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United State of Nursing

Quest continues to establish an Office of the National Nurse

It all started with an Op-Ed piece that appeared in The New York Times in May 2005. Teri Mills, MS, RN, ANP, CNE, a nursing faculty member at Portland Community College in Oregon, posed the question: "Who better to educate Americans on how to take better care of themselves than nurses?"

With that simple concept in mind, she argued, the best figure to lead the charge in applying preventive strategies to improve our citizens' health and lower our country's healthcare costs would occupy a newly created post - that of a National Nurse.

"We're seeing a rise in chronic conditions that are preventable, and it's just been a travesty as a nurse to witness that, as well as the climb of obesity in our country," Mills explained. "I believe nurses are in the best position to do something about it.

"We have a Surgeon General, why not a National Nurse to lead the country into a culture of prevention?"

Mills set about to launch a campaign, the National Nursing Networking Organization, to garner support, elicit feedback and ideas, and hone her idea into an actionable goal. The concept has evolved in the 3 years since - for example, stemming from the original idea to create a wholly new entity, Mills realized an infrastructure exists that can be buttressed and expanded to fulfill her vision. Today, the campaign seeks to begin with the closest thing the U.S. now has to a National Nurse - the chief nursing officer of the U.S. Public Health Service (USPHS) - and adapt it into the Office of the National Nurse. The program also would utilize another existing entity, the Medical Reserve Corps (MRC), to accomplish the new office's goals on a local level. By strengthening existing resources and networks, and unifying them under one national office of nursing leadership, Mills believes the initiative would usher in a new era of healthcare - one that hinges on prevention.

A Broad Vision

The mission for the proposed office is to establish symbolic national leadership by elevating the current USPHS post to a level of high visibility to the nursing profession and the public, to complement the work of the U.S. Surgeon General, to promote involvement in the MRC to improve the health and safety of the community, and to incorporate proven evidence-based public health education in implementing prevention strategies.

In a similar way that Smokey the Bear is synonymous with preventing forest fires, and McGruff is linked to crime prevention in the public consciousness, Mills believes a central, visible nursing figure could bring to the forefront the importance of disease prevention and wellness.

Creating the office, Mills explained, would not only elevate the status of the nursing profession, but also provide a stronger conduit among localized efforts to problem-solve on a community level - essentially optimizing the impact of multiple small efforts through coordinated resource management.

"We know using best practices to deliver a message of prevention requires multiple components," she said. "In addition to a National Nurse stating what the message would be, it needs to be reinforced in a way the public can understand. That's why what we're asking for is to utilize what we have now, which is a Medical Reserve Corps, and to integrate the component of national nurse teams and other disciplines."

The MRC would provide a foundation for building a network of volunteer nurses and other health professionals to promote, encourage and support nationwide efforts that focus on wellness and disease prevention.

A Local Focus

Though the proposed office is a national one, the strategies it would promote are local ones, tailored to the needs of individual communities and implemented by individual nurses. The concept, Mills said, is one of empowerment.

"What we're proposing is having every nurse afforded the opportunity to participate in her own community in prevention-oriented efforts, whether it be immunization clinics or healthy living fairs," she explained.

"It would probably look different in every community because every community's needs are different."

The Office of the National Nurse would provide the leadership that could propel grassroots community efforts around the country. Mills cited some common messages among candidates over the course of the current presidential campaign, such as urging Americans to step up to the plate and see how they can contribute to making the country a better place, as evidence her vision is one whose time has come.

"Certainly nurses want to be a part of that. If you look at the American Nurses Association's Code of Ethics, it says the nurse's primary commitment is to the patient - whether that be an individual, a family, a group or a community, and that we are to advocate for and strive to protect those people's health and safety and well-being.

"That's why most of us went into nursing to begin with, to help keep people well," she continued. "Nurses are really concerned about the demise of our healthcare system. We're tired of being ranked so poorly in terms of preventable deaths compared to other countries, and dead last in industrialized countries in infant mortality."

Uniting an Image

Mills emphasized that elevating the status of a nurse to a high level of prominence on a national stage would be a boon to the profession as a whole. "To be at that top position at the policy table would be so important and so valuable for nursing," she said. "And to be able to portray nursing accurately to the public is a pretty big deal as we face this ever-looming nursing shortage.

"We believe having a national leader to inspire others to enter the profession would be a big deal."

The importance of the prestige implicit in the concept of a National Nurse is part of the reason the campaign seeks to grow the office from the current USPHS chief nursing officer role. The position already is aligned to work directly with the office of the Surgeon General and is reputable among public health nursing leadership.

"We want to elevate that stature and bring about cooperation, not competition, and work together on common goals," Mills said. "We do need to do something differently, and it is a paradigm shift in some regards - and yet not really. All the pieces have been in play for years, we just have to put them together."

The fragmentation of the nursing profession in recent years, due to emphasis on specialty, education level and other factors, is something that could be improved through national nurse leadership, Mills believes, and uniting in common goals is crucial.

"There's just too much work to be done to be pulled apart; we need to come together."

For more information about the campaign, visit

Shelby Evans is associate editor at ADVANCE. <% footer %>

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