The Washington PostDemocracy Dies in Darkness

Is nursing a talent? You can bet your life on it.

Mockery of a Miss America contestant reflects a misunderstanding of what nurses do.

Are speed painting and artistic roller skating more admirable talents than saving lives? That’s what we might take away from the discussion on “The View” this week, when two co-hosts mocked Miss Colorado Kelley Johnson’s talent portion of the 2016 Miss America pageant.

In her scrubs and sneakers (common nurse footwear, but you have to admire a pageant contestant who wears sneakers onstage), Johnson delivered a moving monologue about how her work with an Alzheimer’s patient reminded her that she is more than “just a nurse.”

Johnson, valedictorian of her nursing school class and the pageant’s second runner-up, is a pianist, too. But, rather than take the safe route with a traditional talent, she used her moment in the national spotlight to warmly pay tribute to her profession. She also demonstrated better than any other contestant that night that she is an excellent spokeswoman, well equipped to handle the ambassadorial role of Miss America.

But the next day, Michelle Collins of “The View” laughed:  “There was a girl who wrote her own monologue. Which I was like, ‘Turn the volume up, this is going to be amazing, like, let’s listen.’ And she came out in a nurse’s uniform and basically read her e-mails out loud. And shockingly did not win. I was like, that is not a real talent…I swear to God, it was hilarious. ”

“Seriously?” Joy Behar asked as they watched a clip. “Why does she have a doctor’s stethoscope?”

After following four nurses and interviewing hundreds for a book about nursing published this year, I can state unequivocally that nursing is a talent. Anyone can sing. But most people don’t have what it takes to be a nurse.

Nurses are detectives, investigating deviations, meticulously monitoring vital signs, double-checking dosages, searching for clues. They are scientists, constantly learning, tackling psychology, physiology, pharmacology, chemistry, microbiology. They are teachers, educating people about their condition, demonstrating home health care to patients and parents: how to suction a tracheostomy, change an airway, inject a medication, breastfeed a newborn. They are strongmen, lifting and moving patients out of bed, breaking a sweat when performing CPR. They are confidantes, protectors, comforters, easing fears, cradling babies whose parents can’t be there, consoling loved ones who feel that all hope is gone. They are multi-taskers: supporting, coordinating and inhabiting all of these roles at once. And they are lionhearted diplomats, helping a patient die with dignity in one room, facilitating a recovery in the next, keeping their composure even when they are shaken to the core.

And by the way, nurses use stethoscopes more often than doctors do.

Nurses quickly went after “The View” with a petition and a #NursesUnite hashtag that went viral. On Wednesday, the hosts issued a non-apology, claiming their comments were “taken out of context” and suggesting that angry nurses heard them wrong. “Did they hear the conversation?” Raven-Symone wondered. Whoopi Goldberg cautioned the audience to better “listen” to the show.

Nurses heard them loud and clear over the beeps of the monitors, the demands of their administrations and the moans of the patients they were busy trying to save. It’s part of a nurse’s job to listen. After all, that’s what they do with those stethoscopes.

Did “The View” hosts mean to denigrate nurses? Unlikely. But their comments reflect widespread misunderstanding and, in some cases, disrespect, of what exactly nurses do.

Nursing has evolved considerably since the days of the doctor as patriarch, nurse as handmaiden, a hierarchy rooted in traditionally ingrained remembrances of outdated roles. Until the mid-20th century, nurses were expected to stand when a doctor entered the room, offer him their chair, and open the door so that he could walk through first, in chivalric reverse. Nurses were expected to await instructions passively without questioning the physician. By the 1960s, nursing schools were still teaching that, as one nurse described it, “He’s God almighty, and your job is to wait on him.”

In 1967, psychiatrist Leonard Stein described the nurses’ role in an essay entitled “The Doctor-Nurse Game.” The object of the game, he said, was for a nurse to passively “make her recommendations appear to be initiated by the physician…. The nurse who does see herself as a consultant but refuses to follow the rules of the game in making her recommendations, has hell to pay. The outspoken nurse is labeled a ‘bitch’ by the surgeon. The psychiatrist describes her as unconsciously suffering from penis envy.”

Since then, nurses have developed specialties and expanded their scope beyond formerly physician medical tasks such as inserting IVs and drawing blood. Nursing schools have shifted from hospitals, where doctors oversaw the students, to universities, where the instructors are nurses. Nurse practitioners can practice independently in 21 states and the District of Columbia.

Yet, nurses don’t get enough appreciation for their work. They told me that patients frequently assault them, some doctors regularly belittle them, and visitors often treat them like waitresses. Some hospitals help to perpetuate the doctor-nurse hierarchy. At Vanderbilt Medical Center in 2013, administrators cut costs and risked cross-contamination by forcing nurses to perform housekeeping duties, including emptying garbage cans, changing linens, sweeping, and mopping patient rooms and bathrooms. At some hospitals, nurses are the only employees who are charged for parking. These supervisors’ message is clear: They value doctors more than nurses and treat them accordingly.

Nurses are selfless, highly skilled critical thinkers who deserve honor and gratitude. Johnson is right: No nurse is “just a nurse.” We couldn’t survive without them. And it takes a heck of a lot more talent to earn the scrubs and stethoscope than it does to mock a hero.