We Were Never Just the Help: The Hidden Undervaluing of Nurses in Modern Healthcare

What Most People Still Get Wrong About Nurses

I’ve been thinking a lot lately about how often people misunderstand what nurses actually do. It’s something I hear constantly—people assuming nurses “can’t diagnose and treat” or that we’re “not supposed to make decisions, rather follow orders” in patient care. And if I’m being honest, it’s something that really frustrates me.

Because I know the truth. And I’ve read enough nursing scope papers at this point—about one thousand of them from my own students—to know that most nurses don’t fully realize the depth of their own role either. As part of one of the courses I teach, every nurse is required to research their scope of practice based on their specific licensure and state regulations. They dive deep into the language used by their own Board of Nursing—often for the first time—and what they find is both eye-opening and empowering.

Again and again, they are reminded that they can diagnose—through nursing diagnoses—and that their license allows them to independently assess, plan, and implement care, especially when it comes to holistic and functional approaches. This isn’t just academic—it’s foundational to understanding how they can confidently and legally step into functional nursing roles that leverage their full clinical training.

We’re not assistants. We’re not wanna be-doctors. And we were never meant to be. I can’t tell you how many times I’ve heard someone say, “You’re so smart—you should’ve gone to medical school,” or “Why didn’t you become a doctor?” As if nursing is somehow the backup plan. But here’s the thing: nursing isn’t a stepping stone—it’s its own path. And for many of us, it’s a calling rooted in a different philosophy of care. Especially in functional medicine, where the entire model revolves around whole-person healing, patient partnership, and lifestyle-based interventions—it’s hard not to see that this is what nurses have been doing all along. Functional medicine is finally catching up to what holistic nursing has known for decades. So maybe the real shift needs to happen in how we think about what we do. Because we’re not “just nurses.” We are the very professionals this new model of care has been built for.

Nursing Is Not “Support”—It’s Clinical Judgment and Leadership

There’s this narrative that nursing is somehow secondary. Supportive. Submissive, even. It’s a story that’s been told for generations—and one that has quietly limited our profession, our confidence, and our ability to lead.

The roots of this story are old. Nursing has long been seen as “women’s work”—caring, nurturing, helpful. And while there’s power in those qualities, the systems around us have rarely rewarded them. While medicine evolved to elevate physicians as experts and decision-makers, nursing was shaped as the profession that carries out orders. But here’s the thing—we don’t just carry out plans of care. We create them.

That’s literally what the nursing process is.

Yes, Nurses Can Diagnose—Here’s What That Actually Means

Remember using the nursing process in school?

ADPIE: Assess. Diagnose. Plan. Implement. Evaluate. It’s the foundation of our clinical reasoning. It’s how we’re trained to think holistically—to see the whole person, not just the disease. To identify patterns, prioritize care, and create a plan that actually makes sense for the individual in front of us- NOT a medical diagnosis.

But something happens when we step into our first job.

The moment we hit the hospital floor, that holistic lens gets replaced with a task list. We’re told—implicitly or explicitly—that our job is to get patients to take “the medications the doctor ordered.” We become order-followers, not care planners. All that beautifully integrated, whole-person training? It gets buried under barcode scanners and medication passes.

And yet… it never really leaves us, does it?

That internal dissonance eats at so many holistically minded nurses. We know this isn’t what nursing was supposed to be. We feel that disconnect between our values and our role. This isn't what we were called to do. And it’s exhausting.

But here’s the good news: those nursing diagnoses you might have groaned about in school?You might have thought they were pointless—or just academic jargon—but guess what? They’re actually your superpower.

Because those nursing diagnoses are your license to lead. They allow you to assess independently, identify patterns, and formulate a plan of care within your scope. They’re how you practice functional nursing legally, ethically, and confidently—without pretending to be a someone you’re not, and without staying stuck in a role that no longer fits.

This is not a support role.

This is clinical reasoning.

This is nursing as it was meant to be.

So why do people still treat us like the help?

Because they don’t know what we know.

But it’s time they did.

What a Functional Nursing Diagnosis Really Looks Like

If it’s been a while since you’ve used a nursing diagnosis, don’t worry—you’re not alone. Most nurses were introduced to them in school, and then quickly taught to ignore them once they hit the floor. But in functional nursing, these diagnoses come back to life in a really empowering way.

Let’s take an example many of us have seen in practice: risk for unstable blood glucose

Yes, that’s an actual nursing diagnosis. And no, you don’t have to be a prescriber to work with it.

Here’s how that might translate into a care plan from a functional nursing perspective:

Nursing Diagnosis: Unstable Blood Glucose related to high-glycemic diet, insulin resistance, and lack of patient awareness, as evidenced by patient-reported energy crashes, irritability, cravings, and fasting glucose over 100 x2.

