusiastically welcome and embrace supportive personnel and technology rather than rigidly fight to maintain outworn concepts of the scope of nursing practice! Maintaining and elevating the standard of nursing also means keeping up with the needs of your patients. 5. Nursing is truly making a difference one patient at a time. Whether you are clinical nurses, student nurses, nursing administrators, educators, and researchers; nurses working in industry or even in the Massachusetts legislature, nurses who care for the homeless, nurses who care for patients in hospitals, non-acute care facilities, ambulatory-care settings, in patient’s homes, and on helicopters and ambulances, as nurses, you touch patients’ lives no matter what role you play. Nurses share a bond – a common bond of caring for, and about, others. Be proud and optimistic about your future. You are charged with an awesome responsibility – to work together to promote awareness of your profession as you deliver compassionate care for your patients. You must ensure that excellence in nursing continues, and that your profession not only survives, but thrives. And, on those days when the task seems too great, remember the advice of the legendary Clara Barton to, “Think only of the need and the impossible is accomplished.” Those of us who are privileged to witness this first graduation ceremony for nurses at the Massachusetts College of Pharmacy and Health Sciences proudly honor you for your deep and abiding commitment to care for others. May you find experiences daily through your patients and their families to inspire you to continue your compassionate service for many years into the future. With slight shades of difference each of you have the same compassion for those who are ill, the same education and skills to be used for their benefit, and the same commitment to caring for all who will become your patients. You have a common cause toward a noble purpose that has given each of you the strength to struggle, endure, and overcome obstacles in your personal lives, your educational experience, and your career. The intellect and skills you possess are the work of your own initiative, your life experience prior to and during your nursing education, and your supportive and knowledgeable faculty here at MCPHS have fully prepared you to join the nursing profession. However, it is what is in your heart and soul that really brought you to this moment, and that will carry you through as you minister to those entrusted to your care. If you haven’t yet had time to read the book, Chicken Soup for the Nurse’s Soul, I hope you’ll pick up a copy or, maybe, someone will give the book to you as a graduation present. It’s filled with messages from other nurses that might sustain you, especially on your more difficult days. In the final essay, John Wayne Schlatter presents a memorable tribute “To the Nurses of the World,” concluding that: “no one can practice your profession unless they already possess a brain brimming with wisdom, boundless courage and a heart filled with love. You are living proof that humanity is created in the image and likeness of God, and the name of that God is Love.” |
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