12 May 2020 will be the bicentenary of the birth of Florence Nightingale. Although not the only influential nurse of her period, she has an acknowledged role in laying the foundations of modern professional nursing.
In recognition of this and of the contribution nurses and midwives make to the provision of equitable and universal health coverage today, the World Health Organization (WHO) has nominated 2020 as International Year of the Nurse and Midwife.
The WHO argue that the global impact of nursing and midwifery is clear.
Nurses and midwives deliver care to individuals, families and communities over the lifespan, providing and enhancing the access that people have to local health provision.
At over half of the global healthcare workforce, nurses and midwives provide meaningful input to the achievement of the UN’s Sustainable Development Goals (SDGs).
- They promote health, tackle the social determinants of health and through their care, support people holistically in reducing or managing the effects of illness and disease
- As a by-product of their own employment and in improving health and care for others, they contribute to higher global productivity
The WHO also suggest that as more than half of nurses and midwives are women, female economic security, equality, education and empowerment is increased.
It is right, therefore, that 200 years after Nightingale, and following a century of professional regulation in the United Kingdom, nursing and midwifery takes a brief pause to celebrate all that it has achieved.
The challenges that Nightingale faced in the Crimea were largely due to the rapid spread of communicable diseases in the poorest of conditions, with many more dying from sepsis, dysentery and cholera than through the extent of their wounds. Although she is portrayed holding a lamp aloft in observation and care at the bedside of her soldier patients, it can be argued that her significant impact emerges in the drive she had to look beyond what was directly in front of her.
In seeking solutions to the problem of infection, Nightingale enacted power through the collection of statistical evidence and used this to provide a convincing rationale for improvement in hospital conditions and the education of nurses.
This principle of collecting, appraising and presenting evidence to underpin care and to argue for improvements is central to safety and excellence in current professional nursing and midwifery practice.
Importantly, Nightingale was also a successful leader, translating and communicating her findings visually through original use of the pie chart in order to persuade others of important drivers for change. This ability to present impactful evidence and to ensure that recommendations are implemented in the face of potentially competing resource demands is more vital than ever in effective nursing leadership today,
Nurses and midwives graduating in 2020 will carry this legacy of leadership and evidence based practice well into the middle of the century. The people they care for are facing very different health challenges originating from an increasing average lifespan and the burden of non-communicable diseases.
The effects of globalisation on health are emerging through rising levels of air pollution and the impact of climate change. Lower rates of infectious diseases are becoming vulnerable to reduced vaccine uptake, new pandemics and growing antimicrobial resistance.
There is a worldwide shortage of nurses and midwives to tackle the issues of our time.
These are complex problems, but not without hope. Nurses and midwives now have access to more knowledge and information to solve problems and improve care than Nightingale could have ever dreamed.
In the United Kingdom, and in many parts of the world, their graduate education allows them to care for people with advancing skills and compassion, whilst maximising the use of digital tools, scientific and social knowledge and methods to see beyond immediate problems. Through working in partnership with diverse groups of people experiencing care they have a well-developed understanding of the range of needs and problems.
Professional and ethical codes, networks and organisations are in place to support them in working confidently and to guide their practice in uncertain and advanced situations. The building blocks necessary to forge breakthroughs in knowledge and the provision of solutions to benefit care are therefore in place.
The WHO International Year of the Nurse and Midwife and the Nursing Now campaign is a potential catalyst for the next generation, bringing nurses and midwives together in global citizenship and collaboration and recognising that current national problems cannot be tackled in isolation if continued improvement in universal health coverage and sustainable development goals is to be achieved.
I have argued that Nightingale’s legacy reminds nurses and midwives to be passionate in their commitment to excellence by using evidence-based practice as a basis for problem solving and to drive improvements in care.
Through sound scientific principles and growing global citizenship, combined with values of care, courage and compassion and the development of impactful and influential leadership they will continue to keep the lamp alight well into the 21st century.
Mrs Pat Hibberd, Head of the School of Nursing, University of Birmingham