The World Health Organization has designated 2020 as the Year of the Nurse and Midwife in honor of Florence Nightingale’s 200th birthday.

We owe a lot to Florence Nightingale, but what about Harriet Tubman or Mary Seacole? Nursing – and society – has been changing since the days of these nursing pioneers. It’s way past time to catch up to their timeless insights and fearless activism. We owe to all these women a fair and just analysis of the current state of nursing. The Year of the Nurse cannot be considered unless we contemporaneously consider sexism, racism, classism, power differentials, structural barriers, and privilege.

Some nurses will use the Year of the Nurse to shine a spotlight on the beauty of the profession, as well they should. Nursing personifies virtue, moral character, fortitude, intellect, advocacy, and grit. Historically, we have been trained to show gratitude, nurture others, and display selflessness. We bring these characteristics to our patients and workplaces every day. Health care as we know it would collapse without the skill, science, and art of nursing.

As for me, I’m using the Year of the Nurse to help nurses come to know their individual and collective power.

It’s a damn shame nursing had to be given a platform. Why didn’t we already have it? Some nurses might say I should be grateful for the worldwide platform. While I am grateful, I am also disenchanted by the gesture because it seems we had to wait for a higher power to grant us this privilege.

So who exactly holds power over our collective voice?

Nurses comprise the largest percentage of health care workers in America. Is it any coincidence that:

• The nursing industry is comprised of about 90 percent women, and yet men get paid more than women?
• We lack the power to effect change during a time when the Equal Rights Amendment still hasn’t been ratified?
• We must be given the opportunity to speak up, rather than simply holding power to do so?
• Overwhelmingly, older white men have a stronghold on leadership positions in health care and legislative bodies?
• Harriet Tubman’s and Mary Seacole’s names aren’t as well-known as Florence Nightingale’s in the world of nursing?

There are professional nursing organizations that try to represent nursing. Many nursing professionals also choose not to participate with these organizations because they question the organizations’ intentions, don’t perceive any real value in a fee-based membership, or feel dissociated from organizational efforts. Paying exorbitant dues grants members access to a publication and supports opaque lobbying efforts under the guise of activism and advocacy.

Many of us nurses hold associate’s, bachelor’s, master’s, and doctoral degrees. We hold clinical, educational, academic, and other non-clinical roles. Yet, the disproportionate representation of nurses in board rooms and legislative bodies is limited to either those who are either far detached from our current lived experiences or those who have lobbied for the right to speak. Nurses are written about, but we are not asked to write. Talked about, but not asked to speak. Told to succeed, but set up for failure. We are more than what labels have been placed upon us.

We’re also right where the corporate health care establishment wants us – we offer plentiful expertise and hard work, but we’re kept powerless enough to justify the discrediting of our opinions, observations, and recommendations.

Nurses are not actively sought out for our expertise, only used for it. Excluding us has direct links to sexism, misogyny, exploitation of the human nature of nursing, historical definitions of nursing, and power differentials. Those of us on the front lines of patient care are on the sidelines of health care decision making and legislation.

Consistently, nursing is ranked as the most trusted profession in the U.S. At the same time we’re being ranked as trustworthy, the corporate health care establishment doesn’t trust us enough to make decisions that directly impact us. Where has the label of “most trusted” gotten us? Still on the sidelines, but dutifully grateful for the commendation and proud of our glowing reputation. We selflessly display our chronic back pain, post-traumatic stress, burnout syndrome, apathy, poor coping mechanisms, acting out, and moral injuries as we nurture the corporate structure that damages health care.

Isn’t this situation analogous to an oppressive power differential in a dysfunctional, abusive relationship? Don’t we warn people about these relationships? Is the perception of being trustworthy really what well-behaved oppression looks like?

Here are my Year of the Nurse realizations:

• Lip service from people who call themselves leaders is no longer enough.
• We are the majority; let’s command our representation.
• Non-nursing, executive-driven systems fail in the face of a crisis-level nursing shortage, educational barriers, rising rate of suicide in nurses, and the abuse and exploitation of nurses.
• Health care will get better when you give us equitable time and input to health care decisions.
• Traditional hierarchies in health care are ineffective and need to be flattened.
• We see those of you in positions of power. We see your abuses, your greed, and your unconscionable bonuses.
• We are a force to be reckoned with.
• The establishment is afraid of strong, courageous, brilliant women.

In this, the Year of the Nurse, we need to courageously and openly discuss the deeply embedded sexism, racism, classism, power differentials, structural barriers, and privilege that impact our everyday lived experiences. Then we need to do something real about it.

Now is the time to misbehave, get educated, re-evaluate our dysfunctional relationship with health care, hold each other up, and disrupt the establishment. Let’s use this platform to band together, innovate, use our power, take up our space, and take the lead.

We are innovative, resourceful, and educated. Some nurses chose this profession as a second career. We have carpenters, engineers, entrepreneurs, plumbers, daycare providers, accountants, biologists, educators, social workers, and much more. We are well-rounded experts in much more than nursing. What can we do with all this experience and bypass traditional means?

Share your ideas. Let’s do this!

Sarah E. Jorgenson is a nurse.

Image credit: Shutterstock.com