Commentary by Cortney Davis, MA, APRN, Nurse practitioner, Sacred Heart University Health Services, Fairfield, Connecticut
Thank you to Dr. Thomas Long for his excellent blog entry and for his continued championing of nurses’ writing. I also wonder why nurse-writers don’t have a wider audience. Specifically, as I see more and more narrative medicine courses offered to medical students, I wonder why many nursing programs still fail to utilize the creative writing of nurses–why not narrative nursing courses? After reading Dr. Long’s blog, I asked my husband, a physician, why he thought nurse writers were not as well respected (and as widely read) as doctors who wrote. His answer was immediate: “Authority,” he said. “People think that because doctors have more authority in the work place, they also have more authority on the page.” There is certainly some truth in this, as Long points out. Doctors are often seen as the embodiment of strength and “curing” and nurses, whether male or female, are often seen as the embodiment of a softer, more feminine “caring”–and I think there are other factors at work here as well.
One reason nursing programs may have been slow to incorporate nurses’ writing is the myth of “natural empathy.” Some have assumed that those who go into nursing are already compassionate and empathic (sometimes they’ve even been seen as bleeding hearts, ruled by the emotions and not by the mind). Therefore it might seem that nursing students, those sensitive souls, wouldn’t require the humanities to awaken them to their patients’ suffering. The companion myth is that of the “distant physician.” It’s often assumed that medical students are more interested in the illness than in the patient and therefore would benefit from studying the humanities in order to become more empathic providers. Of course, neither myth is valid, although there is a kernel of truth in both. Indeed, when nurses first began publishing their creative writing, some of that writing was overly sentimental and, in some cases, poorly crafted. When doctors first began offering their creative writing, some of it was overly cerebral and occasionally cold. Now, after several decades, nurse- and doctor-writers have honed their skills and found their voices; the best of them are accomplished, professional and writing on equally high levels.
Another factor relates both to the question of who has the authority and to the myth of natural vs. learned empathy. “Nursing Education,” that big generic machine, for many years also viewed, if secretly, physicians’ work as having more authority, if not more worth, than nurses’ work. This bias was spurred on by many things, including the belittling of the nursing profession by doctors, by hospital administration, by the media, and sometimes even by patients and nurses themselves. This led nursing educators to do their best to rid nursing programs of any hint of “softness”–that natural empathy taken to its limits–and to forge nursing education into a research-based, scientific endeavor. As Long notes, this brought the study of nursing from the hospital bedside to the classroom. Almost at the same time, in the 1970s, along came “medical humanities,” the study of literature meant, among other things, to foster more empathic, nurse-like compassion in medical providers. As medical schools began offering courses in the arts, humanities and creative writing as a way to increase students’ awareness of the “softer side” of caregiving, nursing programs hurried ever farther away from touch and ever closer to technology.
Nursing, it seems to me, missed the boat; only now is it, in some instances, trying to catch up. Still, the majority of nursing programs today have neither the time nor the inclination to offer humanities or writing courses to student nurses. If nursing students are asked to keep journals, the journals are too often seen as an exercise tangential to the real studies; when medical students are asked to keep journals, the journals are often lauded as intimate glimpses into the trials and triumphs of learning medicine–and some of those journal entries are published as beacons to guide other medical students. If the majority of nursing programs are not honoring the creative writing of nurses and using that writing to help guide their students, should we wonder why the names of the best nurse-writers producing poems, essays and novels today are not well known?
That said, some interesting things are happening which give me hope that, little by little, nurses’ writing is moving into a more mainstream consciousness. Nurses’ creative writing, while still for the most part under utilized within nursing education (and here let me recognize and thank Thomas Long and the many other educators who do value nurses’ writing and fight to include it in their courses), is becoming more and more visible, as Long also points out, in the “secular” literary world. Rattle, an excellent and widely read literary journal, featured a “Tribute to Nurses” in the winter 2007 issue, publishing poems and essays by 24 nurses. Many of the poetry volumes, novels and essay collections by nurse-writers have been published by literary presses–among them the University of Iowa Press, Calyx Books, Beacon Press, Random House, and Kent State University Press–rather than by nursing presses. Many nurse-writers have won impressive literary awards–including National Endowment for the Arts Fellowships–which have no connection to nursing or medicine. It seems to me that nurses who write are finding new and exciting outlets and are being recognized not as nurse-writers but as writers.
Yet, within the halls of nursing and medical education, until we move beyond myth and presumption and accept that nurses and doctors are co-workers in the same mysterious and amazing world of caregiving; that we all long to find ways to deal with the complicated emotions our work engenders; that we all want to know what others like us are thinking and feeling; and that we all have essential stories and important contributions to make to students and to the humanities canon–well, until then, we nurses who write, although literary equals to physicians who write, will not enjoy equal recognition.