Nursing now or never

With the World Health Organization's declaration of 2020 as the Year of the Nurse and Midwife (World Health Organization, 2018), we are on the brink of an unprecedented opportunity to make significant inroads toward positioning nursing in more powerful ways within our various national and regional health care service delivery and strategic transformation initiatives. To coincide with this opportunity, the Burdett Trust for Nursing and the International Council of Nurses have collaborated in launching Nursing Now—a 3-year campaign to raise the status and profile the profession (International Council of Nurses, n.d.; 2019). Not only will we celebrate the contribution our discipline makes to the health and well-being of populations worldwide, but we will also be working toward enacting public and health policy globally from a nursing perspective. With health services under severe strain everywhere, there is a growing consensus that we need to move from a 'bio-medical' focus on treating disease to a more people-centred approach, collaborating with the patient to focus on disease prevention and healthy living rather than just dishing out drugs. Nurses are already leading this paradigm shift (2018, para.6). To effect these kinds of structural and attitudinal changes, we need to 'raise the profile of nursing and make it central to health policy' (Crisp, 2016, p. 5). Nursing has a marvelously complicated tradition of working quietly in the background and deflecting credit for outcomes onto other disciplines and components of the health care system. Despite being theoretically committed to relational practice, we routinely allow ourselves to be functionally interchangeable within our work, by setting up systems of care within which we become moveable parts. We believe in our hearts that the care we deliver makes a powerful difference for patients and families, and yet we can rarely document it within the kinds of objective, biometric evidence-based organizational accounting systems that have grown up around us. And for the most part, despite a concerted effort in qualitative and mixed methods research, we have not yet found creative and strategic ways to document that which nursing contributes to the health and healing of so many of our patients. Most of us shy away from public engagement, and we are much more reluctant than our colleagues within the interdisciplinary health team to take the microphone, stand in the spotlight, and showcase our contributions. Political intelligence, media training, and strategic evidence building are not yet routine parts of our disciplinary education, even at the postgraduate and leadership levels. The benefits - for all of us - are clear. Studies in several countries have shown that when nurses are trained and given greater scope to expand their roles, they deliver impressive results for patients. However, beyond this, health leaders must listen to nurses and invest in new models of care if they are to get the most out of this most precious resource (2018, para.13). So with the world lining up to celebrate nurses and give us our moment in the limelight, will we truly capitalize on this unprecedented opportunity? Or will we just congratulate ourselves, enjoy the immediate glow of recognition, and go back to our characteristic ways of engaging. I sincerely hope that we can collectively step up to face our challenges (whether political, relational, structural, attitudinal, or evidentiary) and use this incredible alignment of the stars as nursing's catalyst for action. Many of us live our lives and enact our careers with a profound confidence in the inherent value of nursing to people, communities, societies, and the planet. We know what nurses can be when they do what they do best. And, we know what a powerful impact great nursing makes on the world—in the critical moments of a human life, in the ideas and values that capture the public imagination and in the policy directions that coalesce a profound theoretical insight with an opportune political opening. As we embrace the promise of Nursing Now, we must ensure that no public figure gets elected without being fully informed by nurses about policy priorities from a nursing perspective, that no nursing student enters practice without a well-developed set of advocacy and leadership tools, that no nursing manager is thwarted from enacting support and mentorship systems for nurses by nurses through all stages of a career. Let us do what we can to support the conditions for practice excellence for every nurse, regardless of the field of practice, and let us work to make sure that every person in our societies who could directly benefit from the knowledge and skills of nursing has access to them. This truly is a once in a generation opportunity to place what we know and believe at the center of global and national attention. Let us ensure that we get it right.

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