During 2018, as in every year before, millions of nurses across the world have gone about their work quietly to provide the best possible care and comfort to their patients and communities – despite working conditions that are often very difficult and stressful. While going about their daily tasks many may have been unaware that during this year significant steps were taken towards getting nurses the recognition they deserve for their important role as the largest group of health care providers.
Nursing still the most trusted profession – but invisible
Nurses were once again voted as the most trusted profession for the 17th year in a row. The recently published results of the 2018 Gallup Poll showed that 84% of the public in the US rated the honesty and ethical standards of nurses as “very high” or “high.”
…nurses remained virtually invisible in the mainstream media
Still, it appears that, publically, no one is talking about the work nurses do, or listening to what they have to say. This became clear from the findings of the “Woodhull Study Revisited.” Nearly two decades after the hallmark “Woodhull study on nursing in the media,” nurses remained virtually invisible in the mainstream media. They were rarely quoted or identified as sources in health-related articles, and seldom recognized as nurses in the images that go with articles.
Nursing featured highly in the US News Rankings of “The Best 100 Jobs in America” for 2018 which were released in January. Nurse practitioners came in at fourth place, registered nurses in #18 and nurse anesthetists at#22. Surveys also showed that nurses’ salaries in the US are the best in the world and that they had plenty of job opportunities. Remuneration is generally not a major issue for nurses in the US or the cause of strikes as found in other parts of the world.
In September, the International Centre on Nurse Migration of the International Council of Nurses (ICN) released an analysis of nurses’ pay data showing that in real terms nurses salaries had experienced a fall since the global recession in 2008. The ICN called for better pay for nurses, indicating that this was a real concern considering the worldwide shortage of nurses.
Nurses in New Zealand caught the attention of the world with the Nurse Florence movement which went viral on Facebook. This movement appeared to have been a significant factor on 30,000 nurses standing together and going on a 24-hour strike after the government pay offer was rejected. In their communications, New Zealand nurses also brought across strongly the message of their poor working conditions, primarily as a result of short staffing and their inability to provide quality nursing care.
Nursing shortages and short staffing
Short staffing linked to heavy workloads and being unable to take breaks and compulsory overtime remains a major problem in nursing worldwide and the cause of burnout and high staff turnover. Too few nurses on duty not only affects nurses but mounting evidence shows that safe staffing is essential for patient safety and quality care – as emphasized by the International Council of Nurses in its recent position statement “Evidence-based safe nurse staffing.”
Two bills to introduce minimum staffing levels are currently being considered at the federal level in the US. The issue of nurse staffing was further brought to the attention of the public dramatically when voters in the state of Massachusetts were asked to vote on whether nurse-patient ratios should be legislated – the ballot question received a no vote.
Nurse staffing ratios it still a contentious issue, even within the profession. Many nurses support ratios as a means to force employers to appoint enough nurses. Nursing organizations, as well as many practicing nurses, believe ratios would be limiting, preferring the idea of evidence-based planning to decide on the best staffing models to meet patient needs in real time.
Short staffing may be the result of the economic decisions by the management of health care facilities, but in 2018 the issue of the growing shortage of nurses continued to dominate news about nursing worldwide. Even during an inquiry held this year into how Nurse Elizabeth Wettlaufer got away with killing eight patients in long-term facilities, the shortage of nurses was identified as one of the underlying causes. The manager at one of the facilities mentioned that she overlooked red flags because it was so difficult to fill the nursing positions.
Initiatives to address issues in nursing
There were many major initiatives during 2018 which will hopefully contribute towards improving the image of nursing, as well as nurse recruitment and retention.
Probably the most significant of these initiatives was the launch of the global Nursing Now Campaign, in collaboration with the International Council of Nurses and The World Health Organization. Nursing Now focuses on involving both nurses and public leaders in all parts of the world in advocating on behalf of nurses, increasing investment in nursing, empowering nurses to work to their full potential, and increasing their influence at the level of global health policy.
Nursing Now and the ICN brought the voice of nurses to major international platforms in 2018, communicating to governments and the public how vital nurses are to achieving the goal of universal health coverage. This included the Astana Conference on Primary Health Care where governments committed, through the acceptance of the Astana Declaration, that PHC was the way to achieve health for all. The nursing organizations emphasized the policies should recognize that nurses are the major force in health care and the ones who have direct contact with communities at the grassroots level.
Other initiatives to address the shortage of nurses have included the launch of a major recruitment campaign in the United Kingdom. The UK Nurses and Midwives Council also made it easier for nurses from overseas who want to work in the UK with a further change to the language requirements. Furthermore, the visa cap that applies to the number of skilled workers that can be recruited was lifted in the case of nurses.
The University of Maine in the US took major steps in addressing the nursing workforce crisis in the state. The innovative five-year plan included proposals to recruit more nurses, increase the number of students admitted to training, and also to make it easier for qualified nurses to obtain BSN and Masters degrees.
The year 2018 also saw increased attention to recruiting more males to nursing with special campaigns being introduced in various countries across the world including in Canada, the UK, Scotland, and Iceland.
Still, on the topic of the shortage of nurses, the ICN released a report “Policy brief on nurse retention” in which it emphasized that shortages could not only be solved by recruiting more staff. Attention must be given to retaining skilled and experienced nurses through policy focusing on creating positive working conditions and environments.
Best wishes for 2019
In 2019, let’s work together as advocates for the profession and for our communities by supporting initiatives to boost the image and vital importance of nurses – whether at local or international level. It is up to every one of us to help address the issues that we all face.
From us here at Nurseslabs, we wish you a great New Year in which you are able to take large strides towards achieving both your personal and professional goals!