The Journal of Continuing Education in Nursing

Editorial Free

Moving to the Top of the Pyramid (Again!)

Patricia S. Yoder-Wise, RN, EdD, NEA-BC, ANEF, FAONL, FAAN

Maslow. That name, perhaps unlike any other except Nightingale, evokes instant recall for us. We may not name all of the levels correctly, but we know things start at a basic level at the bottom of the pyramid and move to the less common at the apex. For those of us who don't recall instantly who Maslow is or what the pyramid is, here is a brief recap.

In 1943, Abraham Maslow, a psychologist, proposed a theory of human motivation. This motivation was about human behavior, not a segment such as employment or learning. It was about how we come to live our lives as we do. This theory is most commonly depicted as a triangle or pyramid with a broad base and a relatively narrow top. The idea was that we are most focused on the aspects at the base and sometimes reach the apex. In ascending order, the words depicting human needs are: physiological, safety, love and belonging, esteem, and self-actualization. The purpose of the pyramid is to reflect a priority of needs. For example, if we aren't physiologically stable or we feel unsafe, we likely aren't able to attend to higher-level elements.

This theory is more than 75 years old! And yet, it has utility for understanding the worldwide events of 2020. Educators' efforts in the past 10+ years have been on helping others focus on esteem and self-actualization. We have opened new opportunities for people to develop themselves. Then, in a matter of less than a month, we moved right to the base to be concerned about air, food, shelter (and yes, toilet paper), and safety. When health care providers speak out about concerns for personal safety, we are alerting the world to the fact that even with our best efforts, if we don't have the basics, we cannot actually do what we believe is needed. In addition to our frontline staff working directly with people we know to have positive results for the novel corona-virus (a major concern in itself), we haven't always had the required supplies and equipment we know we need to provide adequate care. Yet, the inventiveness of many of our colleagues has overcome the hurdles of limited supplies and equipment.

Wherever we work in nursing, we need to recognize why the American public trusts us to fix health care. Despite the hurdles placed before many of our colleagues, they provided the best care possible. Our nurses in public health, whose ranks have diminished over many years due to lack of funding, rose to the occasion. School nurses transitioned from on site to online, as did educators and many of our colleagues in primary care practices. The encumbrances of telehealth seemed to evaporate. Many states relaxed their laws and rules related to who could do what, and the idea of scope of practice was considered in a new light of improving access to care. Everyone suddenly was working to their greatest capacity. The voices of the few expressing concern that “they can't do that” tended to be drowned out by the masses who were concerned with rapid responses to a pandemic, and the actual practices demonstrated our full talents.

Now our task is to consider the “what's next.” Being ready to defend what we did and provide evidence that supports the creative approaches used will be a challenge. That work likely will be as demanding as the work done thus far. However, our ability to show what we did as safe and important can lead to new opportunities for us.

When I hear people talk about “getting back to normal,” I am convinced they will be disappointed. Our old normal—for all the things we loved about it—won't be the new normal. The upside of that point is that the things we hated about our old normal also might be gone. We likely won't return to “normal”—we will go to something that will become the new normal, and we are limited only by our creativity and commitment to action. We will ascend to the top of the pyramid again.

Our efforts as educators once again will shift from the intensity of the basics to the intensity of helping others develop their full talents and work to their fullest ability. We will likely take on new skills—how to “message” the importance of nursing care in all settings, what needs to happen financially with organizations, and most of all, how to keep communities and the individuals in those communities safe. Our response to this pandemic has reminded the public how valuable nurses are, and how critical the work we do is, to the health and welfare of the nation and the world. Truly this is the Year of the Nurse and Midwife (World Health Organization, 2020).

Be safe.

Patricia S. Yoder-Wise, RN, EdD, NEA-BC, ANEF, FAONL, FAAN


Editor's Note

This editorial was written when the major issue in our country was COVID-19. During the publication process, the demonstrations related to racism occurred. Although many were peaceful demonstrations, some were not, and the outcome is that some of those people needed health care. Again, nurses rose to the occasion and were where they needed to be to provide care to those who were injured—irrespective of their role in society. Again, we thank our colleagues who are so generous of their talents and await the time we can help them take on this additional learning opportunity as they ascend the hierarchy of living.


The author has disclosed no potential conflicts of interest, financial or otherwise.


Sign up to receive

Journal E-contents