I am delighted to participate in this fundraising event for nursing and want to begin by publicly thanking Johnson & Johnson for their efforts to focus our region and indeed the entire nation on nursing. I also want to thank the many supporters of this event – as a nurse educator I am thrilled that the monies raised will be used to invest in the education of future nurses.

Where are the students in the audience? Welcome and congratulations on choosing nursing as your profession.

I am proud to be a second generation nurse (my mother is proud of that too). Next spring my mother and I will celebrate at her 50th and my 25th reunions at the University of Pittsburgh School of Nursing. I’m also proud to be an ambassador for nursing as I work to recruit students into nursing. I enjoy talking with prospective undergraduate and graduate students about nursing careers. I emphasize careers in nursing, the ability to succeed and advance clinically in many specialties, to work across and at all levels of health care delivery, to obtain advanced degrees in nursing through doctoral study, to become a college professor, a nurse researcher, to advance through health care administration, or to combine one’s nursing knowledge with another discipline such as law, science, or public health. Many people simply have no idea of the opportunities that nursing offers. In part this is because of how the media portray nurses – leaving many in society believing that if they have a good doctor in charge of their care, everything will be taken care of because they think that nurses just do what physicians tell them. I often get surprised responses from parents of undergraduate students that there is such a thing as a doctoral degree in nursing, that nursing research provides evidence for nursing practice, and that nursing practice makes such a difference in patient outcomes. This is not just a result of the media – it also relates to the relative invisibility of what nurses do even in clinical situations. Pat Buresh and Suzanne Gordon, in their wonderful book entitled Silence to Voice: What Nurses Know and Must Communicate to the Public point to the fact that there is much that we can communicate about what nurses do. They make the case that nurses need stronger public communication skills and in fact half of their book is devoted to those skills. We, as individual nurses and members of nursing organizations must then be willing to use these skills to communicate to journalists and the entire public about our work.

I believe in and have based my own career on the tripartite mission of nursing – practice, education, and research, described and espoused by Dr. Claire Fagin, nursing legend and former Dean of Nursing and President at the University of Pennsylvania. Nursing has offered me many wonderful opportunities – a career that has allowed me to advance through formal education and experience, to practice, teach, and conduct research – and I’m just a little passed the midpoint. I have always practiced - I continue one day per week because I love it, it allows me to maintain currency, and because it makes me a better educator, researcher, and leader.

My generation of nurses has been the first to really be able to advance clinically in nursing. Not all that long ago advancing in nursing meant leaving clinical practice behind. The popularity of clinical master’s degrees and clinical doctorates suggests that nurses don’t want to leave clinical practice and behooves those of us in education and practice to continue to build partnerships that facilitate sharing of resources, clinical opportunities for faculty, and teaching and research opportunities for clinicians. The resurgence in interest in Clinical Nurse Specialists is an indication of the vital roles that clinical nursing experts play in health care and the mistakes that can be made during cost-cutting periods. The reduced demand for clinical nurse specialists caused me to go back for a post-masters to become a nurse practitioner (after I completed doctoral study) because I saw that my life as a clinical nurse specialist was in jeopardy. This decision resulted in my husband informing me that if I needed any more letters after my name, I would have to seek them with my next husband.

There are a couple of questions that I and probably some of you have fielded in our careers. The first is common and goes something like this:

“You’re so smart – why didn’t you become a doctor?” Well, the smart answer is – I did become a doctor – but of course the question really refers to becoming a physician. There’s not a short answer to this question and I think actually the better question is why have I stayed a nurse? I’ve stayed a nurse because I like the nursing paradigm focus on people – people who are healthy, ill, recovering, or dying rather than a focus primarily on treating conditions. I’ve stayed a nurse because I’ve been able to achieve my goals through the career choices nursing offers. And I’ve stayed a nurse because I believe that I can and do make a difference for the premature infants and their families I care for, for the students I have the privilege to work with and mentor, and for the nursing profession.

More recently I was asked another question by a resident physician at my clinical practice site. He saw the credentials on my lab coat and asked, “What does one do with a PhD in nursing?” His tone caused me to have an immediate visceral response and a strong urge to come out fighting. I tried to maintain my composure as I explained that a PhD in nursing is a research degree, like any PhD, and I went on to briefly describe my research, it’s basis in my clinical practice, and the scholarly side of my professional life. “Oh,” he said, “I didn’t know that nurses could do all of that.” He’s not alone.

I remain optimistic about the future but I’m not Polly Anna. The workforce issues we face are long-term and require long-term solutions. Given the reality of a smaller workforce, we must be steadfastly focused on quality. We are in the national spotlight and we have an opportunity and an obligation to thoughtfully and carefully re-think how we do things. Keeping things the same has not and will not serve nursing or our patient-clients well. Let’s confidently recruit into nursing, strive to make significant changes in health care delivery and education, use evaluation research to substantiate our achievements, build partnerships between education and practice, and recognize that individually and together we can make a difference.