Words for the Graduation of Nurses in Brazil


Nursing student Marian Tristao Saba asked me to send greetings to the graduating class of the Universidade Federal de Bahia.  She said the class has read the book I wrote with Bernice Buresh, From Silence to Voice: What Nurses Know and Must Communicate to the Public.  Here is what I wrote.

To the Graduating Class of the Universidade Federal de Bahia,
I am very honored that you chose Silence to Voice as the theme for your graduation ceremony.  I speak here as well for my co-author of the book Bernice Buresh, since the writing of this book was definitely a team effort.  The problem of silence is one of the most important we face as patients, professionals and others who work in healthcare.  Nurses are among the most important of those who work in healthcare but the public does not understand what you do and therefore cannot provide you with the resources necessary to do it.  But nurses also do not support one another enough when it comes to moving from silence to voice.  A recent article in the British Medical Journal gave an example of a nurse who wanted to speak up about a patient safety problem.  Instead of encouraging her and supporting her, her nursing colleagues told her that she should “watch her back.” Imagine the difference it would have made if they had told her, go ahead, speak up and we will have your back, we will support you and make sure you are safe.  When you become professional, working nurses, wherever you practice, you can help to change this by supporting nurses who speak up.  When you leave this graduation, promise yourselves that you will not only practice good nursing skills and talk about nursing knowledge but that you will support any nurse, anywhere who has the courage to speak up to protect a patient, another nurse, a nursing assistant, to challenge a physician or administrator or to enhance quality patient care.  And promise yourselves that you will learn to do this with constructive, respectful, but nonetheless assertive language.  Learn the skills of inquiry, advocacy, and assertion.  Make sure that you do not define advocacy as simply hoping things turn out well for the patient but that you move beyond feeling to constructive assertive action.  And most of all do not be afraid to tell your stories.  Make sure you talk about the skill and knowledge involved in caring.  Don’t present yourself as an angel, someone who has a beating heart but no working brain.  Talk about the brain work involved in caring and compassion, about the knowledge you need to help someone recover, cope or die with dignity.  I wish I could be with you on this important day.  But I am with you in spirit as you move into the world of the critical work you have learned to do — learned being the operative word here.   Thank you for valuing my work as much as I value yours.

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