The impact of a global pandemic on the International Year of the Nurse and Midwife

In 2020, the International Year of the Nurse and Midwife and planned culmination of the global Nursing Now campaign, the role of nurses, midwives and carers has been thrust into the spotlight in the face of the COVID-19 pandemic. Robert Fedele writes.

In April, when British Prime Minister Boris Johnson was discharged from hospital after recovering from coronavirus, he singled out two intensive care nurses for standing by his bedside and providing the care that saved his life. The praise was symbolic of the increased visibility and appreciation of nurses worldwide amid the COVID-19 pandemic. “It showed that he saw the intellectual work that nurses do along with the compassion and caring,” reflects Emeritus Professor Jill White, Nursing Now Campaign Board member for the World Health Organization’s (WHO) Western Pacific Region. “To have some important policymakers see nursing in that way was terrific. It’s just a shame it takes a life-threatening episode for that to occur.” The intention of 2020 International Year of the Nurse and Midwife was to raise awareness about the complex work nurses and midwives do, help drive universal health coverage and get more nurses and midwives involved in policy and decisionmaking. But COVID-19, justifiably, has taken priority. “The campaign hasn’t quite been the celebration that we had hoped it would be,” Professor White says, referring to targets to get more nurses included in policy conversations. “While the public express gratitude to nurses for the role that we’re playing [during this pandemic] there is still a long way to go in converting clapping and chocolates to inclusion in policy about everything from proper fit testing of masks to appropriate access to Personal Protective Equipment (PPE). “More than anything, we need inclusion of nurses at high-level decision making at the state and federal level. That will really show that both the International Year of the Nurse and Midwife and the pandemic have actually had some positive outcome, not just for nurses, but for the health of the public into the future.” Throughout the pandemic, the media and public have often referred to nurses as the frontline. But Professor White considers them the last line of defence against COVID-19 and says the public must continue to abide by social distancing restrictions, handwashing and wearing masks if the battle can be won. Another ongoing narrative compared nurses to superheroes. “It’s good to be recognised as important but more important to recognise that in doing what we do, we are doing our job, competently, in a well-educated way, appropriately,” Professor White argues. “When we get put on pedestals, when people get called superheroes, they become something other and that doesn’t necessarily help with us being seen in our rightful role as incredibly important contributors in an ongoing way to healthcare.” At the beginning of the International Year of the Nurse and Midwife, Professor White

“More than anything, we need inclusion of nurses at high-level decision making at the state and federal level. That will really show that both the International Year of the Nurse and Midwife and the pandemic have actually had some positive outcome, not just for nurses, but for the health of the public into the future.”

encouraged nurses and midwives to make their voices heard and capitalise on the opportunities to promote the professions. The call to arms hasn’t necessarily gone to script, but Professor White says nurses and midwives have broadly demonstrated and showcased their work. The challenge is to keep up the momentum. “We really need, at the end of all this, to be absolutely analytical and political about the role we have played, the lessons we have learned and the way in which we can make a better health system more fitted to be able to respond to emergencies, whatever they are, and to really work to our full scope of practice.” Professor White believes COVID-19 has reinforced how appropriate healthcare demands well-educated nurses in the right numbers and the right places, especially politics, where they can hold governments to account and lead change. Some positives to emerge in the wake of the pandemic include increased access to nursing expertise via the expansion of Telehealth, she says. “Telehealth has shown us that the idea of people with chronic and complex diseases having to get up, get dressed, find transport and go and sit in GP surgeries and wait to see a healthcare professional and then retrace their steps all the way home is inappropriate. “We’ve got technology that can be embedded in the home that can be giving real-time information to health professionals, distant from the patient, where remedial action can be taken via Zoom, Skype, phone, and people can live their lives with assistance, particularly from registered nurses.” With the world focused on fighting COVID-19, the Nursing Now Campaign Board have decided to extend the campaign into next year. Extending the International Year of the Nurse and Midwife is also being considered. Launched in 2018 by WHO and the International Council of Nurses (ICN), the landmark three-year global nursing campaign set out to raise the status and profile of nursing so that the profession could work to its full scope and drive universal health coverage. One of the campaign’s biggest successes has been the Nightingale Challenge, which has currently helped promote more than 30,000 nurses globally into leadership programs. “It’s caused nurses to have conversations with each other about what they need to do differently to have more political influence and make the case for what they do and how to extend that,” Professor White says. “It’s given nurses a source of pride, but I think it hasn’t extended, certainly in Australia, outside nursing to people of influence that we had hoped. We hoped that nurses would engage, not necessarily just with politicians, but with people of influence to make them better understand what contemporary nursing is about and for those people to become advocates for the profession.” Australia’s contribution to the campaign has focused on pushing for greater access and equity in healthcare. “COVID-19 has underlined everything that Sir Michael Marmot has been saying for the last probably 30 to 40 years about social determinants of health. It’s absolutely painted that so clearly, that these dreadful diseases hit the most vulnerable, the most unprepared and those with the fewest resources to be able to deal with it. That must change. We absolutely cannot have such blatant health disparities.” As the International Year of the Nurse and Midwife draws to a close, Professor White says she remains continually moved by the solidarity shown by nurses and midwives working across all healthcare settings. “The immediate focus is trying to be good members of our communities and helping educate people through our role modelling behaviour of the importance of handwashing, social distancing, wearing masks, and adhering to curfews and government restrictions where they exist. “I also think looking after each other’s mental health, and our families’ and communities’ mental health is incredibly important. We will come out of this, and when we do, we cannot just celebrate coming out, we have to do the hard work on making sure this never happens again in this way. Nursing’s role in the building of resilient communities, I think that’s probably the most important.”