1. Hader, Richard PhD, NE-BC, RN, CHE, CPHQ, FAAN

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Nursing might be the most trusted and honored profession in America, but a recent collaborative study between the Gallup Organization and the Robert Wood Johnson Foundation found that opinion leaders nationwide believe nurses have very little influence over healthcare reform.1 How can it be that those who deliver the majority of healthcare are perceived as less influential than physicians, elected officials, insurance and pharmaceutical executives, and patients? Why is it that 1,500 opinion leaders defined by the study as university faculty; insurance, corporate, and health services executive; government officials; and industry thought leaders minimally perceive the influence of the nurse's role in defining and implementing healthcare reform? Most importantly, what should we, as nurse leaders, do to not only change this perception, but actually actively participate in healthcare reform?


Actions speak louder than words. It begins with educating ourselves by identifying the key components regarding healthcare reform and seeking the answers to pertinent questions such as, "As a nurse leader, how will healthcare reform change my strategic focus for my area of responsibility?" Because the proposals from the White House and Congress have been in constant negotiated flux, it's important to stay current with press releases from reliable sources such as the American Nurses Association, American Organization of Nurse Executives, and the American Hospital Association. The information provided in these forums will give you a condensed but accurate reporting of the latest healthcare proposals. After you gather this information, it should be shared with your staff members in daily huddle briefings so that they can also stay current and share their thoughts and views on the topics.

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As a collective force, represented by our professional organizations, we can make a palpable difference in legislative outcomes if united in our political viewpoint. If you aren't already a member of a national nursing organization that lobbies our legislators, now is the time to become actively engaged and influence the debated healthcare reform proposals. Our voice is better heard if members of the profession, with support from our national organizations, can issue consensus statements that advocate for nurses and their patients. Those making changes in healthcare need to understand that nurses are the primary healthcare professionals with the most influence on improving the quality of care and safety of patients.


As nurse leaders, we have to role model to change the public perception of the nurse's impact as a healthcare provider. One of our major challenges? Nurses are still in the position of being the least educated healthcare professionals. Our colleagues all have a minimum of a bachelor's degree in their area of clinical or administrative specialty, and many have now progressed to either a master's or doctoral degree to practice their profession. It's long due for nursing organizations and state nurse licensing boards to require that entry into professional practice must be at the baccalaureate level. However, until that happens, it will continue to be increasingly difficult to influence those deciding the future of healthcare in this country.


Richard Hader

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1. Nursing leadership from bedside to boardroom: opinion leaders' perceptions.