As nurses, we often look at our failures and frustrations with a microscope.

The moment we said something out-of-touch to a frustrated laboring mom, or when we were a bit grumpy, room 12 needed help with their compression stockings again, and we hadn’t even eaten lunch. We’ve gone to bed haunted after a shift because we forgot to chart the most recent pain scale score or the side rails were up x2.

In Taking Care by Sarah DiGregorio, she explores the moments of humanity that make up nursing, its shortcomings, traditions, and hopefulness. Her goal? To foster a broader understanding of nurses among the public and to help nurses understand their value in healthcare.

Why Nursing?

DiGregorio has a journalism background but has always admired the nursing practice. Her most memorable experiences with nurses include her upbringing with chronically ill parents, and a NICU stay with her 28-week premature daughter eight years ago. She felt inspired to write about the nursing profession because nurses were there for her during challenging experiences when healthcare felt alienating and dehumanizing.

“...I had these moments where I felt like someone was actually hearing us and was actually able to help us. And those experiences were always with a nurse. And I came to understand that wasn’t a coincidence. And I really wanted to write about that”, DiGregorio explains.

Some of what DiGregorio wants the public to understand about nurses include:

• Nursing is an independent scientific discipline.

• Nurses’ power and ability to get information from patient interactions are paramount to nursing practice.

• The public benefits when they are willing to listen to nurses’ stories and when nurses are eager to share.

The general public and nurses have a natural alliance and connection, according to DiGregorio. She writes in her book that nursing is just as human as tools, fire, and storytelling, and nursing goes back equally as far into the past. We need to strengthen public comprehension of nursing to strip healthcare back to those basics.

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Misunderstandings in the Foundations of Nursing Practice

As we shed light on how nursing became what it is today, we can call out the systems in healthcare that formed due to traditions and no longer serve us.

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A Whitewashed Nursing History

Boiling down the history of nursing to the work of Florence Nightingale alone is doing a disservice and whitewashing the profession. At the beginning of Taking Care, DiGregorio establishes that Nightingale did initiate many of the nursing and sanitation practices that persist in healthcare today. But it’s important to approach that portion of nursing history through the lens of 19th-century Victorian England. That means addressing the classism, sexism, and racism that laid the foundation for nursing culture today.

Long before the 1850s, people were sick. People had babies, and people had mental illnesses. They needed nurses and people—especially women—to take on the role of healing. Because historians have traditionally been less interested in women’s history, they stigmatized or ignored much of the work of female healers.

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Antiquated Payment Structure

DiGregorio explains that the hospitals established the first nursing schools in the United States, and those training centers served primarily as sources of free labor. “So, from the very beginning, nurse trainees provided free nursing for hospitals,” says DiGregorio. When nurses graduated, working as a private duty nurse for a wealthy family was a more secure source of income than continuing to work in hospitals.

“There has been an idea that nursing shouldn’t cost much. And I think a lot of this has to do with the fact that nursing has been sort of gendered as female, and this idea that nurses are angels and it’s in their nature to care”, DiGregorio says. These are all ideals perpetuated by Nightingale.

This characterization has persisted ever since. Nursing services are an expense for healthcare systems, bundled with the room and board fees charged to insurers. Conversely, physicians are often associated with revenue generation through billing. This perception sometimes leads to the temptation of cutting nursing staff due to their expensive nature in the eyes of businesses.

By calling the current nursing systems into question, it’s easier to see how the profession got to where it is today and where we don’t want to repeat history.

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A Vision for the Future of Healthcare

To hope for a brighter future in nursing, it’s essential to be aware of the challenges in the profession today.

In the nursing community, we’ve heard the phrase, “There is no nursing shortage. Only a shortage of nurses willing to work in these conditions.” But for the most part, the general public still sees the shortage simply as a lack of bodies. DiGregorio’s book calls this into question, explaining that nurses are one of the largest workforces in the nation, with three times as many nurses as medical providers. DiGregorio acknowledges the shortage is a complicated problem. The breakage begins with the nursing pipeline, where there isn’t enough capacity for nursing schools to admit all the prospective nursing students due to underpaid clinical instructors and a lack of resources. Once the small cohort of graduates does hit the workforce, it’s also difficult to retain them.

There is a contrast between the public’s perceptions of nurses and how nurses struggle in their field. She explains that while writing her book, “People called up and cried to tell me about a nurse who changed their lives.” On the other hand, “...the nurses who called in…[had] a deep frustration and anger about how difficult it is for them to do their work.” Both of these things are based on reality, DiGregorio explains. The public is grateful for nurses, and nurses also struggle in the current healthcare system.

How we can get to a healthier future in nursing, we can:

• Understand the nursing shortage problem and educate the public on why it exists.

• Help nurses understand their inherent value in healthcare.

• Advocate for systems that incentivize valuing nurses and investing in them.

DiGregorio’s vision for the future of healthcare is for nurses to have their humanity respected to the fullest extent. Nursing is a calling that invites us to participate in some of the most intimate experiences of our patient’s lives, but it’s also a job. And nurses need to be seen as professionals with limits, bodily functions, and emotions.

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A Love Letter to Nurses

DiGregorio describes her book as a love letter to nursing’s vast possibilities. Nurses show up for their patients despite their complicated history, frustrations, failures, and messiness. Nurses are humans and healers and deserve compensation for their expertise in a system that values health and wellness for all.

What’s your nursing story? Check out Taking Care by Sarah DiGregorio and learn how your journey can shape healthcare for the better.