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The Nursemaid Who Wouldn't Disappear

February 25, 2007 - An item on the front page of the "Jobs" section in today's Washington Post reflected the media's continuing practice of using "nurse" as a shorthand for any female who provides paid care to children. Vickie Elmer's piece repeatedly refers to the Maryland infant caregiver it profiles as a "baby nurse," even though the provider has virtually no health care training. Obviously, as Post representatives pointed out to us, there is a historic association between infant caregiving and the word "nurse," as in "nursemaid." And many caregivers persist in marketing themselves as "baby nurses." We're familiar with the view that if lots of people have done something for a long time, it must be right. But to use "nurse" this way today sends a damaging message about professional nursing at a time of crisis. And it poses risks for those who may rely on the mistaken belief that such caregivers actually are trained nurses, as recent press accounts have made clear. We commend DC nurse Mary Brewster for letting the Post know that it can do better, and we encourage others to give the Post their views. more...

"Doctored reality"

March 13, 2007 -- Today The Patriot-News (Harrisburg, PA) ran a good piece by reporter Pat Carroll about the damaging misportrayal of nursing on Fox's "House" and other popular U.S. television shows. The article focuses on the common Hollywood depiction of a "pack of doctors engaging in patient care with no nurses in sight." The piece gets expert comment from several Pennsylvania nurses, and also relies on extensive input from the Center and its executive director Sandy Summers. See the article: "Doctored reality: Nurses chart complaints of marginalization on TV."

"Bitch"

November 9, 2006 -- Tonight NBC's "ER" included two plotlines in which nurse Sam Taggart came off as a tough, adaptive critical thinker who was well-qualified to handle difficult patients, interns, and attendings. The episode is marred by significant missteps, which tend to reinforce the idea that nurses are physician subordinates who take their "orders." But in one of the episode's major plotlines, Taggart masterfully manages two personalities of a patient with dissociative identity disorder. She finally persuades the patient's extremely hostile, resistant persona that he should allow a pericardiocentesis, effectively saving the patient's life. The scene in which Taggart does this, however realistic it may be, is one of the best depictions of a nurse's expert psychosocial care that we have ever seen on U.S. network television. The episode, Virgil Williams's "Jigsaw," drew 14.5 million U.S. viewers and it will be seen by millions more around the world. more...

Abandon hope all ye who seek health care

October 20, 2006 - Today two South African newspapers ran stories describing mistreatment of patients by nurses. In "Nurses ill-treat and victimise HIV/Aids folk," published in The Herald, Nomahlubi Sonjica reports that some nurses at HIV/AIDS clinics shout at patients and disregard confidentiality. And in The Star's "Joburg Hospital: where nurses 'don't care,'" Shaun Smillie describes an abusive nurse who apparently rules an emergency department waiting room "through the use of threats and the muscle of two body guards." Both pieces make a limited effort to seek comment from responsible officials, and the Herald does include a comment that suggests nurses have difficult jobs. But both pieces could have done more to establish context for their reporting, especially the broad assertions in the headlines. Assuming the reports are accurate, why might nurses act this way? Could it relate to workplace conditions? Problems in training? What can be done? Though the reports do underline nurses' role as the first point of contact for many patients, they are clearly a troubling look at the care of the nurses they describe. more...

What every girl should know about nursing

October 15, 2006 - Today The New York Times published an op-ed by Gloria Feldt about women's health pioneer Margaret Sanger. The piece's hook is the Lower East Side Tenement Museum's ongoing restoration at 97 Orchard Street, which shows visitors the harsh lives of early 20th century immigrants, including their high maternal and infant mortality rates. Sanger, then a nurse serving this poor Lower East Side population, began publishing information about birth control--information that was banned as "obscenity." She also opened the first birth control clinic in the United States, and went on to found the group that became Planned Parenthood. Feldt, a former president of that group, is hardly objective about Sanger; there is no mention of Sanger's troubling views on eugenics, for instance. But Feldt argues persuasively that the movement for "women's reproductive freedom" that Sanger sparked has been "crucial to American progress," and she portrays Sanger as a tenacious, visionary patient advocate who understood the powerful influence of the media on the health of her society. more...

