I have a friend who’s not a nurse, she’s just a regular person.

She spent the day in the hospital with her sick husband, and afterward over tea at my kitchen table, she asked me, “Why don’t nurses speak? I asked so many questions today and not one nurse answered me.”

Afterward, another friend, a doctor, stopped by on his way home from work. “God,” he said, “What happened to the nurses? They used to think, challenge me and be a support in health care. Now they don’t even speak.”

“What are you saying?” I asked. “What happened?”

“A nurse called me to see a patient, and when I asked her what was wrong with him, she told me, ‘he says his knee is killing him.’”

“And?” I said, “Did you go see him?”

“Of course,” he said, “and when I got there, he was in pulmonary edema, blue as a southern sky. His chemistries were all out of whack. When I asked the nurse why she didn’t tell me that, she told me I was the doctor.”

“I don’t really know what’s happening,” I told him. “I don’t know why nursing seems to be going retrograde except for the Advanced Practice and Nurse Practitioners. Maybe nurses are tired of working for corporations and being punished for ‘diagnosing and really using their skills.’”

“I agree,” he said, as he thought about it. “If I were a nurse, I’d stop speaking if I was dismissed or even worse, punished for trying to help.”

That night, I fell asleep with healthcare on my mind.

Before I knew it, I woke up remembering a dream I’d had.

I was in a huge white void, like a swirling tornado, screaming, “I want to hear nurses voices!”

“What do you want to hear them say?” the Great Wizard asked, his voice booming.

“I don’t give a damn what they say,” I told him. “I just want them to say it!”

“Why?” the Great Wizard asked.

“Why?” I asked with horror. “Because if they give away their voices they become invisible, and they have no choice in their own lives. If they give away their voices, they give away their power. And if they give away their power, all is lost.”

“All? All what?” the Wizard boomed.

“A defenseless defender is no good to anyone,” I said, “so if we’re going to advocate for our patients or ourselves, we have to use our voices. We have to write or we have to choose an area of nursing practice where we can bill independently if we’re going to consider being in nursing as a business. If we choose instead, to be shamans and healers in order to work on the whole human being including body, mind and spirit, we have to develop a new model. But the whole time we have to remember, if we’re not going to be robots, we’re going to have to join business as independent contractors or small businesses, and for all those things, we have to have a voice!”

“Hmmm,” said the Great Wizard. “You got here just in time. Wait until you see what I have behind this curtain…”

“Stop!!” I said. “Are you a nurse?”

“I’m the Great Wizard,” he said, his voice booming even louder. “I told you that.”

“Then I’m not looking behind any curtain. If you’re not a nurse, I don’t want to hear from you. Nurses will have to develop this new model. We need nurses who know what they’re doing to work in this new economy. No more wizards, no more corps execs unless they’re our own, no more believing in ‘what’s behind the curtain.’ We have to develop new models, because we have to inhabit them.”