The health policy journal Health Affairs has a feature entitled “Narrative Matters,” which are personal essays in the voice of patients, their families and caregivers with a health policy aspect. Health Affairs has been running these essays for 10 years and is a popular feature, crossing over to news features on NPR and in the New York Times. In 2006, the editors of Narrative Matters published a book collection of 46 of their best essays. The essays included in the book are all very powerful. They range from a former governor writing about the culture clashes between medicine and public policy, to a physician’s struggle to care for his father with dementia. What struck me as I read these essays, as well as the other more recent ones available online, was the fact that very few were by nurses. In the book version, there are two essays written by nurses. They are both by male nurses and deal with their moral distress, burnout, and decision to leave nursing. This is a common problem in nursing, and rates of burnout and exit from nursing are much higher for male than for female nurses. It’s good to have their perspectives on the issues voiced, but was disappointing that those were the only essays by nurses included. Of the 10 essays published in 2010, seven were by physicians, two were by patients, and one was by a nurse practitioner. The nurse practitioner wrote about her decision not to have mammograms and the negative reactions she gets when she voices her decision and rationale. We need more nurses writing these sorts of essays, and having them published in high profile journals such as Health Affairs. Publishing in nursing-specific journals is all well and good, but I don’t think many nurses ever read them, and the general public most certainly does not.
Next quarter I am teaching a graduate level course in health politics and policy and in lieu of a course paper I am having students write (and submit) policy-level nursing narratives for Narrative Matters. So stay tuned to Narrative Matters for (hopefully) some stronger nursing voices.
JOSEPHINE ENSIGN 