Nursing Now - Nursing Leadership

Source of picture: www.freepik.com

To coincide with the 200th anniversary of the birth of Florence Nightingale the World Health Organization (WHO) has designated 2020 as the year of the nurse and midwife.

To capitalise on this a global campaign to improve health by raising the status and profile of nursing called Nursing Now is in progress. Nursing Now aims to engage with nurses, governments, partners and stakeholders globally to take what it describes as ‘this once in a generation opportunity’ to achieve the ‘triple impact’ of improved heath, greater gender equality, and increased economic growth. It is a social movement with an active network of 266 Nursing Now groups in 89 countries (as of June 2019) working to influence global and national policy.

It is being run as a programme of the Burdett Trust for Nursing, an independent charitable trust based in the UK. The Campaign Board includes individuals from 16 countries, representatives from the International Council of Nurses, the Burdett Trust for Nursing, and the Director of WHO’s Health Workforce Department. The campaign is co-chaired by Lord Nigel Crisp, who is co-chair of the UK All-Party Parliamentary Group on Global Health, and Professor Sheila Tlou, Co-Chair of the Global HIV Prevention Coalition

It has four main programmes Universal Health Coverage, Evidence of impact, Sharing Effective Practice, and Leadership and Development. With regard to leadership Nursing Now aspires to;

  • work with the International Council of Nurses and other organisations to strengthen and develop programmes for the most senior nurse leaders, and build a network for nurses who have completed these programmes.
  • support nurses at every level to develop their leadership and quality improvement skills and knowledge, so they can lead and manage change.

However the challenges inherent in this are acknowledged in a recent report Investing in the Power of Nurse Leadership-What will it take? Drawing on data from a survey of 2,537 nurses and nurse-midwives from 117 countries, a literature review and eight key informant interviews, it reports that there is a constellation of barriers at work in nursing leadership that marginalize and exclude female nurses in particular from decision making roles. These barriers arise from gender discrimination, bias and stereotyping which serve to limit opportunities for skill development, perpetuates the gender pay gap, and result in unequal treatment between men and women in the health workforce.  In sum it reports women make up 70% of the total global health and social care workforce, yet comprise only 25% of health system leadership roles. This is unsustainable morally, ethically and practically.

In an effort to redress this imbalance Nursing Now has issued the Nightingale Challenge which  asks every health employer around the world to provide leadership and development training for a group of their young nurses and midwives during 2020. The aim is to have at least 20,000 nurses and midwives aged 35 and under benefitting from this in 2020, with at least 1,000 organisations taking part. Although a laudable aspiration health systems worldwide are hard pressed and securing commitment to this target will be difficult.  Also leadership development activity is only part of the solution, fundamental changes in health and social care organisations are needed if leadership is to flourish.  Taking account of local contexts and combining expert support, organisation development as well as leadership development are needed if such change is to happen, and evidence-based approaches are essential to ensure a return on the huge investments made. Also urgent political action is needed in many nations, particularly with regard to resource allocation, if health and social care systems are to meet the pressing challenges presented by an ageing population, multi-morbidity and a diminishing workforce.

The Nursing Now campaign is timely and shares many of the aspirations of the Centre for Health and Social Care Leadership.  The need for evidence to underpin leadership development is central to the vision of nursing now and the Centre.  For example based on work exploring the nature of compassionate leadership we have secured funding to investigate this further in England, New Zealand and Australia.  We aim to contribute to the evidence base in this vital area of health and social care to stimulate changes in policy and improve health care delivery. In addition the centre is well placed to provide leadership development activities to enable nurses to become influential leaders who can draw on their own experience, evidence and data, and is developing a portfolio of provision in this area.

Our hope is that when the World Health Organization’s first State of the World’s Nursing Report  is published on World Health Day in 2020 Nursing Now and the Centre will have made important contributions to the advancement of Nursing Leadership.

By Dr Alistair Hewison, Senior Lecturer in the School of Nursing and co-lead for Clinical Leadership at the Centre for Health and Social Care Leadership, University of Birmingham