CELEBRATING NURSES IN 2021

In 1961, I graduated from the University of Alexandria in Egypt and became a nurse. I never stopped being proud that I chose this profession. The month of May is a reminder to celebrate nurses and the discipline of nursing. Before I share my thoughts about what we are celebrating, and while we are beginning to see some rays of hope in some parts of the world about the containment of the Covid-19 global pandemic, we must pause to remember the millions affected, as well as the millions we lost.

I hope each one of us reflects on what you have and what you gleaned from living through and coping with Covid-19 during this prolonged period of the pandemic and in its aftermath. And, also reflect on what and why you are celebrating.

Here is what I believe we are celebrating today.

We celebrate today the many scientists from many parts of the world who collaborated in developing the vaccines that give us hope that we may reopen borders, schools and businesses.

We celebrate today the evidence nurse scientists developed, allowing ICU nurses to better manage lung functions for patients by proning them and the evidence based palliative models of care that helped patients die with dignity.

We celebrate today the WHO’s publication of the first world report about nursing, which provides robust global data and recommendations that should be used as a blueprint for the nursing workforce for years to come.

We celebrate today that 2020 and 2021 were designated the years of the nurse and midwife by the WHO, ICN and many other organizations. That is also a first in global nursing.

We celebrate today that the world now knows what we always knew, that nurses are the heart and soul of health care systems. The severe shortage of nurses globally and the closure of ICU beds that were much needed for Covid-19 victims was due to the fact that were not enough nurses or that there were not enough educated or qualified nurses to care for patients. This is reminding ministries and universities to increase the numbers of well-prepared advanced practice nurses. We already see the outcomes through increasing applications and admissions to schools of nursing.

We celebrate today you, wherever you are, frontline nurses for your dedication, commitment and professionalism in using evidence-based science to manage pain, ventilation, difficulties in daily life activities, discomfort, loneliness and the emotional support needs of patients infected with Covid-19.

We celebrate today frontline nurses everywhere for their compassion in caring for families who could not be with loved ones, and for their vital role in supporting their patients’ admission, discharge and end of life transitions. We celebrate them knowing that, in spite of their passion and nursing education, they too suffered from anxiety and faced many risks to their wellbeing and their families’ wellbeing. But, they demonstrated grit, resilience and creativity in a time of uncertainty.

We celebrate today nursing educators for how quickly they pivoted to using new innovative strategies, some they had to invent. They ensured their nursing students continued to receive quality education and to graduate, learning essential theoretical and clinical knowledge that prepared them to provide safe, quality care.

We celebrate today nurse scientists for continuing their programs of research with human subjects in spite of many restrictions and many precautions. They created new strategies and goals to insure science productivity continued because of their strong belief in the importance of advancing the needed evidence that translated into impactful, quality care.

We celebrate today hospital administrators who reorganized with warp speed to accommodate, heal and care for an unknown virus for which there were no known treatments. We celebrate their staff for creatively developing new protocols and routines.

We celebrate today health care teams that put the care of patients above mediocre paternalistic and hierarchal teams. We celebrate the new global emphasis on interprofessional education and interdisciplinary, equitable teams that place more emphasis on addressing the needs of patients and their care and less emphasis on the needs of team members. 

We celebrate today organizational leaders who realized health care policies must be informed by nurses’ wisdom, knowledge, expertise and voices. We celebrate them for their inclusiveness of nurse leaders in all decision-making bodies.

We celebrate today nurses’ strong advocacy voices for better policies to create and safeguard equitable working environments for nurses.

We celebrate today nurses who use theory to guide their practice, who are able to articulate the paradigms that drive their assessment of patients and the framing of the interventions they give. 

We celebrate today nurses who are mothers and fathers whose professional commitment and moral compass drove them to continue to care for Covid-19 patients in spite of the limited resources and treatments, and fear of infections for themselves and their families. This commitment has been at the expense of their psychological and physical wellbeing.

Lots that cause us to celebrate - but, celebrations are only a short stop for reflection. We nurses and midwives must continue in the long journey toward insuring access to quality care for the most vulnerable populations and insuring a healthy and equitable environment in health care for providers and recipients of care.

I am so proud to be a nurse.

Based on speeches given in Pakistan, Switzerland and Portugal.

 

Commentary on 2020 and 2021, Years of the Nurse and Midwife

From: Meleis, A.I. (2021). Commentary on 2020 and 2021 Years of the Nurse and Midwife. Nursing School of Coimbra (Ed.) Education and Interprofessional Work in Health, (p. 11-15).

In an unprecedented action, WHO declared 2020 the year of the Nurse and Midwife, and indeed it was an incredible year!

The COVID-19 Pandemic ravaged the world, causing many sorrows and much grief. It challenged health care services and health care delivery. But, it also shed an incredible light on the centrality of nurses’ roles in all aspects of the pandemic, from prevention, to diagnosis, to treatment, to healing, to managing the end of life transition. While nurses have always been at the center of health care, and in many ways have always played significant roles in health care, the global visibility and the challenges associated with the uncertainty of a new pandemic highlighted nurses’ caring and healing roles. Nurses’ knowledge, practice, voice, advocacy and caring shined.

Two other aspects of nursing practice became very apparent. One is qualitative and the other is quantitative. The severe shortage of nurses, which has been well known and much discussed, in the face of the heightened needs for expert caring in hospitals and in intensive care units, put a face on these shortages. The second highlighted aspect about nurses was the central roles they played in palliative care and in the end of life process. Due to isolation because of COVID-19 contagiousness, families could not be with patients during end of life care. But nurses were there to virtually connect their patients with families and to provide evidence-based quality care to patients during their last hours. They provided family care as well, which was virtually delivered. Telehealth acquired a different meaning and importance during this pandemic. Bravo nurses!

Policy makers saw firsthand how the shortages of nurses devastated health care delivery systems and how nurses’ expertise in family health and end of life was instrumental to provided care. What nurse leaders have always discussed and highlighted for policy makers became a tangible reality.

WHO made another unprecedented decision - to declare the continuation of the year of the nurse and midwife through 2021. Now it is imperative to take full advantage of the visibility of nurses’ roles and science in global health, as well as the declaration of WHO, to press on toward universal health policies, to insure equitable and quality health care.

Two particular areas that could benefit from the timing, the context and the touch needed for quality care are, first, nurses’ educational opportunities, and second, nurses’ leadership roles in health care policies.

Building on the platform and the goals of Nursing Now recommendations and strategic goals, which are endorsed globally, countries must provide university education for nurses that prepare them to deliver evidence-based models of care. Portugal must promptly move all educational programs for nursing to universities. Countries are expected to insure that nurses are well prepared for leadership roles and that health care policy bodies include nurses’ voices. Nurses should be expected and allowed to work up to their full capacity, and their scope of practice should be congruent with their educational levels. Nurses should be well positioned to influence health care policies globally.

I wish for my Portuguese nursing colleagues a year of leadership marked by actions, beginning with the inclusion of all nursing schools within the halls of universities as full partners and with the appointment of nurses to every policy making body in the country.

The year 2021 should be an action year for nurses who are very well positioned to use nursing knowledge in the development of the best care models and policies that will enhance the quality of care.

References

Meleis, A.I. (2021). Commentary on 2020 and 2021 Years of the Nurse and Midwife. Nursing School of Coimbra (Ed.) Education and Interprofessional Work in Health, (p. 11-15).

Nursing Now: https://www.nursingnow.org/

WHO. (2020). State of the World’s Nursing 2020: Investing in Education, Jobs and Leadership: https://www.who.int/publications/i/item/9789240003279