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Nurses Win Trust, Leadership Next?

 |  By  
   December 07, 2010

Nurses are the most trusted professionals in the nation and once again top a list they have dominated for 11 years. Since 1999, the only time nurses have been ousted from the top spot of Gallup's annual survey was in 2001, when firefighters were ranked highest following their heroism on Sept. 11.

Not surprisingly, car salespeople, lobbyists, and Congress rank at the bottom of the pile.

Eighty-one percent of Americans say nurses have high or very high honesty and ethical standards. This is much higher than those for the next most trusted professionals, military officers and pharmacists. Physicians are number five on the list.

It's no surprise to anyone in the profession that the general public trusts nurses. When people are hospitalized, nurses are the ones who provide hands-on care, performing intimate and important medical tasks and helping patients return to health. They are patient advocates who often explain complex treatment regimens that help patients understand their care.

So what can nurses do with their status as most-trusted professionals? A different Gallup poll from almost a year ago found that opinion leaders from across the country believe nurses should have greater influence in many healthcare areas—from reducing medical errors to improving efficiency and reducing costs—but that significant barriers continue to block them from fully achieving those goals.

In this older study, the opinion leaders said nurses are not able to exert greater influence and leadership because they are not perceived as important decision makers or revenue generators, compared with physicians, and that nurses do not have a single unified voice with which they speak about national issues.

The issue of revenue generation is one I addressed in a July story in HealthLeaders Magazine. In hospitals, nursing care is billed as part of room and board, so the individual contributions to patient care are not captured as nursing-related. Tracking nursing skill level, time, and costs would enable organizations to determine the impact of nurses on cost and quality.

The second issue, that nursing lacks a unified voice, has plagued the profession for years. Lobbyists from nursing organizations such as the American Nurses Association, American Organization of Nurse Executives, and the National Council for State Boards of Nursing, among many others, all are seeking access to the same spheres of influence. It's time nursing settled on some agreed principles and worked toward the same goal. The American Medical Association is a good example. Physicians may disagree on individual issues but Congress can be confident that the AMA speaks for physicians in this country.

The lack of voice can be improved at a local level as well. Highly-educated, experienced, and with a wealth of knowledge about patient needs, nurse leaders are ideal candidates to serve on boards of directors for healthcare organizations. Too few boards contain permanent nursing representation and too few nurses consider it attainable.

Nurses at the bedside can leverage their trusted positions and take responsibility for getting things done. Joining committees, becoming knowledgeable about quality improvement, communicating effectively with the healthcare team, and speaking up for their patients are ways to be accountable for nursing and its influence.

Nurses can't afford to let others make decisions about nursing and healthcare for them. The stage has been set and it's time to grab the opportunity.

Rebecca Hendren is a senior managing editor at HCPro, Inc. in Danvers, MA. She edits and manages The Leaders' Lounge blog for nurse managers. Email her at

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