Why we must invest in our future nursing leaders

Nursing is my past, present and future. After a twelve-year career as an actor, I now follow in my registered nurse mother’s footsteps, working as an early-career public health community staff nurse with newly arrived asylum seekers, some of our society’s most disadvantaged members.

I believe we must invest in tomorrow’s nursing leaders because we are the future and beating heart of our profession, requiring courtesy and kindness yet boldness and insistence. While we welcome experienced mentorship, we can provide reverse-mentoring through partnership-working, bringing fresh perspectives to creative problem solving for the many issues faced in healthcare.

Additionally, as future leaders, we can provide peer support, learning from international best practice. As nurses, we are one of the only healthcare professions there 24 hours a day, seven days a week, 365 days a year, allowing us to intimately and holistically know those we serve on individual and population levels. Therefore, we can advocate in a way no other profession can, making us prime drivers for change. This change must be individualised, person-centred and co-produced with communities, involving empowerment, role-modelling, training projects and public health education and promotion, enabling disease prevention.

All United Nations (U.N., 2015) Member States committed to 17 Sustainable Development Goals, uniting them in global partnership to address global health issues. As future leaders, we have the capabilities, power and tools to be authentic and effective agents for social change. We can propel forwards the agendas of addressing global health injustice, eradicating global health inequalities, and achieving universal health coverage for all.

Coming from a high-income country, I am acutely aware we have much to learn from lower and middle-income countries, from the innovative and revolutionary initiatives they have implemented, as the State of the World’s Nursing Report highlights (World Health Organization (WHO), 2020). However, we are also ethically obliged to help others as a resource-rich nation (Campbell, Pleic and Connelly, 2012). Global working requires future nurse leaders to be inclusive and inclusively literate, pertinent as nursing education, fields and specialities vary significantly internationally.

Covid-19 exposed that healthcare systems, locally, nationally and globally, were unprepared. And while individual nurses require the ability to recover from difficult situations, anecdotal evidence suggests a co-opting of the terminology “resilience”. We often see the term resilience used as a weapon against individual nurses, diverting from systematic failings, causing individuals to experience internalised guilt, feelings of inadequacy, and I am confident sometimes preventing disclosure. It is victim-blaming and potentially gaslighting. If individuals cannot bounce back, there can be the perception they are not strong enough to be nurses. Attitudes must change. Because when the adrenaline of managing the pandemic wears off, systems will question individual nurse’s resilience if they struggle with potential physical, emotional and psychological fallout and trauma.

Instead, future nurse leaders need to help cultivate and develop emotionally intelligent, reflective practitioners who advocate for healthcare systems that operate likewise. Additionally, we must become more proactive and less reactive as a profession, demanding protected time for continuing professional development and restorative clinical supervision. Our future nursing leaders must fight to enhance our professional status. We need more nurse specialists, researchers and further investment in advanced nursing services. Most importantly, we need to see ourselves as leaders. If we do not, how can we expect other healthcare professionals to see us this way? We must use the lived and empirical evidence we have accrued as nurses to exhibit these leadership capabilities while working collaboratively with our interprofessional colleagues to achieve global health goals.

I hope by focussing on these suggestions, we encourage all nursing professionals to develop and flourish, addressing the four pillars of clinical practice, leadership and management, education, and research. To do so, we need to enable, empower and educate our early-career nurses and students to harness each of these. Too often, we tell these individuals only to focus on clinical practice, or they have little knowledge of the other pillars and how to develop their careers accordingly. This thinking is detrimental to our profession, as we should celebrate nursing in all its multi-faceted glory.

I believe, to achieve this goal, much has to change. We must be cognisant of “toxic positivity” because perceived “negativity” is often essential to drive change when backed by evidence. Future nursing leaders have the power to do this. They must be campaigners and lobbyists who can intelligently influence on local, national and global stages. Governments, policymakers, non-governmental organisations and national and international nursing associations need to acknowledge and invest in the benefit of these opportunities for our profession. And we do this by illustrating how these changes will improve the population health of the communities we all serve. Our leaders must be present and heard in government to effect change.

