NURS 492 Week 2 Discussion Board Forum 2 Example

Discussion Board Forum 2: Giving Voice to What Nurses Know

NURS 492 Advanced Concepts of Nursing Practice, Discussion Board Forum 2

Thread by [Student Name]

The unit, the writer's experience and the classmates are composites; the textbook, Scripture and journal articles cited are real.

For thirteen years I have walked into patients' rooms and said, "Hi, I'm Kelly, I'll be your nurse today." Last month, a patient's daughter listened to me explain her mother's new heart failure medications and then asked, "Are you a real nurse, or one of the aides?" I was a little hurt, but this week's reading made me wonder whether my own introduction had invited the question. I had just spent ten minutes explaining fluid restriction, daily weights and the signs that should bring her mother back to the hospital, yet nothing in the way I presented myself told the family that this teaching came from a licensed professional with years of cardiac experience.

Buresh and Gordon (2013) argue that nurses often communicate through a virtue script, describing their work in terms of caring, compassion and dedication rather than the knowledge and judgment it requires. They urge nurses to introduce themselves with their full names and titles, as physicians and other professionals do, and to explain what they are doing and why, so that patients understand that a nurse's monitoring, teaching and decisions are skilled work. My first-name greeting is friendly, but it says nothing about my education or responsibility, and it sounds the same as everyone else who enters the room.

The public picture of nursing reinforces the problem. González et al. (2023), in a scoping review of 60 studies of nurses in the media, found that most studies reported a predominantly negative image that did not represent the profession's real character. Hayward (2023) analyzed an Australian hospital reality series and found that doctors spoke 87.9% of the dialogue, all major characters were doctors and the narrator mentioned nurses about 4 times per episode compared with 30 times for doctors. If the public seldom hears nurses explain their work on television, the bedside may be the only place they learn what nurses know. That gives every nurse a small but real share of the profession's public image, one introduction at a time.

Scripture speaks to this. Jesus told His followers not to hide a lamp under a basket but to put it on a stand so it gives light to the whole house (English Standard Version Bible, 2001/2016, Matthew 5:14-16). I do not read that as permission for pride, but as a call to let the gifts God has given be seen for others' good. My knowledge of heart failure is useful to a patient only if she knows to trust it and ask about it. So I have changed my introduction: "Good morning, I'm Kelly Morgan, your registered nurse. I'll be watching your heart and breathing today and teaching you about your new medicines." Saying what I know is not boasting; it tells the patient who to ask.

Reply to Danielle

Danielle, you raised a real concern: your hospital removed last names from badges after a nurse was followed home by a patient's relative. Safety must come first, and I would not ask anyone to risk being found outside work. Your hospital's decision was made for a real reason, and nurses deserve that protection. Still, I think there are ways to communicate professional identity without full names. Buresh and Gordon (2013) emphasize the title as well as the name, and a badge that says "Registered Nurse" in large letters, together with an introduction that explains your role, still conveys expertise. González et al. (2023) found that the media image of nurses is largely negative and often unrealistic, which suggests that every patient interaction is a chance to correct that picture, even when the name is limited. Lainidi et al. (2023), in a review of 76 studies on voice and silence among health care workers, found that organizational culture strongly shapes whether staff speak up, and that speaking-up programs often disappoint when the culture does not support them. A badge policy is one signal of culture; how nurses are encouraged to describe their work is another.

Scripture calls us to speak for those who cannot speak for themselves (English Standard Version Bible, 2001/2016, Proverbs 31:8-9), and part of that is making sure patients know that a qualified nurse is advocating for them. Could your unit propose badges that list credentials and role even without last names? A short script for introductions, practiced at a staff meeting, might also help nurses describe their role confidently without sharing anything that makes them easier to find outside work.

Reply to Marcus

Marcus, I agree that nurses' voices are missing from health policy, and your example of the state staffing hearing where no bedside nurse testified was striking. Smith et al. (2025), in an umbrella review of nurses' engagement in policy development, found that hierarchical marginalization of nurses' voices, gender dynamics, limited leadership roles and nurses' own beliefs about power all limit participation, but that developing policy skills and understanding helps. That last point gives me hope, because it is something we can change. Skills in policy are learned like any clinical skill, through practice, mentors and small first steps such as commenting on a proposed rule. Hayward (2023) also found that nurses were background characters in the reality series she studied, and she called for nurses and nursing organizations to take collective action to improve their portrayal. Public policy and public image are connected: legislators, like viewers, learn about nursing mostly from what they see and hear. When nurses are absent from both the screen and the hearing room, it is easy for decision makers to treat staffing and scope of practice as questions for others to answer.

Esther hesitated to approach the king, but Mordecai asked whether she had come to her position "for such a time as this" (English Standard Version Bible, 2001/2016, Esther 4:14). Nurses hold knowledge about patients that legislators need. Perhaps our capstone is a good time to join a professional organization's advocacy day or to submit written testimony. Would you consider doing that together with a few of us from this class? Even a single letter to a state legislator, describing what we see on our units, adds a nurse's voice to a conversation that usually goes on without us.

References

Buresh, B., & Gordon, S. (2013). From silence to voice: What nurses know and must communicate to the public (3rd ed.). ILR Press.

English Standard Version Bible. (2016). Crossway. (Original work published 2001)

González, H., Errasti-Ibarrondo, B., Iraizoz-Iraizoz, A., & Choperena, A. (2023). The image of nursing in the media: A scoping review. International Nursing Review, 70(3), 425-443. https://doi.org/10.1111/inr.12833

Hayward, B. A. (2023). Nurses are background actors in medical reality television: A character network analysis and call for authentic action. Journal of Advanced Nursing, 79(8), 3035-3046. https://doi.org/10.1111/jan.15583

Lainidi, O., Jendeby, M. K., Montgomery, A., Mouratidis, C., Paitaridou, K., Cook, C., Johnson, J., & Karakasidou, E. (2023). An integrative systematic review of employee silence and voice in healthcare: What are we really measuring? Frontiers in Psychiatry, 14, 1111579. https://doi.org/10.3389/fpsyt.2023.1111579

Smith, L., Roberts, K. J., Giambra, B., Polfuss, M., Danford, C., Sheppard-Lemoine, D., Schultz, T. R., Winter, N., Mulcaster, A., Alrimawi, I., Honda, J., Brysiewicz, P., Carr, S., & Feetham, S. (2025). Nurses' engagement in healthcare policy development: An umbrella review. International Nursing Review, 72(4), e70109. https://doi.org/10.1111/inr.70109