Hell is other nurses

October 12, 2006 - Recent Dear Abby columns have addressed the problem of new nurse "Susan in St. Louis." In a letter published on August 30, Susan says she "hates her job" and is already "getting ready to change careers," mainly because of "other nurses and the environment." Abby's initial response and letters from other nurses that Abby publishes in a follow-up column today stress the many different options that those with nursing degrees have within nursing and health care generally. Unfortunately, there's nothing about why nurses might (as one nurse says) "eat their young," what might be done to improve the conditions that are driving nurses like Susan from the profession, or how important it is to world health that we find ways to keep them at the bedside saving lives. We thank Abby (Jeanne Phillips--right) and her correspondents for raising these issues in her column, which is widely distributed through the Universal Press Syndicate. more...

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Mourning Edition

March 1, 2007 - NPR Morning Edition host Steve Inskeep has recently made statements in on-air interviews with disaster health experts that assume only physicians matter, presumably because they provide all important health care. On February 22, Morning Edition ran an interview with a former U.S. Coast Guard officer who argued that the nation was not well prepared to provide health care in the event of a disaster. When this expert said that a community had to ask whether it could handle hundreds of thousands of casualties, "all requiring triage and other kinds of life and death care," Inskeep (below) asked if that meant asking whether such a place had "hundreds of vacant beds ... hundreds of idle doctors?" Today, when the "chief of medical affairs" at a New Orleans hospital noted that a lack of "health care providers" was hampering efforts to restore area hospitals to full capacity, Inskeep wondered whether even hospitals like his that had remained open "don't have enough doctors available." In both stories, the experts sooner or later worked nurses into the conversation. In fact, while physician care is of course very important, most of the critical care in such emergencies (such as skilled triage) is provided by nurses. And it is the severe shortage of nurses that would likely present the most urgent health care human resources problem during a mass casualty event. more...

The real story

March 5, 2007 -- Check out a good article in today's Salem News (MA) about the flawed depiction of health care on popular U.S. television shows like ABC's "Grey's Anatomy." Julie Kirkwood's piece focuses on nurses' arguments that such shows can distort the public's view of health care and health workers, with negative effects on the real world. The story aims to debunk some of the key "myths" such shows present, and it includes extensive comment from Center executive director Sandy Summers about how the shows undervalue nursing care. The piece is "As seen on TV: Real-life health care workers say medical shows aren't telling the real story."

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Digging through crap

November 9, 2006 -- Tonight ABC's "Grey's Anatomy" included a plotline in which the "nurse's job" of "dig[ging] through crap" was used relentlessly as a symbol of professional disaster for the show's smart, ambitious surgical interns. Intern Cristina Yang spends most of the episode sifting through the stool of a boy who has swallowed Monopoly pieces. This is presented as a brutal punishment from Cristina's chief resident. Intern Izzie Stevens joins Cristina, in a desperate effort to avoid her own mandatory peer counseling. The plotline equates nursing with disgusting, trivial work that no educated, ambitious person would ever want to do (ewww!). Later, nurse Moe pages Cristina when the boy starts vomiting. Cristina quickly diagnoses a perforated bowel and directs the clueless Moe to page the chief resident. Thus, nurses do alert physicians to obvious changes in patient conditions, so the physicians can give life-saving care. Physicians also provide all other important care on the show, though nurses may be present at the edge of the main action, silently doing some little nurse thing. The episode, Mark Wilding's "Where the Boys Are," was seen by 20.6 million viewers in its initial U.S. airing and millions more around the world. more...

Dismissible offence

October 17, 2006 - Today The West Australian reported on an effort by Royal Perth Hospital nurse Diane Harrison to publicize "critical bed shortages," and an apparent government move to "silence" her, despite legal protections for such public sector whistleblowers. Anne Calverley's article highlights (but does not discuss) the particular difficulty bedside nurses may face in pushing for sufficient resources. Nurses spend more time with patients than any other health professionals, and patient advocacy is central to their profession, yet nursing has long been associated with unempowered meekness. Ms. Harrison's decidedly unmeek advocacy is apparently linked to overcrowding in her hospital's emergency department. The piece might have explained how such conditions can affect patients and staff. Even so, we thank Ms. Calverley and the West Australian for coverage of these important issues. more...