Covid-19 has illustrated how reactive the nursing profession can be, but we need to invest in our workforce and education proactively. We already know retention of new registrants within their first two years is a significant issue, and pre-pandemic, we had global staffing shortages of nine million individuals (WHO, 2020). However, I worry this pandemic will exacerbate this, prompting a mass exodus of new registrants and near-retirement nurses unless we address potential emotional and psychological burnout.

Additionally, despite nurses and midwives making up fifty per cent of the healthcare workforce, our education receives only a quarter of the expenditure on healthcare education (WHO, 2020). Therefore, we must address safe staffing legislation and better pay, terms and conditions for our profession. Without the infrastructure to secure enough staff to support students, how can we encourage and nurture them to become future leaders? We have to inspire our future nursing leaders at all stages of their careers. Again, this requires us to be campaigners and lobbyists. We reach hearts by sharing the stories of those we care for as natural empaths. Then, we back this up with evidence regarding the human and health economic cost.

Craig Davidson RN

https://twitter.com/CraigDavidson85

REFERENCES

CAMPBELL, R.M., PLEIC, M. & CONNOLLY, H., 2012. The importance of a common global health definition: How Canada’s definition influences its strategic direction in global health. Journal of Global Health [online]. 2(1), pp. 1-6. [viewed 18 April 2021]. Available from: DOI: 10.7189/jogh.02.010301

UNITED NATIONS, 2015a. Sustainable Development Goals [online]. United Nations. [viewed 18 April 2021]. Available from: https://sustainabledevelopment.un.org/sdgs

WORLD HEALTH ORGANIZATION, 2020. State of the World’s Nursing Report – 2020 [online]. World Health Organization. [viewed 18 April 2021]. Available from: https://www.who.int/publications-detail/nursing-report-2020

Why I believe the Royal College of Nursing should rejoin the International Council of Nursing.

I’ve thought long and hard about what I wanted to put in this blog post. And why I genuinely believe the Royal College of Nursing (RCN) should rejoin the International Council of Nurses (ICN).

For the RCN, I am a member of the Greater Glasgow branch. I was a Scottish representative on the RCN’s Students’ Committee from January 2018 to December 2019, becoming chair in 2019. Now, I currently am a steering committee member on the RCN Nurses in Management and Leadership Forum and an RCN Newly Qualified Nurses Twitter curator.   

Now, as with all nurses, I would consider myself a critical thinker, and I have done my research. I am not one to go with the tide. Quite often, I’m sure the opposite could be said of me. But, before I get into that, I want to explain a bit more about why I consider myself a global nurse. 

I have always been conscious of global and social justice issues. My dad’s nickname for me as a young child was actually “eco-warrior”. I consistently reminded him we needed to be turning off light switches and recycling. However, I digress. 

I first became aware of global nursing when I was chosen to be one of a group of nursing students from my university, Glasgow Caledonian University (GCU), to take part in an educational exchange trip with our international counterparts, California State University, Long Beach. I know, how awful, a summer in California. What I found so fascinating was not just the similarities we had as global nursing students, but the differences. And how much we had to learn from each other. 

Fast forward to my fourth Honours year at university. I became even more interested in global nursing when I undertook my advanced modules in public and global health. For my global nursing assessment, my report focussed on the factors increasing the HIV prevalence rate among Zimbabwean sex workers. This report discussed the nursing and healthcare strategies involved in addressing this. What I found so fascinating was that in this “low-income country”, as defined by the World Bank, nurses were not only providing but leading interventions. These are solutions we could be replicating back here in the United Kingdom. We have so much to learn from them. Due to this, when applying for my first staff nurse role, I actively sought out a position, successfully gaining a post in infectious (communicable) diseases in May 2020.

