Janet Lamm Buness is the director of nursing at an eight-bed hospital in a remote part of Alaska. She is responsible for its nursing services, including long-term and home health care, handling standard administrative tasks such as budgeting and purchasing for a nursing staff of about 25, as well as taking call and covering clinical positions when necessary.

Buness became involved with a state outreach program to help staff RNs who want to pursue a BSN degree, and was instrumental in persuading the University of Alaska School of Nursing to offer RNs a distance-learning option for earning a baccalaureate degree. Working with and supporting that group has been satisfying. "I've always felt that if nurses want the respect of the health care community, they need to move up to a regular bachelor's degree, in order to be viewed as colleagues on an equal basis," Buness said.

More nurses educated at the bachelor's level will improve the image of the profession, she believes, and enable nurses to interact on a more professional level with others in the health care field. Nurses need to work at being willing to stand up and be heard, she said, to express their opinions and ideas as part of the health care team.

Buness has been president of the Alaska Nurses Association and chaired the Alaska Board of Nursing. She also co-chaired Alaska Colleagues in Caring, a workforce data collection and analysis program funded by a Robert Wood Johnson Foundation grant. Buness facilitated the shift of the program to the Board of Nursing, which is continuing to look at ways to improve nursing and recruit more people into the profession.

Buness said she didn't consciously set out with the goal of advancing the profession; it just happened.

"There is a connection between advancing the profession and being able to recruit more people to it," she said. "We try really hard here. But it is difficult to recruit young people into nursing. If we do get more people coming in, I think there will be some issues with the caliber of person we are able to attract. The issue becomes recruiting quality people and keeping that quality up. We need to look at how we can recruit young people, too."

A magazine ad for nurses brought Buness to Alaska nearly 20 years ago. "I enjoy the remote, rural area. I have never wanted to leave. I think it is because you know the patients, you have a real connection with the people in the community and the people at the hospital. I have good insight into what people are going home to, how they are going to manage."

As for her extensive involvement in nursing outside the job, she said, "This is a big state, but it has a small nursing base. You know everybody and people ask you to do things. There is a small, core group of people that is very involved."