Johns Hopkins University School of Nursing Graduation speech by Sandy Summers
July 22, 2016 -- Today Truth About Nursing director Sandy Summers delivered the graduation speech to recipients of Nursing degrees at Johns Hopkins University School of Nursing's commencement ceremony in Baltimore. Sandy described her vision of where nursing can go in the future, some of the global health problems the new nurses should consider tackling, and the inspirational value of some of her own nurse heroes! See below for details...
Perspectives on nursing
Problems facing the world that nurses should address
Hamilton and nursing: Talk more
One example of advocacy: The Truth About Nursing
Nurse Heroes #1 and 2
Nurse Hero #3
Nurse Hero #4
Nurse Hero #5
Nurse Hero #6
Nurse Hero #7
Nurse Hero #8
Nurse Hero #9
Nurse Hero #10
But how? What will you do with this piece of paper Hopkins is handing you today?
I'm sure you've thought about that. And most of you probably have plans about your first job or further education in nursing. I'm sure you're thinking about the NCLEX, BSN graduates.
But because this is a graduation speech, I'd like to share a few thoughts about the big picture. How will your nursing career, you know, change the world?
Nurses can improve the world by caring for and educating patients, because nursing saves lives. But great nursing often requires that you exert strong advocacy.
I would like you to consider every person on Earth to be your patient, not just the people we get paid to take care of. Larger problems in society require knowledgable advocates. And since advocacy is the quintessential description of what nursing is, nurses are uniquely placed to tackle big problems. I feel we are obliged to advocate on a large scale and be nurse leaders because of the education we have received here at Hopkins.
As you know, the world has many problems. Once a week I want to start a new non-profit to combat one or more of them, but I'm trying to tackle the one big problem I've taken on, and no one person or single institution can resolve them all. So I'd like to challenge you to get involved.
As you have probably heard, Gallup polls consistently find that people believe nurses to be the most ethical and honest profession. Since we're apparently so honest, I have to confess that I'm ambivalent about these polls. That's because I feel this impression of nursing is often associated with the angel stereotype of nursing, which is an unskilled, hand-holding, pillow-fluffing image. These are actually good activities, but the public needs to know we have education, skill, and autonomy.
But, back to the ethical and honesty polls, since nurses do seem to have this special status with the public, this perception that we have high integrity, I believe it gives us a special responsibility to guide decision-makers and society to be more ethical, especially in areas of public health. We have an obligation to turn our knowledge into effective advocacy to change the world.
It seems that many global problems we face are caused by a faulty moral compass, by misplaced choices that may be rooted in greed, ignorance, fear, or poverty, driven by powerful forces that may seem beyond our control. So how can we reset this moral compass and guide decision-makers to act more ethically in the pursuit of global health?
Every day 92 people in the US are killed by guns. Not all of them make the newspaper. Your ethical leadership could greatly reduce these deaths.
Healthy food is essential for good health—it is the basic element of primary care. The federal government helps farmers grow food with the Farm Bill legislation, but only 1% of it goes to growing fruits and vegetables—the superfoods that prevent heart disease and cancer. Your leadership inside and out of government could flip the farm bill on its head, so public resources fund only healthy foods.
Sixty-two people have as much money as half of the world. Reducing this tremendous inequality would improve health. For instance, a recent study found that increasing the minimum wage reduces pre-term births.
Inequality leaves one out of three people with no basic latrine—one of the largest root causes of illness and death. I love India's new public health policy, No Toilet, No Bride, that makes it a requirement for there to be a toilet in the groom's home before marriage.
One in 12 people, mostly female, must spend much of their lives carrying water. Poor access to water fosters disease and keeps girls out of school. A lack of education, which is currently the case for 62 million girls, leads to overpopulation, disease and poverty.
One in 9 people go hungry every day in part because so many land and water resources are used to produce foods that feed the least people. Plant-based diets lead to better health, reduce global warming, and provide enough food so everyone can eat.
Some corporations continue to violate the 1981 International Code of Marketing of Breast-milk Substitutes and spread misinformation about breastfeeding and the safety problems of formula. This is a large factor in why 3 and a half million children die every year from the diarrhea/malnutrition cycle. Nurses must protect lactating mothers and their babies from corporate interests.
Less than 1% of the US budget is allotted for foreign aid. It's not anywhere near enough. If we push the government to more heavily invest, and strengthen the global health infrastructure in impoverished countries, we will be better able to stop the next Ebola outbreak in its tracks and protect the entire world. We almost didn't stop it last time.
My vision of an ethical world is one where everyone has access to clean water, a latrine, food, health care and a way out of poverty. And nurses can and should guide decision-makers to these very attainable goals. Those 62 people have enough money to make this happen.
