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Running head: POSITION PAPER

Position Paper
Ray Thacker
Westminster College

Running head: POSITION PAPER

It is believed that male nursing grew largely due to the US Army Nurse corps started
February 2, 1901 when the Army Reorganization act was passed by congress and made the corps
permanent in the Army medical department (The evolution of male army nurse corps officers).
Now two-thirds of the nurse population in the corps is male. Before the Army recognized nursing
others had seen the profession as important. Although many of those who cared for the sick were
women of a lower class who could only find work caring for those who were sick and injured
nursing was transformed into a now respected career. Most notably Florence Nightingale, an
influential nurse during the Crimean war. She set the foundation for nursing as a career and
described it as [a] n art: and if it is to be made an art, it requires an exclusive devotion as hard a
preparation, as any painters or sculptors work (Science quotes, 2015). Another who became
famous through his works of art also performed in the role of nursing is Walt Whitman. The
great American poet and author of O Captain! My Captain! and Leaves of Grass, was a
dedicated nurse who entered the field as a volunteer visitor of wounded soldiers, a task he clearly
enjoyed. The mounting casualties of the Civil War quickly drew him into a more harrowing role:
caring for severely injured men with severed limbs, gangrene and uncontrolled pain. Whitmans
efforts, motivated by compassion and altruism, earned him the trust and the appreciation of
surgeons and soldiers alike, but he never accepted pay for his services, instead he used his private
funds to support in the care of the wounded. The experience had a lasting effect on his health
and his poetry. He described his service as the greatest privilege and satisfaction . . . and, of
course, the most profound lesson of my life (Gutman, 1998). In one of his Drum Taps poems he
said an eloquent and passionate celebration of caring, certainly one of the canon of poems about
nursing. For those who argue that nurses and physicians ought to develop detachment and
clinical distance, this poem is a kick in the pants (Whitman, 1900).

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Today the profession has taken on a more profound role. The role is one of high esteem,
gratitude, self-giving, high standards, and one that is seen as a prestigious undertaking in many
communities. The profession of Nursing is seen by many as the most honest and ethical
profession (Saad 2006). The education of a nurse has evolved from the days of Walt Whitman
and Florence Nightingale. Anyone who has earned a degree in the science and art of nursing has
met a high standard of learning. The learning includes, but is not limited to, body mechanisms
and pathologies, language of the medical community, how to care for the many varieties of
patients who are out there, culture and how to understand ones uniqueness, pharmacology and
complementary medications, understanding lab values and monitoring results, to name a few.
Nursing school also advises students on how to approach ethical dilemmas, problem solving,
cultural preferences and competency, leadership, and the best ways to manage conflict should it
arise. This education is valuable and needs to be provided by those who have had the experience
and the knowledge passing it on to the next generation of nurses. it is important to gain this
through a accredited college, one that is valued and identified by peers and by the Board of
Nursing. Another concept of importance is to understand that this only provides a nurse with the
book smart. The real education is gained through experience and forming the learned book
knowledge into a practical form. This education is the type of learning that no school can
provide.
Lastly, it is important for a nurse to not loose track of their nursing roots and to help
upcoming nurses, passing gained knowledge and expertise onto the student nurse whenever the
opportunity is available.
There is no typical nurse. Each individual brings a unique aspect of nursing to the patient
and helps make nursing as remarkably diverse as any other profession. Only a nurse working

Running head: POSITION PAPER

with a patient can have such a intimate conversation with another individual that reveals many
things one person would never reveal to another. This aspect of a nurse, male or female, brings
the quality of care into focus. Continuing education and the use of evidenced based research has
helped The Institute of Medicine succeed in their goals of making the medical environment a
safer environment by causing no harm to the patients who are seen. To err is human: Building a
safer health system was first published in 1999 this report stated, [a]t least 44,000 people, and
perhaps as many as 98,000 people, die in hospitals each year as a result of medical errors that
could have been prevented (Institute of Medicine, 1999, par. 1). Many of these errors include
medication errors, errors in properly acquiring diagnostics, errors in dosages of medications,
communication failure from staff to staff and staff to client. The world is changing, and the
medical field is changing at a faster rate now than it ever has. This is due largely in part by
nurses who study research, perform research, analyze research, and who are not afraid to
brainstorm and fight as a advocate to make change when change is needed to decrease the errors
and keep their patients safe.
Education continues to provide nurses with the means to close the communication gap
between the healthcare provider and the client. This includes recognizing effective
communication from distorted communication and jargon. Patients already feel out of control
and out of touch when they enter the medical community, the overwhelming feeling of being
isolated through medical terminology and navigating the system associated with some facilities
and healthcare plans can be overwhelming. The quality of care is increased by the nurse who has
learned how to properly communicate and identify concerns through verbal and non-verbal cues
and become the advocate for the individual. This can be performed using several methods of
communication and by knowing when to use the power the nurse has. As a nurse I would start

