Nursing now and forever

This blog was written by Nursing Now Champion, Sir George Alleyne. Sir Alleyne is the Director Emeritus of the Pan American Health Organization.

When Lord Nigel Crisp, Co-Chair of Nursing Now, asked me to write a comment for the International Nurses Day, I accepted with alacrity. This was not only because I had agreed a couple years ago to be one of the Champions of Nursing Now and its three-year campaign (2018 to 2020) to raise the profile and status of nursing worldwide, but because of a long-held conviction that the critical role of nursing and nurses in our society was not promoted often and loudly enough. I am grateful to Professor Edward Greene for giving me the opportunity to include these comments in his GOFAD blog on this important day.

May 12, 2020 also has enhanced historical significance because it is the 200th anniversary of the birth of the legendary nurse Florence Nightingale. The theme for the celebration of this year’s international day is “Nursing the world to health.” In a sense this was prophetic, as it was chosen long before nurses and other health workers were thrown into increased prominence and yes, danger by the pandemic of COVID-19.

Three years ago, I was a co-author for a publication that analyzed the major problems for which the world should prepare – pandemic influenza, antimicrobial resistance, the noncommunicable diseases (NCDs) and of course climate change. It is pertinent to highlight the role or rather roles nurses must play in nursing the world through these challenges. It was not pandemic influenza – at least not yet – but COVID-19 that has shown into the sharpest possible relief one of the most critical roles of nurses that sometimes seems to be taken for granted in the discussions of the technical advances in the profession and the loud and proper cries for them to take leadership roles in for example primary health care and universal health coverage.

In the middle of the pandemic and as there was no known effective treatment, it recalled the medicine of the pre-antibiotic era when successful outcomes of disease often turned around nothing more, nothing less than good empathetic and compassionate care. It brought back to me the end of Florence Nightingale’s nursing pledge of 1893 in which the nurse “pledged to devote myself to the welfare of those committed to my care”. I also recall the comment made by Prime Minister Boris Johnson about his stay in hospital and his deep gratitude to the nurses who stayed by his bed and cared him through the worst of his illness. When we laud and salute the nurses and healthcare workers as heroes of this pandemic for their courage in the face of personal danger, we also do so for the care they give to the sick in the face of uncertainty and unfortunately in the frequent assistance in helping to die with dignity.

Of course nurses in their many other roles as educators, advocates, practitioners, leaders, policymakers, teachers etc. have multiple roles to play in nursing the world to some semblance of health through prevention and therapeutic initiatives in the other three areas of challenge.

There are numerous data on the state of nursing globally and regionally and they all show the picture of a gendered workforce that constitutes almost 60% of the total health workforce and one that is projected to have a shortfall of some 6 million by the year 2030. There are many good plans and policies for helping countries to address this gap but the one that seems almost intractable is that of the migration of nurses from the less developed to the more developed countries and the often ignored fact that even in the developed world the majority of countries are both recipients and senders of their trained health workforce.

Nursing holds a special place in the annals of Caribbean health. There is justifiable pride in the Jamaicans Cubah Cornwallis who treated a future King of England and the legendary Mary Seacole – a practitioner who saved the lives of many in the cholera epidemic of 185-1851 and achieved international fame by using private funds to go and nurse the wounded in the Crimean war of 1853-1856 . And the 20th century saw Barbadians Nita Barrow and Ena Walters excel from the base of their training at the local Barbados General Hospital. The career of Nita Barrow is a storybook journey from the local nurse to the international civil servant to being President of a major International non-governmental Organization and finally being Governor General of her country. Ena Walters similarly rose to be Matron of her hospital for some 26 years, was a major educator and has the distinction of being the founding president of the Regional Nursing Body – a professional entity which is arguably the most successful and best organized of all the health professional organizations in the region. But these are only a few of the many who have brought credit to their profession through the years but they demonstrate that good nursing training can be equipment for excellence in other fields.

The local application of the theme for this year’s day must embrace at least three problems. First, there must be preservation of the health gains which have been made primarily through the devotion and caring of the magnificent cadre of Caribbean public health nurses who have not occupied the spotlight and gained enough encomiums for their heroism. Theirs has been a meritorious constancy of community practice which is reflected in such data as the number of children who live and thrive past their first birthday. Second, nurses must be part of the advocacy that the region, while maintaining these gains, must now address the current pandemic and then ensure that the frequently used words “never again” refer to the resolve to establish the framework to deal with future epi and pandemic threats. Nurses must also be actively involved in addressing the epidemic of NCDs which do not evoke the public hysteria caused by the diseases of contagion but are equally destructive to life and living of our people.

So, on this International Day, I offer my sincere congratulations to all nurses and midwives and thank them especially for that care which is so central to their ethos and ethics. Finally, let me admit the bias that comes from the fact that my wife is a proud graduate of the school of nursing of the University Hospital of the West Indies.

George Alleyne

May 12, 2020