Why Are Nurses Still On Top?

For the 20th straight year, nurses lead the GALLUP Poll Annual Ranking of Professions for having the highest honesty and ethical standards among 22 occupations (Saad, 2022). WOW! The nation’s 4.3 million nurses consistently rank huge percentage points over other jobs. After congratulating and patting ourselves on the back (again), should we look deeper at why nurses are always ranked this highly? Why do Americans see us as highly honest and ethical?

Nursing at its finest is amazing. Being with people in the most intimate moments of life is sacred. Countless nurses fully and rightly enter into these critical caring moments. Truthfully, however, we all know nurses who miss the holy moments for whatever reason. In addition to sacred presence, solid clinical judgment at every point of care is life-saving.

I met a woman this week whose husband was hospitalized for gallstones and a good nurse picked up on subtle physical and mental changes. Her detection and intervention saved the man’s life. But again, we know situations where nurses miss things and patients suffer or even die. The woman also told me there were “not so good” nurses she didn’t trust because they “just pushed buttons on machines.”

One wonders where people get these high impressions of nurses. Have people witnessed nurses being honest and ethical from experience or secondhand from news reports or TV shows? Do they assume nurses have high ethics because they, too, have a sense of the sacredness of the work. I think it’s probably a combination of these, along with one more thing.

From the beginning, modern day nursing was designed to be a highly moral, honest, and ethical work. Florence Nightingale and other 19th and 20th century nurse leaders required nurses to possess high moral character and designed nursing education to enhance this high character (Fowler, 2021). This innate morality is beautifully explained in this incredible quote (long but worth the read!) from E. Margaret Fox, matron of the Prince of Wales’ Hospital, who wrote in her 1914 book First Lines in Nursing (as cited in Fowler, 2021, para 14-15):

In many relationships in life people are inclined to take themselves too seriously; with regard to the profession of nursing you can hardly do so…In no other field of work, save that of medicine, are you brought into a succession of close and delicate intimacies with others. You are admitted where the patient’s nearest and dearest relatives are excluded. You are told what is never breathed even in confidence to wife, mother, or son; your hasty, lightly-expressed opinion may depress or exalt some yearning spirit in a manner out of all proportion to your knowledge or experience.... Is it not, then, important that you should at once begin to realise the responsibilities you have taken upon yourselves in becoming nurses? This sense of responsibility should influence all you say and do, for your words and actions will show what you are. Therefore, as conduct is the outcome of character, so character is more important in a nurse than mere cleverness. How necessary it is then, that such attributes as reverence, gentleness, discretion, and uprightness should enter into every nurse’s character, and be continually cultivated by the earnest practice of good habits and patient continuance of well-doing.

The Bible speaks of character throughout Scripture. Proverbs 3:3-4 sums it up well:

Do not let mercy and kindness and truth leave you [instead let these qualities define you]; Bind them [securely] around your neck, Write them on the tablet of your heart. So find favor and high esteem in the sight of God and man. (Amplified Translation)

The high view of nurses the Gallup poll portrays makes sense, both from the standpoint of what nurses do as well as what nursing is. Let’s pray for ourselves, our colleagues, and for the nursing profession that we can continually practice at the highest ethical level and keep earning the public’s trust.

Fowler, M.D. (April 7, 2021). The Nightingale still sings: Ten ethical themes in early nursing in the United Kingdom, 1888-1989. OJIN: The Online Journal of Issues in Nursing, 26(2). https://doi.org/10.3912/OJIN.Vol26No02PPT722

Saad, L. (January 12, 2022). Military brass, judges among professions at new image lows. Gallup. https://news.gallup.com/poll/388649/military-brass-judges-among-professions-new-ima ge-lows.aspx

Kathy Schoonover-Shoffner, PhD, RN, is the Editor-in-Chief of JCN and National Director of NCF.


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