Our Deans’ lecture series, co-sponsored by my colleague Arthur Rubenstein at the School of Medicine, were created to inform and encourage a thoughtful discourse on the issues that challenge and inspire the nursing and medial community. After listening to Dr. William Foege’s speech on November 13th on the power of individuals, I hope those who could not attend can still read about him and his accomplishments to learn how he practiced what he talks about: the power of the individual in making the world a better place.
From citing the works of Maurice Hillman – the microbiologist Foege referred to as “the Louis Pasteur of our time” – to discussing Molly Melching – the founder and executive director of Tostan, an organization designed to empower African women, Dr. Foege highlighted the many ways in which “individuals make coalitions work.”
Hillman, for example, developed eight out of the 14 vaccinations routinely given to children across the globe, such as vaccines for mumps, measles, chickenpox, pneumonia and meningitis. Hillman, who died in Philadelphia in 2005, “left a legacy pf social DNA,” Foege said. “The product of his mind has gone into millions of people’s bodies and changed them forever.”
That, he said, is the essence of global health: “A million steps in a chain where everything goes right so that everyone at the end benefits.”
I have had the pleasure of serving on the Global Health Council with Dr. Foege for more than four years, and I learn something new and inspiring every time I see him. Beyond his own work – from spearheading the eradication of smallpox to creating a model for improving the rate of immunizations in developing countries – Dr. Foege offers a plan of action to all of us, but most especially to the future generation of health care providers.
The challenges to global health, he explains, are clear: poverty, illiteracy, unemployment, gender bias. But, he maintains, this is the golden age of global health because the tools, the resources and the communication methods utilized are all better. But perhaps most importantly, he added, individuals are making coalitions work.
As I think about the School of Nursing, I see that Dr. Foege’s challenge to the leaders of tomorrow – to think and act both locally and globally – are evidenced in all that we do. Look, for example, at the United Community Clinics, housed in the basement of the First African Presbyterian Church in West Philadelphia, where nursing students experience the challenges of running a free clinic – recruiting volunteers, collaborating with different disciplines, securing funding, addressing community needs. Then note Dr. Loretta Sweet Jemmott, an eminent researcher who has revised her safe-sex curriculum to meet the cultural and community needs of people throughout Africa, where she works on both the governmental level and in the field to help stop the spread of HIV that threatens the continent.
The challenges are many, but we at the School of Nursing are prepared for the task. And perhaps the reason we are so prepared is because we realize that our work –as nurse scientists, clinicians, and members of the global community – is work that makes a difference in the lives of all people. We also focus on vulnerable and underserved populations, and we have answers that could make health care available for all.
I am so grateful to have had Dr. Foege address the Schools of Nursing and Medicine, and I would like to end this blog with some of his own wisdom: As we embark upon the challenges of the future, we must remember who are bosses are – and remember that they are not the ones who sign our paycheck. Our boss is every person who will be born in the future because we are preparing the world in which they will live.
Wednesday, November 14, 2007
Friday, August 3, 2007
A Solution to the Healthcare Provider Shortage or a New Problem?
Across the globe, the significant shortage in the number of healthcare providers has prompted thought leaders in healthcare to develop numerous plans of action to meet the needs of the sick. The article “Non-physician clinicians in 47 sub-Saharan African countries,” published online by Lancet on June 14, 2007, discussed how 25 sub-Saharan African nations classified by the World Health Organization as having a critical health worker shortage are enlisting the services of non-physician clinicians (NPCs) to fill the void created by a lack of physicians and nurses.
NPCs, while not trained as doctors, can perform many of the same diagnostic and clinical tasks as physicians. In some African countries, NPCs have received advanced training so that they can carry out more specialized tasks, such as administering anesthesia and performing caesarean sections. NPCs are experienced nurses who receive an additional year of education and a six-month internship or non-nurse secondary school graduates who have three additional years of training and a yearlong internship. The NPC system allows nations to provide their citizens, especially those in extremely rural and poor areas, with much-needed healthcare workers who are trained at a fraction of the cost and in less time than it takes to educate and train physicians.
Are NPCs the answer to the worldwide nursing and physician shortage? According to the Lancet article, the sub-Saharan African countries that have employed the use of NPCs are planning to increase their training programs. They have found that NPCs from rural and poorer areas that returned to practice in those same regions were less likely to leave, as has been the case with physicians and nurses.
Since developing nations have struggled to recruit and maintain a sufficient number of nurses and physicians, there are many who say NPCs are a viable, cost effective solution. However, in America and other developed nations, our certified nurse practitioners, midwives, clinical nurse specialists, and nurse anesthetists are trained and qualified to provide quality care and more enhanced access to healthcare. Leaders, elected officials, and/or healthcare ministers from different countries need to recognize the important roles these nurse specialists play in healthcare, provide them with healthy work environments, compensate them well, and amend laws and regulations that will allow them to function up to their education and experience capacities. Providing more funding for educational programs will also attract more potential nurses to the field and keep them practicing.
The nursing shortage is at a critical stage around the world and it will only become worse as the population ages. It is time to make a commitment to finding qualified healthcare providers and offering creative solutions that do not include developing new categories of workers. NPCs confuse the public, and may decrease women’s and men’s interest in nursing education. Could this accelerate the nursing shortage? What are your thoughts?
NPCs, while not trained as doctors, can perform many of the same diagnostic and clinical tasks as physicians. In some African countries, NPCs have received advanced training so that they can carry out more specialized tasks, such as administering anesthesia and performing caesarean sections. NPCs are experienced nurses who receive an additional year of education and a six-month internship or non-nurse secondary school graduates who have three additional years of training and a yearlong internship. The NPC system allows nations to provide their citizens, especially those in extremely rural and poor areas, with much-needed healthcare workers who are trained at a fraction of the cost and in less time than it takes to educate and train physicians.
Are NPCs the answer to the worldwide nursing and physician shortage? According to the Lancet article, the sub-Saharan African countries that have employed the use of NPCs are planning to increase their training programs. They have found that NPCs from rural and poorer areas that returned to practice in those same regions were less likely to leave, as has been the case with physicians and nurses.
Since developing nations have struggled to recruit and maintain a sufficient number of nurses and physicians, there are many who say NPCs are a viable, cost effective solution. However, in America and other developed nations, our certified nurse practitioners, midwives, clinical nurse specialists, and nurse anesthetists are trained and qualified to provide quality care and more enhanced access to healthcare. Leaders, elected officials, and/or healthcare ministers from different countries need to recognize the important roles these nurse specialists play in healthcare, provide them with healthy work environments, compensate them well, and amend laws and regulations that will allow them to function up to their education and experience capacities. Providing more funding for educational programs will also attract more potential nurses to the field and keep them practicing.
The nursing shortage is at a critical stage around the world and it will only become worse as the population ages. It is time to make a commitment to finding qualified healthcare providers and offering creative solutions that do not include developing new categories of workers. NPCs confuse the public, and may decrease women’s and men’s interest in nursing education. Could this accelerate the nursing shortage? What are your thoughts?
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