November 21, 2007, 4:40 pm

The Office of National Nurse: THE Logical Choice



A funny thing happened on the way to creating the Office of National Nurse.

We have one.

The leader that Teri Mills envisioned has been sitting in Washington all this time.


She is already in place.

She is already a nursing leader.

All she needs is the title and the authority to expand her position.

She is the Chief Nursing Officer of the United States Public Health service and her name is Rear Admiral Carol A. Romano.

A rose by any other name….? Not quite.


Here are the changes the Office of National Nurse will bring, as stated on the National Nurse website:

  • Establish symbolic national leadership by elevating and strengthening the Chief Nurse Officer of the USPHS to make this position visible to the nursing profession and the public.
  • Complement the work of the US Surgeon General.
  • Promote involvement in the Medical Reserve Corps to improve the health and safety of the community.
  • Incorporate proven evidence-based public health education when promoting prevention.

Sounds good, yes?

Then why aren’t the leaders of the nursing profession on board? This is a simple, yet profound change that will have far reaching results in terms of the visibility of nursing and a positive impact on public health.

This post was inspired by a recent article in Nursing Spectrum that is no longer available online. The article quoted many leaders of nursing groups who are opposed to this change in title. I was dumbfounded. I wrote to express my concerns and my support for the Office of National Nurse. Here is my letter to the editor of Nursing Spectrum, they asked for permission to use it so it may be in a future issue:

Dear Editor,

This is a response to your article, “National Nurse Debate Fuels Concerns” by Debra Anscombe Wood, RN, on November 9, 2007.

I’m a registered nurse and member of the Emergency Nurses Association and the California Nurses Association. I fully support making the position of Chief Nursing Officer into Office of the National Nurse.

In thirty years of nursing, I was never aware that this country had a Chief Nursing Officer. Having a visible, recognizable nursing leader would be a fantastic recruiting tool for the profession. It would increase the visibility of the United States Public Health Corps, put a new emphasis on public health nursing and increase awareness of the Medical Reserve Corps.

I want to see Rear Adm. Romano on TV, hear her opinions, have her opinions sought out regarding health care issues so that the public sees and hears that nursing is relevant. What a wonderful, under utilized role model we have already in place!

It is hard to grasp the reasoning behind the dissent expressed by the nursing leadership of our various organizations. Everything Teri Mills envisioned for the ONN is already in place! All that would be required would be funding to increase the visibility of this current national nursing leadership position.

Why is it so hard to envision this is a win-win situation for the country, for nursing and for our patients? Is it solely a question of money? Fund the Office of National Nurse and increase the visibility of the USPHC and their work in public health and you will have more nurses choosing public health as their specialty, which leads to greater patient education in the community and more efficient use of health facilities for care (better use of clinics, primary care providers such as Nurse Practitioners and appropriate use of the ER are just a few examples).

Ah, there is the rub. Funding. Everyone is afraid of losing their funding and so we once again see the disconnect between nursing leaders and those of us on the front lines. How will nursing ever get the respect it deserves when its leaders cannot even support the expansion of a leadership position that already exists? The Office of National Nurse is a grass-roots effort funded by educators and staff nurses (like me!) who see the need for a more visible presence of nursing in the media and in the communities. The American Association of Nurse Executives can’t see funding the Office of National Nurse because they feel all money should go toward fixing the nursing shortage. The quote from their representative, Jo Ann Webb, states, “…we don’t see the need for a national nurse.”

With all due respect to the AONE, we already have one! Her name is Rear Adm. Romano. Expand that position into the Office of National Nurse. Fund it! Utilize Rear. Adm. Romano in a way that every citizen in the United States knows we have a national nursing leader. That message will not be lost on the young men and women who are choosing their careers.

There are no losers should the CNO become the Office of National Nurse. Why that can be so obvious to a staff nurse and not to the leadership of the ANA, the AACN or the AONE is hard to fathom.

Make the Chief Nursing Officer position the Office of National Nurse. It is right, it is needed and it makes sense.

Kim McAllister, RN

You can get more information on the Office of National Nurse at the official site. And here’s a video starring Teri Mills and some of our future colleagues discussing the issue.


  • Mother Jones RN

    November 21, 2007 at 5:00 pm

    What a super post! I also support the establishment of the Office of the National Nurse.


  • Susan Sullivan

    November 21, 2007 at 7:05 pm

    I too have admired the efforts of Teri Mills to elevate the CNO of the USPHS to a more visible and nationally prominent position. That office will then be positioned to lead a cultural shift to prevention in our healthcare. The resistance of “nursing leaders” is perplexing…Any minimal funding necessary to retitle the position will yield a dramatic return on investment, as focusing on prevention saves healthcare dollars and reduces morbidity caused by preventable diseases in our nation. Such a prestigious national nursing leader would impact nursing recruitment, job satisfaction and retention…Surely nursing leaders can see this is a no-brainer… it is a win/win for nursing, patients and the nation. Go for it!

  • Monica Flannery, RN

    December 16, 2007 at 1:14 pm

    I have worked with Terri on a few projects to enhance the visibility and awareness for the creation of an Office of the Natinal Nurse.
    Nurses are highly regarded and have a persona of respect as we are on the forefront to advocate for all our patients.
    The evidence, support, and desire is overwelmingly united by nurses and the public. We have the power to identify risk factors and educate the public on working on prevention of disease.
    The Government usually deals with crisis aftermath but a change is needed to identify risks and use our nurses to de-escalate potential medical crisis into a proactive approach. Government prominence and funding is a necessity to focus on promoting Health and educating on the benefits of Preventative Health behaviors.
    Our school systems are a major concern: kids are falling through the cracks and have no resources to deal with their stressors. Many situations have arised that could have been prevented. Virginia Tech, is one prime example. Our troops are another significant concern. Our troops need to have education and resources to help them transition back into society. Mental Health needs to be Governmentally recognized and funding should be the very least we can offer our kids for their devoted tour duties.
    I strongly support the formation of the National Nurse and feel the time is of the essence.
    Many of our troops are homeless, have unmarketable skills and are dealing with severe Post-Tramatic Stress Syndrome. It is our duty to help support them in their transition back into our society with support systems in place to help them deal with their traumas and re-educate them to be marketable. We owe them more than what they are currently being offered.
    NJ supports the creation of ONN on a National Level.
    Monica J. Flannery, RN

  • […] Kim from Emergiblog wrote a post about this issue several months ago, and I encourage you to read her comments. […]

About Me

My name is Kim, and I'm a nurse in the San Francisco Bay area. I've been a nurse for 33 years; I graduated in 1978 with my ADN. My experience is predominately Emergency and Critical Care, and I have also worked in Psychiatry and Pediatrics. I made the decision to be a nurse back in 1966 at the age of nine...

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