Why a challenge led to the Nightingale Challenge

This blog was written by Lord Nigel Crisp, Nursing Now Co-Chair

In May 2017, I was challenged by some young nurses to do more to support their development. This was at the time when we had just announced the launch of the Nursing Now global campaign to run from 2018 to 2020 and I was describing our very early plans.

“There are lots of programmes for senior nurses,” they said. “But what about young nurses?  We are the future.”

The young nurses had a point. There are four and perhaps five generations in the nursing workforce from baby boomers to the millennials and generation Z and each has different expectations of their work, different skills, and different attitudes and behaviours. All are vital and an inclusive global campaign has to involve them all. And, I know, that organisations everywhere tend to adopt the mindsets, attitudes, and opinions and habits of the oldest generation to the exclusion of others.

These young nurses and their challenge remained at the forefront of my mind, as we developed the campaign and strengthened our work with young nurses over the next two years – appointing two young nurses to the campaign board, requiring national Nursing Now groups to involve young nurses in their work, and including young nurses in all our meetings and advocacy activities. 

But we needed to do more, and I continued to ask myself, what could we do to involve the young nurses fully in the campaign and make sure it could benefit from their energy, insight, and enthusiasm as well as from all the experience and talents of their older peers? We wanted all generations involved. And, of course, they were right, the leaders of the future would be among today’s young nurses. How could we support and develop them?

I remembered the challenge much later when we were looking for big ideas. There was a lot of enthusiasm among campaign board members to do something about developing young nurses. And in early 2019 we settled on the Nightingale Challenge.

The Challenge has two very distinctive features. It places the responsibility for development firmly with employers and it is bottom-up and country-led. Both are fundamental to the very nature of the Challenge and in line with the core values of Nursing Now. They respect the differences between countries and situations and recognise that local people know best what is needed in their country. Outsiders can help if invited to, and global learning and solidarity are vital, but there is no one-size-fits-all. A development programme needs to start where people are, in their situation and environment.

The Nightingale Challenge is a challenge to employers to provide development opportunities for their young nurses and midwives. Employers have a responsibility to develop and support all their staff and we used Florence Nightingale’s bicentenary and, subsequently, the Year of the Nurse and the Midwife as a lever to persuade employers to join the Nightingale Challenge. Many have responded, most impressively. India is the leading country for Nightingale Challenge sign-ups,  where Sangita Reddy, the President of the Federation of Indian Chambers of Commerce, led the way in persuading employers to participate. Around a third of the participants globally are from India.

This approach has great advantages because the programmes are owned locally and can be linked with other programmes run locally. They are also more likely to be maintained and become mainstream than centrally funded programmes. One of our goals is to embed the development of young nurses -and other health workers – firmly in the policies of all employers everywhere. The downside of this approach is that the opportunity to participate depends on the willingness of employers to do so and their ability to allocate resources. 

The Nightingale Challenge team has attempted to mitigate these problems by partnering countries, piloting smart phone-based programmes that involve very little resource, and, in a few cases, persuading donors to fund proposed leadership programmes. There is enormous scope for even greater creativity in the future.

The Challenge is very deliberately bottom-up. Employers can decide to provide formal programmes, mentoring, buddying, action-learning sets, work experience, shadowing or whatever else they decide will work best in developing the participants as leaders, advocates and change-makers in their environment. The very small global team can provide ideas, support, offer links with others, give examples of what has worked elsewhere, and run webinars with employers and participants. 

The Challenge team has been very flexible about the programmes. They can involve other professions and older people, but the majority need to be nurses and midwives aged 35 and under. This is the group that count towards the numbers which we record globally. 

The Challenge was launched a year ago with the hope that 20,000 young nurses and midwives would be enrolled in leadership development programmes over the course of 2020. Today, there are more than 28,000 nurses and midwives in more than 70 countries taking part in Nightingale Challenge programmes. We are already beginning to see some very innovative programmes developing and some very interesting linkages across countries and continents. I am delighted that we are extending the Nightingale Challenge to the end of June 2021 so that we can really see its development with new ideas, new relationships and improved services. And, I hope, it will help show the public that nursing and midwifery are rewarding and valuable careers.

The extension will also give us a chance to develop further the network of young people and see how powerful it can really become. Later this month we will be launching the Nightingale Challenge Global Solutions Initiative which seeks to connect early-career registered nurses and midwives participating in Nightingale Challenge leadership programmes, as well as nursing and midwifery students from around the world to share ideas for nurse and midwife-led innovations to resolve global health issues. Next year, we will be encouraging Nightingale Challenge participants to join us in a global lobby of parliaments to make a statement about the importance of nursing and midwifery and about what needs to be done. 

We will also be working with partners to see if there is an appetite among nursing and midwifery organisations to carry the Nightingale Challenge on into future years. I have been deeply impressed by the work of so many people around the world who have worked tirelessly to make their Nightingale Challenge programme a success for their country and their population.   

The Nightingale Challenge will have been successful in my view if in ten years time there are some tens, or hundreds, or even thousands of nurses in leading roles in their villages, towns, and countries around the world who say that the Nightingale Challenge contributed to their development and to improving health in their country.