Political muscle

October 11, 2006 - Recent press items have underlined the remarkable political influence that the California Nurses Association (CNA) has built in recent years. On September 28, KGO-TV (the Bay Area ABC affiliate) ran Ken Miguel's "Nurses Association Carries Political Clout." The report describes CNA's victories over California Gov. Arnold Schwarzenegger on staffing ratios and other legislative issues, and the union's recent push for the state campaign finance initiative, Proposition 89. Today, The Los Angeles Times' blog "Political Muscle" reported that CNA would run an ad during an upcoming "The Tonight Show"--on which Schwarzenegger was to be a guest--accusing the Governor of failing to rid the state of special interest influence. CNA's use of political and media tools is not what people expect from nurses, but it may be an effective way for nurses to advocate for patients and themselves during this difficult time. more...

Take Action!
What is happening with the Benghazi Six?

March 9, 2007 -- We have created a web page to help you follow the story of the five Bulgarian nurses and one Palestinian physician who remain in a Libyan jail because of allegations that they intentionally infected hundreds of children with the HIV virus. Click here for the latest news on their case. These health care workers were again sentenced to death in December 2006, although it appears that European governments remain focused on the issue, and there are suggestions that the prisoners will at least be spared execution. Please write a letter to ask (politely) for their release. Thank you.

Supervisors

October 4, 2006 -- Today The New York Times ran a balanced piece by Steven Greenhouse about a National Labor Relations Board ruling taking a more restrictive view of which employees may join unions. "Board Redefines Rules for Union Exemption" explains that the case involved nurses at a Michigan hospital who assigned other nurses, aides, and technicians to particular patients and gave them specific responsibilities. The NLRB majority found that these nurses were "supervisors," ineligible to join unions, since they used "independent judgment" in overseeing other employees and could be held accountable for their work. The NLRB dissenters and labor unions argued that the decision could effectively exclude from union membership millions who had no genuine management authority. In addition to raising issues about where to draw the line between labor and management, the dispute reveals something about how nursing itself is regarded. It may not be easy to see these nurses as "management" in a traditional sense. But we also wonder how much of the strong reaction to the NLRB decision is driven by a sense that the general idea of nurses as "supervisors" is absurd. The dispute also seems to reflect a quandary bedside nursing advocates face. Nurses exercise independent judgment, and many, like those who act as charge nurses, have significant professional authority. This must be better understood if nursing is to get the resources it needs. Yet current law may create incentives to minimize or distort that professional role--as the NLRB dissenters seemed to do by arguing (in Greenhouse's words) that the board's ruling could exclude from unions "a doctor overseeing nurses or a lawyer overseeing a secretary." more...

The Producers

January 2007 -- Late this month, a friend of the Center got a phone call from producers/writers from a popular U.S. network prime time TV hospital show. Our friend is a recognized expert in a particular health field, and the producers were calling for a script consult, which she gladly gave them. However, our friend reports that the producers were "SUPER surprised" to learn that she was a nurse, that she had a PhD, and that despite being a nurse, she was one of the leading researchers in this key health field. Our friend took the opportunity to provide a lot of information about nursing and how it might be more accurately integrated into this and other story lines. She even referred the producers to the Center's web site. Their reaction? The show's audience is "interested in doctors not nurses," and there are no plans to have any nurse character handle any of the health activities under discussion. This is the self-reinforcing loop: Hollywood tells its global audience that only physicians matter because that's what the audience expects, and the audience expects that in large part because that's what Hollywood constantly tells it. In fact, the real nursing role is highly dramatic, which is why TV physicians spend so much time doing it. We salute our friend for her advocacy. And we'll be looking for the episode in which her nursing expertise will surface--probably in the words and actions of a physician character. more...

Take Action!
4. Crossword helper (3 letters)

February 27, 2007 - Yesterday, The New York Times Crossword Puzzle included the following as the fourth of its "Down" clues: "I.C.U. helpers." We thought: "Hmm. That's not an accurate or sensitive way to describe the skilled physicians who work with the elite nurses who play the central role in keeping critical patients alive. This is the premiere crossword puzzle in the world!" Imagine our shock when we discovered (and today's published solution confirmed) that the "correct" answer was in fact "RNS." OK, we're joking. Of course we knew instantly that the answer involved nurses, and that the Times puzzle's place in the cultural landscape was irrelevant, since ignorance of nursing's true value is endemic in all segments of global society. The puzzle was created by Peter A. Collins, and edited by puzzle superstar Will Shortz. Incidentally, the answer to the clue heading this analysis is "NYT." more...

