Nurses are the Beating Hearts of Health Care

By Jim Towey

Nurses bring kindness to the sick and suffering, confidence to the fearful, compassion to the dying, and consolation to the grieving.  The nurse risks her own health – at times, life – for those in her care. (I use the feminine pronoun because over 90% of America’s nurses are women – so no offense to the brave men who also chose this high calling!)

She is at the bedside of the patient with no family members.  She is the one skipping meals and shortening vacations to take extra shifts at understaffed facilities.  While others are frightened or repulsed by the sight of blood and guts or tempted to flee from the terminally ill or disabled, a nurse sees the beauty of the individual, not the brokenness.  People in need seem to unleash her maternal instincts and mercy.

A noble history

This noble profession traces its roots to Florence Nightingale, the foundress of modern nursing, and Clara Barton, the battlefield heroine of the Civil War who later founded the American Red Cross and served for 23 years as its first president.  Both 19^th century women lived into their nineties, and died at the time Agnes Gonxha Bojaxhiu was born.  She didn’t receive nurse training until she was in her late thirties.  The world knows Agnes as Mother Teresa of Calcutta, the saint of the gutters.  Her work with lepers, the disabled and dying inspired not only her religious followers but many others to choose a career of caring.  

The nursing profession has grown dramatically and is no longer confined to America’s 7,000+ hospitals.  Today nurses also are deployed in hospice and home health care, elderly housing, schools and prisons, community clinics, public and rural health centers, on military bases and outposts – and even on cruise ships.

I had the privilege last week of speaking at Case Western Reserve University, which has one of our country’s largest and most respected nursing programs.  The campus is joined at the hip to the world-renowned Cleveland Clinic which gives hundreds of Case nursing students excellent internship and externship opportunities.  Two months ago, I was with Aging with Dignity Board member (and longtime nurse) Mary McElroy and spoke to a gathering of over 150 nurses of Community Hospice of Jacksonville.  To be in the presence of these women who showed such heroism during the Covid pandemic (my blog tells the story) was to realize how many ordinary but saintly people are in our midst unawares. 

These women and men in nursing comprise an army of compassion that is over 6 million strong– from certified nursing assistants to licensed practical nurses to registered nurses to nurse practitioners, as well as to those who educate, train or supervise them.

A tough job

It has never been easy to be a nurse, and that is especially true now.  Burnout is prevalent, particularly after Covid, and increased electronic documentation requirements make the work more bureaucratic and less patient centered. The nursing shortage now upon us owes to an aging work force (the average nurse is 52), turnover (a recent survey  reports that over 1 million RNs will quit or retire by 2030) and a lack of educators and accredited programs (in 2021, schools with nursing programs turned away almost 100,000 qualified applicants because of lack of space, faculty and clinical sites).  The supply of nurses lags badly behind demand and as the age wave of Baby Boomers continues to wash over America and saturate its hospitals, this crisis will only worsen.

Artificial intelligence and nursing

And what will happen when artificial intelligence intrudes on the relationship between patient and provider?  Will we trust the wisdom of our nurses or follow the algorithms of machines?  The Wall Street Journal published a cautionary tale, “When AI Overrules the Nurses Caring for You,” that demonstrated how nurses can become beholden to AI protocols, at the expense of their patients.  In the years ahead, cost-cutting and bottom-line pressures will make AI increasingly more attractive to big medicine.  One AI pioneer, Mark Andreessen, said “anything that people do with natural intelligence today can be done much better with AI…Talking to an empathetic AI friend really does improve their (a patient’s) ability to handle adversity.”

Really, Mark? Is that you or your chatbot talking?

AI can’t love, and Andreessen knows it.  If you are on your death bed, or in a NICU unit while your newborn hangs between life and death, do you want the warmth of a human hand holding yours, or a chatbot machine beside you rattling on with algorithmic encouragement?

It remains as true today as in the time of Nightingale and Barton: Nurses, in all their beautiful humanity, are the answer to what ails us.