Running head: POSITION PAPER

my career out building a foundation of understanding how to use the powers only a nurse has.
Diane Forster-Burke has spent time in teaching these principles of power to many nurses who are
now employed in the field. These six powers are: The Potential Power of Numbers, Expert
Power, Legitimate Power, Referent Power, Reward Power, and Coercive Power.
Nurses are the largest group of healthcare providers in the nation. According to the U.S.
Department of Health and Human Services in a 2004 national sample of registered nurses there
are 2.9 million registered nurses who are dispersed throughout every voting district (U.S.
Department of Health and Human Services, n.d.). In politics numbers are like gold.
The legitimate power, also called positional power, introduces the legal and
organizational authority for nurses. The legal authority is described and maintained through
careful deliberation as defined in the Nurse Practice Act. Each nurse receives his or her license
through the State Board of Nursing following a board exam to verify the competence of the
individual. This process combines a combination of steps to require proof of graduation from a
accredited nursing school, clinical hours of learning and understanding, and completing a
background check for licensure. The organizational authority is more individualized for the
position the nurse would be working. It includes specific requirements for a job position when
the job is posted and includes the management and responsibilities. This helps identify the
holder of the positional power through a chain of command system.
Referent power is the ability of an individual to attract others and build loyalty. This
ability is based on the nurses interpersonal skills as well as charisma. Many who work in the
nursing field remember or have a coworker they admire and would help out at any cost. This
may be a preceptor from their past or a co-worker they see who goes the extra mile to help others
and gains respect. This type of power cannot be taught but can be felt by those around them.

Running head: POSITION PAPER

Expert power is the power of an individual derived from the skills or expertise of the
person and the organizations needs for this skill set and expertise.
Reward power is dependent on the ability of the person to confer value and material
rewards onto others.
Coercive power is often used as a last resort to convey the possible application of
negative influences on the situation.
As a professional nurse there are many roles that one may fall into. These may include
but are not limited to a leader, medication administer, community resource, supporter, politician,
educator, collaborator, researcher, advocate. With my past medical background I have realized
the most significant role is to be an advocate for my client. Advocacy includes being a teacher, a
confidence builder, and a safety expert. While I start my path into a new medical career, building
on the past foundation of gained knowledge I will continue to focus on being an advocate in
every aspect of care. As I add to my knowledge base I can begin to develop additional roles such
as a delegator and a leader.
The nursing scope of practice I will follow and be expected to abide by will be the Nurse
Practice Act. This defines the breadth of practice for the nurse and is defined by each state. The
Nurse Practice Act is a solid base of legalities for the nurse. It holds the nurse accountable for
their actions and also defines their role in patient care and in delegation. As a Registered Nurse I
hold many responsibilities, one of which is working with and appropriately assigning proper
tasks to others in the medical field including LPNs, UAPs, and CNAs (LaCharity, 2013). When
a nurse has a team to work with what can be trusted in their tasks and abilities it makes the large
load of a nursing floor, manageable. The individual needs of the patients within a team can be
better met if divided by a equally talented team so the RN can focus on patients who have critical

Running head: POSITION PAPER

needs, for this to occur the tasks such as ADLs, ambulation, and feeding patients can be
delegated to other trained individuals. However the RN is still accountable for all their actions
and for the overall welfare of the patient.
Accountability is being able to say yes to an action or task. This is not only for
themselves, but also for the clients, and for all the personnel for which tasks have been delegated.
Accountability includes demonstrating honesty and integrity and being sure to seek clarification
of orders while providing timely care in a confident manner and safe environment. The nurse is
accountable to the organization he or she belongs to as well as to the profession of nursing. Each
nurse is an individual but collectively nurses are viewed as one. If nursing collectively is to
maintain the standard of the highest ethical profession then individually we must be maintain our
accountability.
As a Registered Nurse I want to ensure the personal and professional ethics are carried
out and they can be seen by all I work with and those I serve. Even the smallest measures of
voracity such as following through with a warm blanket you promised a patient, or a drink of
water. I believe the greater sum of nursing is made up of its smaller parts and together this could
be the potential power of numbers.

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References

Gutman, H. (1998). Commentary, Selected Criticism. In The Walt Whitman Archive. Retrieved
from http://www.whitmanarchive.org/criticism/current/encyclopedia/entry_83.html
LaCharity, L.A., Kumagai, C.K., & Bartz, B (2013). Prioritization, Delegatoin Assignment:
Practice exercises for medical-surgical nursing: critical thinking in patient care. (5th ed.,
Pearson new international ed.). Upper Saddle River, N.J.: Pearson.
Saad, L. (2006). Nursing tops the list of most honest and ethical professions. The Gallup Poll.
Retrieved on April 15, 2015 from www.galluppoll.com/content/?ci=25888&pg=1
Science quotes by Florence Nightingale. (2015 todayinsci. Retrieved from
http://todayinsci.com/N/Nightingale_Florence/NightingaleFlorence-Quotations.htm
The evolution of male army nurse corps officers (2009, July 7). In U.S. army medical
department, office of medical history. Retrieved April 10, 2015, from
http://history.amedd.army.mil/ancwebsite/articles/malenurses.html
U.S. department of heath and human services. HRSA. (n.d.). Preliminary findings: 2004
National sample survey of registered nurses. Retrieved April 1, 2015
Whitman, W. (1900). (Leaves of Grass) The Wound-Dresser. . Retrieved from
http://www.loc.gov/exhibits/treasures/whitman-wounddresser.html

Running head: POSITION PAPER