Self defense

September 15, 2006 -- Recent media items have highlighted the high level of abuse nurses face, which affects patient care and the global shortage. One of the most striking pieces was the story of Portland (OR) emergency nurse Susan Kuhnhausen, who arrived home one day to find an armed intruder in her house. As a September 9 Associated Press piece reports, Kuhnhausen managed to disarm the man, and strangled him to death. The police viewed this as self-defense--and they later charged Kuhnhausen's estranged husband with having hired the intruder to kill her, as a followup AP piece reported today. This case seems unrelated to nursing, though Kuhnhausen appeared to present a model of a nurse strongly defending herself from a serious threat. But the media coverage still drew attention to issues of workplace violence against nurses. In part that's because Kuhnhausen (right) has herself been a leader in advocating for legislative measures to protect nurses from such violence, as a good article by Robin Moody in the March 11, 2005 Portland Business Journal showed. In addition, the AP's September 9 story led Portland FNP Tracy Klein to write a letter to the Oregonian noting that, contrary to implications in the story, nurses like Kuhnhausen "are not immune to the impact of such violence just because they may see it in the workplace." Klein noted that one study had found that 20% of ED nurses sampled met symptom criteria for post-traumatic stress disorder. In fact, nurses experience abuse in clinical settings across geographic and subspecialty boundaries. A good September 7, 2006 piece by Alison Ribbon in the Mercury (Australia) reported that two thirds of Tasmanian nurses surveyed had been physically or verbally abused in the preceding month. The abuse affected patient care, and more than 10% of the nurses had "left a post because of aggression." Like the Portland Business Journal article, the Mercury piece pointed to a reluctance to address the abuse, which may relate to the "virtue script" nurses are still expected to follow. We thank the news entities above for their attention to these issues. more...

Fast-track fixes sought

October 4, 2006 -- Today USA Today ran a generally good article by G. Jeffrey MacDonald about the faculty shortage at U.S. nursing schools. The piece is "Nursing schools short on teachers: With care in demand, fast-track fixes sought." Relying on expert comment from several nurses, the article explains some basic aspects of the faculty shortage, including its role in the overall nursing shortage. It also describes some measures being pursued to address the lack of faculty, though it paints too rosy a picture of the likely effects of those measures. The piece also could have provided more context to show why the shortages exist. On the whole, though, the piece gives readers a basic sense of the problem, and we thank those responsible. more...

"Do they deserve this six-figure salary for what they do?"

October 26, 2006 -- Today The Boston Globe posted a poll on its web site in the wake of a successful nurses' strike at the University of Massachusetts Memorial Medical Center in Worcester. The poll appeared in the site's business section. The introductory text said that the strike was about a plan to reduce what were, according to the hospital, "excessively generous" contracts under which the "average nurse...working a 40-hour week makes $107,000 a year." The site then asked if the nurses were "right to strike," and whether "they deserve this six-figure salary for what they do." The Massachusetts Nurses Association (MNA) said that these descriptions of the strike issues and the average nurse pay were inaccurate. The union urged nurses to respond to the "insulting" poll by explaining that they were indeed worth that kind of money for their important work. We think the poll's most basic flaws are that it wrongly assumes that everyone knows "what [these nurses] do," and that it clearly suggests that it's nothing very important or difficult. We doubt the paper would have run such a poll about a "six-figure salary" for a given employer's lawyers, accountants, ad executives, or newspaper editors. But the idea that a nurse would make such a salary evidently suggests to the Globe that our society has its priorities all wrong. more...

House, R.N.

December 19, 2006 -- Today The New York Times ran "Is There a Barber in the House?", a "Cases" item by Larry Zaroff, M.D., and Jonathan Zaroff, M.D. The piece tells how an "experienced nurse" with "good sense and a good sense of smell" had "come to the rescue" by making the "correct diagnosis" of a life-threatening illness." The nurse had noted that the patient had a strange odor, coming mainly from her hair. The odor turned out to be poisoning from organophosphate insecticide, stemming from a friend's washing of the patient's hair with a bottle she thought was shampoo. The patient recovered after her head was shaved. The piece is a laudable example of physicians recognizing the key role nurses can play in diagnosis. Of course, the nurse's work was not just the result of "experience," "sense," and a "sensitive nose," but of nursing education, skill and the profession's holistic focus. more...

