Why Are Nurses No. 1 in Honesty, Ethics? Because They’re All About the Patients

Maryann Alexander, chief officer of Nursing Regulation for the National Council of State Boards and Nursing (NCSBN), spoke with HealthLeaders about what makes nurses the most trusted profession.

This transcript has been lightly edited for brevity and clarity.

HealthLeaders: Long before COVID, nurses were the most trusted profession. As a nurse yourself, what are some of the reasons for that? 

Maryann Alexander: Nurses are strong patient advocates and excellent listeners, and even though their care is based on science, they incorporate empathy and compassion into the plan of care for every patient.

However, what really sets nurses apart is the time they spend with patients. They are the ones that are with the patient when they arrive at the hospital, throughout the stay, and on the day they are discharged. A nurse is often the first to recognize a change in the patient’s condition. They learn more about the patient than just their medical problems and intervene to address the social determinants of health. They get to know the family and caregivers and answer questions.

The first thing that patients say when they are uncomfortable, have questions, are anxious, or feel like something is not right is, “Call my nurse.” They have trust in the nurse to competently address their concerns and ensure their well-being. This is the heart of nursing.

HL: How does nurses’ training factor into being so trusted?

Alexander: To be trusted, you have to be competent. Nursing education’s focus is on the development of knowledgeable, safe, and competent clinicians who deliver high-quality care and are experts in assessment, management/treatment, patient education, prevention, and wellness.

Second, another component of nursing education is the development of a caring attitude. This includes being a patient advocate, listening to the patient and family, and having empathy and compassion.

HL: In 2020, COVID placed nurses and their patients in the most difficult of circumstances, yet their ethics rating soared. What is your perspective on that? 

Alexander: The pandemic did not change one’s integrity or ethics. Nor did it change the principles I mentioned: competence, quality care, advocacy, and compassion. If anything, the pandemic demonstrated and highlighted all the qualities that make up the nursing profession and have earned the profession that title.

HL: The nursing profession is facing intense challenges right now, with burnout, staffing shortages, and rising hospitalizations. How do you see the profession five years from now, and will it still be the most trusted?

Alexander: This is not the first time in history that nurses have faced these and other challenges, but underlying the profession, at its very heart, is the belief of how important the work of nursing is, the determination to problem-solve, and the need to ensure that every patient has nurses they can trust.

NCSBN is cognitive of the many challenges facing nursing today and in the future. We know that the workforce needs to be assessed to determine whether there is a sufficient supply of nurses to meet the ever-increasing demand for their services. That is why we continue to conduct our national nursing workforce study every two years.

Our most recent study to be released in April of this year highlights how critical the situation is. However, I know that nursing has great leadership, and I am confident we can work together to ensure that nurses will meet the challenges of today and remain the most trusted profession for decades to come.