I was asked recently to reflect on my sabbatical leave
explorations and findings related to the global challenges facing the
discipline of nursing, as well as signs of progress in the discipline. In a
nutshell, nurses are positioned to making major contributions to universal
health care and to increasing access of populations’ to quality care. Nonetheless,
nurses globally continue to face major challenges that constrain their
abilities to exercise their voice and function up to their full capacities and
expertise. No surprise there!
It will also come as no surprise that there is a global shortage
of nurses, a maldistribution of nurses, a high attrition of nurses, as well as gaps
in educating and training health care professionals to meet the changing needs
of societies, with the increase in the aged and very old populations worsened
by the epidemic of non-communicable diseases, and the shift from hospital care
to community based care. There is a global need to transform the education and
the practices of members of the different health professions and to prepare
them to confront these needs.
However, the more fundamental issues that are not as well
recognized and addressed are the inequities in nurses’ compensation, the
devaluation of their contributions and the structurally limited opportunities
for educational and career advancements. Less discussed, but well perceived and
recognized, is the fundamental power differential and the privileged status of the
medical profession as well as the support and benefits given to physicians over
nurses. In searching for solutions addressing inequity and devaluation that
nurses face in health care systems globally, simply increasing the number of
nurses will not solve the problem if fundamental inequities and challenges are not addressed.
Global thought leaders in nursing have given energy to
articulating some solutions. It is the wisdom of many colleagues that I offer
here on their behalf.
- Provide financial and human resources’ support for nurses’ professional and advanced education.
- Develop and facilitate career ladders that acknowledge and value practice expertise.
- Insure a place for nurses on any and all boards that deal with health care (hospital, community, government, local, regional, global, etc.).
- Ministries of health should include equal voices for members of all the health care professions at all policy and decision making levels.
- Educate health professionals interprofessionally, educate health professionals for team work and educate health professionals for leadership.
- Empower nursing organizations and support their policy initiatives and representatives.
- Work with social and entertainment media outlets on developing and implementing strategies to enhance the image and status of nursing.
- Connect academic and clinical education, with faculty role modeling clinical expertise and students experiencing clinical systems at all levels.
- Address abrogations in gender and professional equities and in the rights of populations for health care and nurses to provide quality evidence based care.
- Facilitate partnerships with communities and between organizations.
- Develop and support scholarship to innovatively address patient, family and community care challenges.
- Eliminate trivialization of research geared toward quality of life for providers and recipients of health care.
- Provide and facilitate opportunities for interprofessional partnership locally and globally.
And yes, while there is much nurses can learn from each other
globally, it is believed that the more economically capable countries can and
should facilitate the implementation of the recommendations listed above.
In my next blog I will discuss the many signs of global
progress in and about nursing.