Preventable errors

September 4, 2006 -- Judy Foreman's "Health Sense" column, published today in the Boston Globe and syndicated nationwide, focused on ways to prevent medication errors. "Be sure those pills you're given are the right ones" contains valuable information about how patients and health workers can work to reduce errors. The piece refers in passing to the fact that nurses give and can help to explain medications to patients. But it cites no nursing experts, relying instead on four different physician sources. And it misses the key role nurses play in catching most medication errors--a role that calls upon nurses to be critical thinkers and advocates, not just people who mechanically implement the plans of others, as the piece's description implies. The piece also ignores the extent to which the nursing shortage and the general undervaluation of nursing hampers efforts to reduce drug errors. Short-staffed nurses are less able to catch the errors, detect changes in patient conditions, and provide other care that enables drugs to work safely and well. Underpowered nurses have a harder time advocating for changes in medication plans and medication administration systems. And the piece repeatedly suggests that only "doctors" prescribe drugs, even though most of the over 200,000 U.S. advanced practice nurses regularly do so as well. more...

Support group for nurses involved in serious errors

February 21, 2007 -- If you have been involved in a fatal or near-fatal error practicing nursing, consider joining a confidential support group being set up by Wisconsin nurse Julie Thao. Ms. Thao is the nurse who was charged with criminal neglect (a felony) for making a medication error that resulted in a tragic death last year. Ms. Thao, who has expressed a great deal of remorse, pled no contest in December to two misdemeanors for unlawfully obtaining and dispensing a prescription drug, in exchange for prosecutors dropping the felony charge. Now Ms. Thao is interested in helping others involved in serious errors, which are all too common, as Judy Foreman's September 2006 Boston Globe piece on preventable errors shows. Ms. Thao notes:

The depth of grief and devastation following an error such as this is often compounded by a profound sense of blame and shame, especially if others involved reacted in a punitive way. Despite enormous support from friends, family and many within the healthcare field, I am still faced with a sense of being alone, and that only someone who has been through this could truly understand. We need each other! We need to connect, and show each other that we were able to go on, that this is survivable.

Please contact Julie Thao at julie_thao@tmit1.org for more details on the support group. Anonymous participants are welcome. more...

Buzz Saw

October 9, 2006 -- Today The Oregonian ran Janet Goetze's profile of Oregon nurse Teri Mills, RN, MS, ANP, and her campaign to create a federal Office of the National Nurse. The National Nurse would undertake public health media campaigns and try to attract more nurses to the profession. The piece, labeled a "Monday Profile," is mostly about Mills. But it also gives information about the progress of National Nurse legislation in Congress, and about the lack of support the initiative has received from the Oregon Nurses Association, whose executive director reportedly suggests the idea won't "produce results." When we first heard of the National Nurse in Ms. Mills's May 2005 op-ed in The New York Times, the idea seemed somewhat unformed. However, the draft legislation seems to present a concrete and realistic proposal that may prove useful to nursing and public health. The Oregonian piece might have included more specifics on the legislation. The bill would give the National Nurse authority to publicize nurses' "distinct role" in health care, and patient safety issues including nursing "staff levels" and "working conditions." On the whole, the article is a good portrait of a tenacious nursing advocate and an innovative idea to improve public health. more...and join the campaign to advocate for the National Nurse!

The Star-Ledger: "Nurses urge TV dramas: Get real"

January 28, 2007 -- On January 11, the New Jersey Star-Ledger published an excellent piece by Carol Ann Campbell on Hollywood's treatment of nursing. The article is headlined "Nurses urge TV dramas: Get real; Portrayals deceive public, groups say." The substantial piece features extensive comment from nurses (including Center executive director Sandy Summers) who explain how popular U.S. television dramas regularly show physicians doing important work that nurses really do, while nurses are shown as peripheral subordinates, when they appear at all. As the piece notes, this widespread undervaluation is a factor in the critical nursing shortage. We thank Ms. Campbell and the Star-Ledger for this piece, which stands in stark contrast to a slew of recent articles in the major print media that explore Hollywood's "medical accuracy" but completely ignore nursing. more...

