If you still think of nurses as behind-the-scenes bit players on the health-care stage, you're holding on to some outmoded images. Nurses today are actively working to improve the health of our country, and their impact is enormous.

The Role of Nurses

Nurses are highly educated health-care professionals who are adept at bridging the gap that sometimes occurs between health-care providers and patients. Most nurses can quickly and easily translate complex medical jargon into understandable, actionable messages for patients, and are prepared to work with patients and families to find healthcare solutions that fit individual lifestyles. These skills make nurses ideal community health educators.

For years, nurses have worked within communities as patient advocates and health resources. In the 1800s, Dorothea Dix championed the need for safe places of care for the insane; her work with the mentally ill continued after her stint as Superintendent of Army Nurses during the Civil War. Mary Breckenridge, a nurse-midwife, founded the Frontier Nursing Service and many family centers to provide much-needed maternal, infant, and family care in the Appalachians in the early 1900s.

Effectiveness of Nursing Care

Today, nurses continue to improve the health of at-risk health-care populations. Numerous research studies have proven the efficacy of nurse-led, home-based programs designed to improve the health of people with chronic heart failure (CHF). CHF commonly leads to multiple expensive hospitalizations, but research has shown that nurse-led home visits can decrease hospital re-admissions by as much as 45 percent, while improving patient compliance with treatment plans.

Research has also demonstrated the effectiveness of nurse-led diabetes education programs, especially for poor and minority populations. In one research study, participants who took part in the first year of the program were less likely to be hospitalized, and had better blood sugar and blood pressure control. Other research studies confirm that diabetes management programs ultimately improve patients' health while decreasing healthcare costs.

Nurse-led intervention can improve asthma control as well. A study that examined nurse-led, school-based asthma education programs for kids with asthma found that children who attended such programs were more knowledgeable about their asthma and better able to manage their condition.

Nurses are also working to combat infant mortality. The overall infant mortality rate in the U.S. is 6.06 per 1000 live births, but among African Americans, the infant mortality rate is 14 per 1000 live births. (Hispanic and Native American populations also have alarmingly high infant mortality rates.) Yet simple, seemingly low-tech interventions, such as regular prenatal visits from specially-trained nurses, have been show to positively improve the health and well-being of both babies and families. At least one study has shown that nurse visits can decrease the likelihood of low birth weight, a common risk factor for infant mortality. Other studies have found that nurse-led home visits can increase infant immunization, improve parenting skills and improve child development.

People are taking notice: the Affordable Care Act includes $1.5 billion in new grants to increase nurse-led visits to expectant mothers in high-risk communities. It also increases funding for community-based Nurse-Managed Health Centers.  

Nationwide, the focus of healthcare is gradually beginning to shift away from illness care and towards wellness promotion. Nurses are on the forefront of the fight for health.