Subject: Protecting the Integrity of Nursing Practice and Patient Care

To the North Carolina Board of Nursing and Members of the North Carolina General Assembly,

I am writing as a registered nurse who is deeply concerned by the growing calls for political and ideological activism within the nursing profession and healthcare workforce. I feel compelled to speak out because this direction is not only harmful to the unity of our profession but also dangerous to patient care and fundamentally at odds with the ethical foundation of nursing.

Nursing is not, and must never become, a vehicle for activism within the clinical setting. When activism enters healthcare, patient outcomes will suffer. History and evidence show that when care decisions are influenced by ideology, anger or protests–whether seemingly justified or not–, or protest, patients experience delays, disparities, and, in the worst cases, preventable harm or death.

We do not have the moral or professional right to decide who deserves care, compassion, or life-saving treatment. Patients come to us in their most vulnerable moments, and they must be met with unbiased, evidence-based, and humane care—every single time, with no exceptions.

As nurses, we take an oath to Do No Harm! That oath is not conditional. It does not change based on a patient’s beliefs, background, or affiliations. Asking nurses to engage in activism under the scope of nursing creates animosity, division, and moral conflict; that inevitably bleeds into bedside care. Of course, as human beings, we can sometimes carry negative emotions to work with us (or into our work places). Yet, as professionals, we know to keep that under control. Encouraging organized activism into healthcare settings will not subdue those emotions, but will almost certainly increase the risk of those emotions, consciously or unconsciously, impacting patient care.

There is absolutely a time and place for advocacy and civic engagement—but it must occur under one’s personal identity, not under the authority, uniform, or scope of the nursing profession. Nursing is a trusted profession precisely because the public believes we will treat all patients equally, without judgment or discrimination. Once that trust is eroded, it cannot easily be restored.

I am calling on the North Carolina Board of Nursing and our state legislators to take a clear and firm stance: healthcare professionals must remain neutral caregivers within their professional roles.

I urge all nursing and healthcare organizations to stop promoting actions that divide nurses against one another and against the patients we serve. Calls to strike or withhold care—explicitly or implicitly—do not represent the values of nursing. They undermine public trust, fracture the workforce, and contradict everything our profession stands for.

Nurses must be united around one non-negotiable principle: all patients deserve the same standard of care, dignity, and respect. Anything less is a betrayal of our oath, our ethics, and the very reason nursing exists.

I respectfully ask for leadership, clarity, and courage in protecting the integrity of nursing practice and ensuring that activism remains separate from patient care. Our patients’ lives—and the future of our profession—depend on it.

Sincerely,

Brandi Smith, RN