Nurses Find Media Image Needs Intensive Care

January 10, 2007 -- The Center for Nursing Advocacy announces its fourth "Golden Lamp Awards," our annual list of the best and worst media portrayals of nurses. The 2006 list includes a range of media from all over the world. Among the "worst" award recipients were the Nobel Prize-winning Médecins Sans Frontières (Doctors Without Borders), Italian political leader Silvio Berlusconi, nurse recruiting campaigner Johnson & Johnson, and hit Hollywood shows including ABC's "Grey's Anatomy" and Fox's "House." "Most of the best depictions of nursing appeared in the print media," said Center Executive Director Sandy Summers, who cited specific pieces in the The Philadelphia Daily News, The New Yorker, and Bangladesh's Daily Star as being among the best. Summers also praised nursing scholars and advocates who had made an impact in the general media, and many companies, including Wynn Las Vegas, drug chain CVS, and ALR Technologies, for promptly modifying damaging images in their products or ads. The Center noted that, as usual, many of the least accurate and most damaging depictions were in the influential television medium. Besides "Grey's Anatomy" and "House," the Center's "worst" list included episodes of NBC's "ER" and "Heroes," and HBO's "The Sopranos." See our press release, or our full or summary versions of the Golden Lamp Awards.

What a tangled webisode we weave

January 2007 -- From November 2005 until March 2006, California travel nurse company Access Nurses posted on a company web site 18 brief "webisodes" of what is apparently the first Internet-based reality show, "13 Weeks." The webisodes spotlight six nurses living in a posh Orange County mansion while working at local community hospitals. The show was ostensibly designed to address the nursing shortage by highlighting how exciting travel nursing can be. Of course, it is clearly a vehicle to promote Access Nurses as well. "13 Weeks" gets points for diversity, for avoiding most nursing stereotypes, and for giving career seekers some sense of what nurses do. However, the show's focus is mainly on the "fun in the sun" aspects of travel nursing. Eight webisodes follow the nurses on outings, including wine tasting, kayaking, and visiting an amusement park, and most of the other episodes include significant non-clinical elements. The work portrayals are cursory and at times troubling--it's not a serious documentary. In the end, viewers are likely to get that some nurses are articulate and committed (and fun-loving!), but not so much that they are clinical experts whose work saves lives every day. And the full-bore endorsement of travel nursing as a solution to the shortage is problematic, given that many feel its rapid growth is more a dangerous symptom of the crisis than a cure. more...

Nursing Diaries Part I now available for your nurse recruitment needs!

Get your DVD copies of "Lifeline: The Nursing Diaries--The Rookies" (Part I) by filmmaker Richard Kahn. When we reviewed Part I of the documentary in Dec. 2004, we gave it 4 out of 4 stars for its nursing portrayal. From our review: "Part I gives an unusually good sense of the value of highly skilled nursing. It shows nurses working in three intensive care units at Mass. General: the cardiac surgical intensive care unit (CSICU), the neonatal ICU (NICU), and the surgical ICU (SICU). The episode shows nurses doing so many critical health tasks that the media commonly has physicians doing that it almost seems like it must have been a conscious goal of the filmmakers. However, it may simply be the natural result of taking a comprehensive look at what nurses really do. We see nurses autonomously managing patient care, detecting critical problems, formulating key interventions, explaining things to patients, families, and the viewer, and generally managing recoveries with little physician involvement." Read the full review here. Order a copy of Nursing Diaries Part I for US $10, which includes shipping. We are selling these essentially at cost in order to make access to this video as easy as possible. To order, please make a $10 payment here.

Join our new Chapters!

December 3, 2006 -- The Center has started chapters in major media markets. Initially, we have started U.S. chapters in Allentown, Ann Arbor, Austin, Baltimore, Los Angeles, and Hartford at UConn; and Canadian chapters in Hamilton, Toronto and Vancouver. If you are interested in joining any of these chapters, please click on the chapter links above for more information. And please let us know if you would like us to choose your media market for our next chapter.

What will Center for Nursing Advocacy Chapters do? We envision meetings every month or two. At the meetings, members will brainstorm and work together to improve media coverage of nursing around the world--but most especially within their home media markets. For instance, members might talk about nursing achievements, events, problems, or issues that they wish to ask the local media to cover. Or they might discuss giving organized feedback to a media entity for a nurse-related product it has created. See more on our chapter mission and activities page. Can you kick off a chapter formation by hosting a local meeting of like-minded nurses and nursing students?

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