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.