Adrienne Camara, RN, nurse care manager, Blue Cross & Blue Shield of Rhode Island

Each year we celebrate Nurses Week from 6 de maio to 12. These are very specific dates, and I didn’t know how they were connected to nursing. After some research I learned that Florence Nightingale’s date of birth was 12 de maio, 1820. She is considered the founder of modern nursing, and we always conclude Nurses Week on her birthday in honor of her legacy to nursing.

Nightingale developed the “Environmental Theory" in which she defined nursing as “the act of utilizing the environment of the patient to assist him in his recovery." She believed that the main problems affecting health outcomes were “diet, dirt and drains," meaning a larger focus needed to be placed on sanitation - the availability of clean and nutritious food, clean linens and hospital wards, and better drained sewers and improved ventilation. She followed this guiding principle as she trained women to be nurses during the Crimea war – primarily, she trained them to clean, which made a huge impact. In 1854, the British government requested Nightingale go to a hospital in Turkey to aid the military. Her team of nurses quickly went to work and, within weeks of arriving, the mortality rate of British soldiers drastically improved. Her accomplishments during the war convinced people of the value and dignity of educating nurses.

Years later, those very same principles around cleanliness and public health ring true. Think about the impact of cleanliness on the current COVID-19 pandemic. Imagine where we would be without Nightingale’s persistence to keep the environment clean to decrease the spread of germs.

While Florence Nightingale’s core tenets remain, the field of nursing has evolved greatly over time. Today there are more than 3.1 million nurses in the American healthcare system. We work in countless, diverse settings – we’re not just in hospitals anymore. We promote health to individuals, families, and entire communities. Nurses work collaboratively and independently. Education for nurses rarely ends when we leave nursing school. Nurses often go on to become certified in their chosen field. They can also go on to earn degrees in related fields or a master’s or doctorate in nursing, as well as a nurse practitioner degree allowing them to diagnose and prescribe treatment.

Nursing is one of the oldest occupations. After Florence Nightingale paved the way, the first formalized nursing programs started in hospitals in the late 19^th century. Today, we have numerous nursing certifications and degrees, but the most prevalent form of preparation for nurses is a four-year degree, a bachelor’s in nursing. At least 80% of registered nurses today hold a bachelor’s degree from one of more than 871 schools offering training for nurses at the undergraduate, graduate, and post-graduate levels.

Nurses have a broad scope of duties – utilizing a mix of knowledge, skills, and judgement every day as we act as patient advocates, lead healthcare teams, and research ways to improve patient care.

Here at Blue Cross & Blue Shield of Rhode Island we have nurses ingrained throughout our company. I work in care management with a team of nurses. Our work includes helping to manage the health of people who have been in the hospital, nursing homes, or rehabilitation facilities, emergency rooms, and those with multiple health conditions. Care management is a collaborative process that assesses, plans, implements, coordinates, monitors, and evaluates the options and services required to meet our members’ needs. Essentially, we help our members get and stay healthy, to stay on track with their care plans, and help to fill any gaps or needs for their health. We help educate our members regarding their health and often assist in connecting them with resources to meet some of their most basic needs such as shelter and food. We facilitate member wellness and autonomy by advocating for the member’s needs. We do all of this through a vast continuum of healthcare. This amazing team of nurses is assisted by our support team and health advocates. They truly make the difference for our nurses’ success in helping members connect with resources here in Rhode Island, and their knowledge often extends to other states to help meet the needs of members living outside Rhode Island.

We could not do the work we do every day without Florence Nightingale’s lasting legacy. She first made the case for why nursing is necessary, and how impactful nurses can be – how strong we are when we work together. Healthcare would look vastly different today if not for the work of Florence Nightingale, and it’s my pleasure to honor her – and all nurses – on 12 de maio.