Last year my husband bought us the cast recording for the musical Hamilton, and our kids—who are both musicians—have been playing it non-stop ever since. Are you also fans? If not, one of the main characters is Aaron Burr, who matched wits with Alexander Hamilton over decades until Burr finally shot Hamilton to death in a duel—a good example of a gun death that could have been prevented. In the musical, Burr repeatedly tells Hamilton to be more careful, to make his personal advancement the priority. “Talk less—smile more.” Burr fights only for himself. Hamilton, on the other hand, fought until his death to make the country stronger and the world a better place. Of course, he made some enemies. The musical suggests, though, that if you really want to help others, you speak and act boldly and don't back down. That doesn't mean you have to smile less—but it does mean you have to talk more.
But since the history of modern nursing, nurses have been told to keep our heads down and our mouths closed. My job at the Truth About Nursing is to educate the public about nursing, often by reaching out to the media to ask them to do a better job portraying the life-saving value of nursing. But we need more nurses to speak forcefully and persuasively about the problems we see—in the delivery of health care, in politics and social policy as well.
Maybe you are thinking, "OK, but these issues are so huge, I'm just one person, I have loans..." But you're not just one person. You have the privilege of being a Hopkins grad who knows other Hopkins grads and you are connected with other people and will meet more who share your interests. Join a few other like-minded people, it takes fewer than you think. Small groups of people can move mountains.
I'm not asking you to do anything I haven't tried. When I was in the MSN/MPH program here in 2001, a small group of my fellow students and I noticed that a federal budget being proposed involved cuts to funding for nursing, at a time of great need. We discussed what we could do and decided to focus on a key root cause—poor public understanding of nursing. We felt that blinded decision-makers to the abilities and autonomy of nurses. We founded a non-profit to work on this and our small group is still together 15 years later—Hopkins alumni Gina Pistulka, Christine Stainton, Richard Kimball— and Kelly Bower, with whom I'm honored to share the stage today.
But I do want to inspire you by telling you about some of my nurse heroes who have made a more immediate impact—people who have picked up their heads and talked more about the truth as they saw it, making the world a healthier, stronger place.
Nurse Heroes #1 and #2, Texas nurses Anne Mitchell and Vickilyn Galle, who reported their physician colleague to the Texas medical board for dangerous practices in 2009. For this act of patient advocacy, they were charged with felonies. After many court battles, they were found not guilty. They pressed on and later the physician and three others were jailed and fined. Anne Mitchell and Vickilyn Galle tackled the good-old-boy establishment, held their ground and fought back, winning a big victory for patients in West Texas—and for nurses everywhere who speak up for patient safety.
Nurse Hero #3, Mary Pappas, the New York City school nurse who set in motion the governmental response to the H1N1 flu outbreak in 2009, after identifying and managing hundreds of student symptoms—and for advocating for a nurse in every school at the Obama Administration's flu summit.
Nurse Hero #4, Martin Schiavenato at the University of Rochester, who developed a glowing "orb" that uses artificial intelligence to measure pain in premature infants, giving voice to the weakest among us. We need more nurses to invent technology that can help patients.
Nurse Hero #5, Martha Ryan, who founded the Homeless Prenatal Program in San Francisco that cares for homeless, pregnant women with great success, and helps them find jobs and permanent housing.
Nurse Hero #6, Elizabeth Ngugi, Professor at the University of Nairobi in Kenya, who did the unthinkable in the early days of the AIDS crisis by reaching out to the sex workers in the slums of Nairobi to educate them about HIV prevention, and helping them find safer jobs.
Nurse Hero #7, on stage today—Nicole Warren, who works in Central Africa to combat violence against women in part through empathy training for men—helping them understand what it is like to be a woman in a world full of violent men.
Nurse Hero #8, Hopkins professor Jackie Campbell, for leading research on domestic violence and increasing public understanding and support for abused women.
Nurse Hero #9, Kaci Hickox, 2011 Hopkins alumna from the MSN/MPH program, who successfully battled two US governors and thousands of internet trolls to fight for common sense and fair treatment for health care workers returning from caring for Ebola patients. Without her strength and unrelenting efforts, we possibly would have seen returning health workers treated like criminals. Kaci's advocacy led to more respect for Ebola workers and a level of comfort where Time magazine honored Ebola workers as their person of the year in 2014.
Nurse Hero #10, Jennifer Worth, for writing a memoir about her nursing experiences that eventually became the globally acclaimed television series Call the Midwife. Please write about your experiences as they happen. Storytelling is the most powerful way to convey the value of nursing. Call the Midwife shows nurses acting autonomously not just in childbirth, but for many people in crisis in their community.
My nurse heroes all identified problems that were hurting people. Then they spoke up and worked to address the problems—relentlessly—until the situation improved.
I challenge you to stand up and make the kinds of contributions my nurse heroes have. This is our work as nurses: to speak out and fight for people who are unable to fight for themselves. We must paint an ethical vision of the world and inspire others to join us on that path.
So you can smile more, or less, but whatever you do—talk more. Make advocacy the core of your work—for your patients, for your colleagues, and for future generations.
Thank you for inviting me to be part of your celebration and congratulations. I look forward to following your progress as the next generation of nurse heroes!