Subsequently, I am now undertaking a distance-learning, part-time Master of Public Health at GCU while working as a staff nurse. I have an active interest in global, public, and sexual health, particularly in blood-borne viruses and health protection measures. And one day, I hope to work on global and public health policy as a nurse researcher and academic. Possibly even as a governmental advisor, who knows? Furthermore, wanting to become part of a wider, global nursing network, I was invited to become a member of Sigma Theta Tau International Nursing Honour Society’s first Scotland Chapter, Omega Xi. And I am now part of their Nightingale Challenge for novice nurse leaders. 

Back to global health: “Global health” has become the popular term used when discussing health issues that transcend national boundaries. It is a field of study and practice, which seeks to understand and provide solutions to address the socio-economic, physical and behavioural factors that lead to global health inequities to achieve optimal health for all global citizens. Global health action can be either proactive or reactive, depending on the issue, and requires all nations and actors, including non-governmental organisations to share a common desire to address these using a transnational, multidisciplinary approach. We only need to look at the Covid-19 pandemic, which illustrates how much we have needed to pull together internationally. 

So, that takes me back to my original argument as to why I think the RCN should rejoin the ICN. Now, I know the fees we, the RCN, paid the ICN were in excess of £400,000 and were a significant deciding factor in our reason behind withdrawing during our Annual General Meeting (AGM) vote. The ICN requires funding from its associate members to function. However, recent evidence has come to light, highlighting that no one member association will be required to pay more than ten per cent of the ICN’s annual income. 

I genuinely believe the RCN’s withdrawal from the ICN caused them to reflect upon their governance and finance structure. That being said, I passionately believe “high” and “middle-high” income countries, as defined by the World Bank, which the UK falls under, have a moral and ethical duty and responsibility to support poorer nations. However, it goes far beyond that. It would be arrogant to assume that it’s just about what we would gain being associate members of the ICN. I think it’s more about what we can get from working with over 130 other countries with shared global nursing issues and goals. 

Now, more than ever, our nursing goals are global: recruitment and retention of nursing staff; fair pay, terms and conditions for nurses; the advancement of our profession, and ultimately, achieving the best we possibly can for the communities we look after. I believe that no one country can tackle these as an island. And we only need to look at Brexit, an entirely different debate, to see how increasingly insular the UK risks becoming. 

It is my understanding that the RCN’s November member consultation will be asking if RCN members believe the RCN should rejoin the ICN. Yet, it will also highlight the fact there are other global and European nursing associations we could be members of. However, none of these other associations has the ICN’s unique relationship with the World Health Organization (WHO). Why would we not want that? That relationship with the WHO is so special. The ICN has a seat at the World Health Assembly, the decision-making body of WHO. They were responsibly for lobbying for the WHO, both internationally and in Europe, to have a Chief Nursing Officer. And many people may not know, but they were co-authors of the WHO’s “State of the World’s Nursing Report – 2020, among many other things.

I believe that to have the most global influence; we need to be at the table. And for me, that is for us to be members of the ICN. And for us to have a seat at the World Health Assembly. So, whether this blog post encourages you to align your views with mine, I at least hope it gives you a more informed opinion and encourages you to do further research.

All the best,

Craig.

Sometimes it’s okay to celebrate your achievements…

Sometimes, it’s perfectly okay to be proud of your personal and professional achievements every once in a while. And for Clare Manley and my tiny seed of an idea, “Retaining the Passion: Journeys Through Nursing”, a podcast for nurses and those interested in nursing issues, hosted by newly registered nurses to be recognised by and featured in Sigma European Region’s October Newsletter really does mean the world to us.

It is a true passion project for us. And although we often struggle to find a work life balance, for us this doesn’t feel like work. There also appears to be real tangible benefits. And not only are Clare and I learning from our reflections but we appear to be helping other student, novice and more experienced nurses too.

So, thank you Sigma Nursing for the recognition. And long may PodRTP last for as long as you want us.

All our love and appreciation.

Craig and Clare.