ollowing a torrent of corporate mergers and nursing staff layoffs in the 1990s, “the lay public got the image of the nurse just kind of being thrown away,” says Sharon Pontious, associate professor and former interim dean of the School of Nursing. “Parents were saying to their kids, ‘Why do you want to be a nurse? Why don’t you go into business or computers?’” From 1995 to 2002, 31 percent fewer would-be registered nurses sat for the national licensure exam. The U.S. Bureau of Labor Statistics projects the dearth will reach one million nurses by the year 2010. And the pervasive gender stigma continues to dissuade males from entering the profession. Fourth-year School of Nursing student Bill Torres is not fazed by criticism he hears from some people. “They see it as a pink-collar job. As a nurse, you have to care, and caring is not a male trait.”

Neither is Gary Lees, M.S.N. ’93, clinical coordinator, nurse practitioner, and case manager for the Intensive Psychiatric Community Care program at the Miami Veterans Affairs Medical Center. “So often, even nurses say to me, ‘You’re a man, why didn’t you become a doctor? Didn’t you get in to medical school?’” Many nurses, male and female alike, still battle the myth that nursing is a consolation career for medical school misfits. But the reality is medicine would crumble without nursing because it cannot fully address the holistic needs of patients. “Nurses are uniquely trained in the adaptation of the disease process,” Kornse explains.

Often the human side of health care involves taking the time to educate patients on their afflictions. Or it might mean giving a back rub to ease discomfort or washing patients’ hair on Christmas Eve. “It was amazing how they’d turn around and how their families would react,” says School of Nursing assistant professor Lee Schmidt, Ph.D. ’01, recalling the smiles of the well-coifed patients on his holiday shifts.

When Gary Lees takes his patients to Shake a Leg Miami, a nonprofit sailing program for people with disabilities, he often sees breakthroughs in those who are otherwise unresponsive. “It’s having an experience of life. That relationship-building says to them, ‘This guy cares about me.’”

edia campaigns such as Nurses for a Healthier Tomorrow, National Nurses Week, and the Johnson & Johnson Campaign for Nursing’s Future disseminate the virtues of the profession. But the greatest marketing challenge for nursing is that its role is constantly evolving. “If we can’t quantify and articulate what nursing care is, we’ll always be the target of slash and bash,” says Schmidt, who researches how patients view good care. “We have to define it and say, ‘This is the difference nursing makes.’ Then we might become the sacred cow.”

Patients have told Schmidt that the hallmark of good nursing is being treated like an individual. “They weren’t a room number, they weren’t a diagnosis, they were an individual person.” Schmidt stresses “watching over,” which means checking on patients often and detecting problems early enough to avoid the so-called “failure to rescue” phenomenon. With more than 40 percent of all registered nurses aging past 50 by the year 2010, who will teach new nurses how to recognize subtle but critical nuances in their patients’ health?

he change in the health care environment has introduced the need to expand the sources of care and make it more economically efficient,” says School of Nursing dean Nilda Peragallo. She notes that physician-nurse roles are ever more intertwined and interdependent. Nurse practitioners, advanced practice nurses with at least a master’s degree, are joining physicians and physician assistants as primary care providers. “At times, medicine and nursing have been at crossroads, but what really works best for the patient and family is that we work as a team. Students need to learn that early on.”

For Peragallo, an accomplished researcher who holds a joint faculty appointment at the School of Medicine, collaboration with the University’s scientists and physicians was a powerful recruitment tool. So was Miami’s diverse population. A native of Chile, Peragallo comes to UM from the University of Maryland. She is the principal investigator of Project SEPA, an HIV risk-reduction intervention she studied in a group of Latino women in Chicago, funded by the National Institutes of Nursing Research at the National Institutes of Health. President of the National Association of Hispanic Nurses, Peragallo is acutely aware that nursing schools must teach how to provide “culturally competent and linguistically appropriate care.”

Equally important is attracting minority students into the profession, which is the goal of partnerships between the School of Nursing and ethnically diverse institutions such as Florida Memorial College and St. Thomas University. Cultural ignorance, more than just a language barrier, actually can harm patients. “I had to learn very carefully that in some Hispanic cultures, when you admire a baby,” Pontious says, “you have to touch the baby or you will give him the ‘evil eye’ and he will develop certain problems. In some Native-American cultures, a medicine man comes around and sprinkles corn around the patient’s bed. If we disturb the corn, the family believes the patient will get worse.”

hough the shortage offers large sign-on bonuses and high job security, many nurses cite their greatest reward as the ability to provide comfort during the most intimate, integral moments of their patients’ lives. It’s why nursing student Bill Torres lights up when he describes “the way people look at you when you help ease their pain.” For Kornse, it’s “being able to maintain critical thinking, dignity, and strength in the face of tragedy.” For Lees, it’s “helping someone deal with his own humanity—his vulnerability, fear, and anxiety.” From care provider to educator, advocate, guardian, and often friend, nurses must recognize and communicate their profound importance in the health care system.

“I think the image has changed over time, and people need to know what nursing is about,” Peragallo says. “If people just knew what we did, they would come knocking on our doors.”