From Silence to Voice: What Nurses Know and Must Communicate to the Public (The Culture and Politics of Health Care Work)

by Bernice Buresh

How does a nurse know what question to ask a patient, what tone of voice to use, or when to hold the patient’s hand? These actions stem from attentiveness, knowledge about the patient and his or her condition, clinical judgment, experience, and well-developed caring skills.

We believe they can do this by replacing the virtue script with what we call a “voice of agency” that accurately describes nurses’ complex and critical work.

developing a sense of agency depends on recognizing the importance of nursing work and their own importance in carrying out this work.

Nurses must communicate more accurately about their work to get the kind of resources they and their patients so desperately need.

Being a nurse is about saving patients’ lives. ▪ Being a nurse is about making sure a patient doesn’t develop a fatal complication before, during, or after surgery. ▪ It’s about paying attention to the “small” but significant details such as smoothing out the wrinkles on a sheet so a patient doesn’t develop an excruciating and costly bedsore. ▪ Sometimes by sitting and talking to someone, I find out the most important things—like whether patients understand how to take their medications, whether they have

In other words, evaluating hospital care in terms of its ability to offer positive experiences could easily put pressure on the system to do things it can’t, at the expense of what it should.

To begin constructing your anecdotes or arguments, think of an incident from your work that would help someone understand nursing.

Having observed nurses in action for years, and noting the complexities of keeping patients safe, we conclude that there is no such thing as a “little thing” when it comes to the care of the sick.

Instead of calling these actions little things, nurses need to explain why they are really very big things.

many frame nurses’ caring as an individual attribute without taking into account that it stems from knowledge and experience.

compassion cannot be produced on demand but depends on skill and knowledge.

know that in one study, 86 percent of medication errors that were caught were caught by nurses, not by doctors?