Functional Nursing Care Plan:

1. Assess:

   • Gather a full nutrition and lifestyle history—meal timing, carb quality, hydration, movement, sleep, stress.

   • Use nursing judgment to explore root contributors like skipped meals, sugar addiction patterns, or dysregulated cortisol.

2. Diagnose:

   • Map out the patient story using tools like the Functional Matrix and Timeline.

   • Identify patterns contributing to glucose instability.

3. Plan:

   • Collaborate on realistic interventions like eating balanced meals every 3–4 hours, pairing complex carbohydrates with healthy proteins and fats, and introducing gentle post-meal movement.

   • Build a self-monitoring plan based on patient goals and readiness.

4. Implement:

   • Educate the patient about blood sugar dysregulation and its connection to fatigue, mood, and cravings.

   • Offer food lists, meal timing guidance, and tracking tools to support awareness.

   • Introduce sleep hygiene and nervous system regulation practices, as appropriate.

5. Evaluate:

   • Reassess symptoms, engagement, and energy patterns at follow-up.

   • Refine the plan based on patient feedback and response.

And this isn’t just anecdotal. A study published in the International Journal of Nursing Knowledge in 2025 found that nursing diagnoses—specifically in the context of diabetes—played a critical role in improving patient outcomes and guiding individualized care planning. The research showed that when nurses used structured, NANDA-based diagnostic reasoning, they identified high-priority needs like "ineffective health management" and "unstable blood glucose"—and from there, built care plans that truly made a difference in patients’ lives.

In functional medicine, we often say that we don't care about the patient's medical diagnoses list, because we are looking upstream at the root cause. But nursing diagnosis do just that. Maybe other providers should consider using nursing diagnosis to justify their functional care plans as well, lol! So no—you don’t need a prescription pad to change someone’s health. You need your nursing training. And you need to use it fully.

Other great examples of nursing diagnoses that align beautifully with the functional mindset include: Disturbed Sleep Pattern, Ineffective Health Maintenance, Inadequate Fluid Volume, Chronic Functional Constipation, Inadequate Nutritional Intake, Impaired Skin Integrity, Excessive Sedentary Behaviors, Decreased Activity Tolerance, Risk for Imbalanced Blood Pressure, Ineffective Breathing Pattern, Impaired Family Processes, Excessive Caregiver Burden, Post Trauma Syndrome, Ineffective Emotional Regulation, Excessive Loneliness, Impaired Immune Response, and Inadequate Health Knowledge. This is just a small sample of the variety of diagnoses that are all within the nursing scope and reflect the whole-person, root-cause approach that the functional approach is built on.

This is functional nursing in action. It’s licensed. It’s legal. It’s holistic. And it’s powerful.

Why the Healthcare System Wasn’t Built for Nurse-Led Care

The truth is, the healthcare system wasn’t built for us to lead. It was built for us to serve. Not because we lack the knowledge or ability—but because systems are slow to change, especially when they benefit from keeping some voices quieter than others.

But nurses are done being quiet.

Rewriting the Narrative Starts with Us

We’re not here to replace anyone. We’re here to complete the team. To fill the gaps. To bring balance.

But that starts with us stepping into our own unique greatness. It starts with us learning our scope, claiming our voice, and rewriting the story we’ve been told about who nurses are.

No one is coming to save us. No one is coming to rewrite the narrative for us. That’s our job.

And I believe we’re ready.

If you haven't yet, I highly recommend reading the book Witches, Midwives, and Nurses on this topic.

Nurses, Your Voice Matters in the Future of Healthcare

The truth is, the healthcare system wasn’t built for us to lead. It was built for us to serve.

Not because we lacked knowledge or skill—but because systems are slow to change, especially when they benefit from keeping certain voices small.

But nurses are done being quiet.

We’ve spent decades navigating a model that undervalues our clinical reasoning, silences our insights, and limits our scope. And yet, despite all of it, we continue to show up. We advocate. We teach. We guide patients back to themselves when the system forgets who they are.

That tug you feel—that sense that you’re meant for something more, that nursing is bigger than the tasks you’ve been given—that’s not your imagination.

That’s your calling.

The time has come to remember who we are. To see nursing not as the backup plan, but as the revolutionary path it was always meant to be. Holistic. Root-cause focused. Grounded in relationship, education, and healing.

We don’t need to ask permission to lead. We just need to remember what we’re capable of.

We are the steady hands that will reshape healthcare from the inside out.

And it starts now—with us.

If this resonates with you, you’re not alone.

We’re building a movement here. A new future for healthcare. And nurses are at the heart of it.

Come join us.