International Nurses Day 2021: A Vision for Future Healthcare
Written by Claire Alexander, 12 May 2021
Last night, Dua Lipa used her platform as a Brit Award winner to pay tribute to NHS workers and named emeritus Professor of Nursing Dame Elizbeth Anionwu as her choice for “best British female of the year.” It was a less random intervention than it might at first appear.
Today marks International Nurses Day 2021, celebrating the contribution that nurses make to societies around the world. Under the theme Nurses: A Voice to Lead – A Vision for Future Healthcare, this year’s day of recognition focuses on the changes to and innovations in nursing and how this will ultimately shape the future of healthcare.
While the COVID-19 pandemic has exposed and exacerbated existing issues facing nurses, including nursing shortages, excessive workloads and high levels of pressure and stress, to name a few, it has also given way to a much-needed conversation on the crucial role that nurses play in delivering healthcare and the urgent need to invest more in nursing, at national level, across Europe, and globally.
This important conversation has been intensified by the World Health Organization (WHO), which has designated 2021 the “International Year of Health and Care Workers” in appreciation and gratitude for the dedication of nurses and other healthcare professionals in the fight against COVID-19. Indeed, the general public has in many countries expressed appreciation for the bravery and hard work of healthcare workers during the pandemic through movements such as ‘Clap for Carers’ in the UK, and other similar initiatives elsewhere.
The hugely important role of nurses in ensuring sustainable and resilient future healthcare systems is evident. But for this to become a reality, we need sufficient numbers of nurses, who are equipped, encouraged and supported to progress through their careers, and appropriately valued and remunerated. It will now be important for this recognition of the valuable role of nurses to be translated into concrete action and investment if the future of healthcare is to live up to our expectations. But where to start? Three important areas should be high on the list.
Tackling nursing shortages: a burning platform
Nursing shortages have been a problem in countries across Europe for over 20 years, and the effects of the COVID-19 pandemic have only fuelled issues of recruitment and retention. For example, the International Council of Nurses (ICN) estimates that the COVID-19 Effect, which has added to the current shortages and ageing of the nursing workforce, could lead to a potential shortfall of up to 13 million nurses worldwide by 2030.
In the UK, findings from a survey of lung cancer specialist nurses run by Lung Cancer Nursing UK revealed that more than half of lung cancer nurse teams had lost at least one staff member during the first wave of COVID-19, due to either redeployment or being unable to work because of the disease. And the UK Lung Cancer Coalition’s COVID-19 Matters report raised the alarm over a steep increase in the “intention to leave” rate among the lung cancer nurse workforce, from 16% to 60%. This is particularly concerning given that specialist nurses, such as lung cancer nurses, are highly trained, safety critical members of multi-disciplinary care teams, and even harder to train and replace.
With one out of six of the world’s nurses expected to retire in the next ten years, the gravity of the situation is undeniable. Already during COVID-19, there have been drives in many European countries to recruit retired nurses back into work to help with the pandemic response, given the existing shortages. Much-needed action is already being taken in some countries to address the nursing shortage issue. In Germany, for example, a package of reforms has been rolled out over the last couple of years to improve conditions for nurses and make the profession more attractive, especially for young people. But let’s be clear, nursing recruitment and retention should be high on every health minister’s list of priorities.
Caring for those who care for us: nurses’ mental health must not be forgotten
Adding fuel to the fire, the ICN has revealed that studies and reports from its members across regions suggest the pandemic has significantly increased nurses’ reported rates of intention to leave the profession, with the main drivers being heavy workloads, insufficient resourcing, burnout and stress related to the pandemic response. In fact, around 80% of ICN’s national nursing associations have received reports of mental health distress from nurses working in the COVID-19 response. This is hardly surprising given that nurses have been on the front line, directly exposed to the virus and often lacking adequate personal protection equipment (PPE). This has not only led to nurse fatalities from COVID-19, but has also sparked anxiety for many about the possibility of infecting family members.
These new and additional pressures brought about by the pandemic come on top of existing areas of concern in a profession which is often characterised by long hours, high physical demand, and significant mental health pressure.
In the face of potentially increasing nurse shortages, the need for a fit and resilient workforce is more important than ever, including to ensure preparedness in the face of any future crisis. In the UK, the NHS is already taking steps in the right direction, investing an extra £15 million in mental health support for nurses, paramedics, therapists, pharmacists, and support staff, to support workers and make the NHS more resilient.
Valuing specialist nurses: encouraging progression in career
Specialist nurses manage the care for patients with specific conditions, are experts in the field and advocate for patients throughout their journey. They are able to practice at an advanced level and manage complex care, making the patient journey more efficient and a better experience for patients. They often lead clinics and clinical services and play a major role not only in delivering care but also in enabling patients to manage their own symptoms. For many nurses, a specialist role is one that they aspire to.
According to Ber Oomen, Member of the European Specialist Nurses Organisation (ESNO) Advisory Committee:
“Specialist nurses are the ROLEX professionals to the patients. While their primary function and competencies are easy to understand, their roles have greater relevance than ever. Nurse specialists also hold special narratives that you only experience when they care for you in the complex recovery process, from very first contact – in ambulance – to finalisation of treatment, health at home, family and work – and even beyond.”
It has been shown that patient outcomes can be better if care by a specialist nurse has been given. For example, a study in the UK showed that both radiotherapy and chemotherapy patients have a lower risk of early death or emergency admission after they have received an assessment and care from a lung cancer nurse specialist, particularly if contact began at the time of diagnosis.
Further, specialist nurses represent good value for money, reducing the number of emergency admissions, the length of hospital stay, the number of follow-up appointments and the number of medical consultations. For example, a community and home-based heart failure programme led by specialist nurses in the UK was found to deliver a 35% reduction in all cause admissions and significant cost savings.
Despite this, specialist nurses are often undervalued. Given the vital role specialist nurses can play in improving quality of care and effectively meeting the rising demand of healthcare, their importance should be appropriately recognised as we work to make our vision for the future of healthcare systems a reality.
Making the vision for the future of nursing a reality
Highly trained and well looked-after nurses, who are supported and incentivised to stay in the profession long term, will be key to us having a resilient and sustainable healthcare workforce for the future.
While COVID-19 has exposed and exacerbated problems facing the nursing profession, it is not the only threat. Problems including nursing shortages, excessive stress and mental health pressure on nurses have been building for years. The pandemic has put these issues higher on the agenda than ever before and has already sparked debate around health policy change to improve the resilience of healthcare systems at both EU and national levels, for example with EU proposals to build a European Health Union.
Let’s hope this renewed focus on the healthcare workforce – fundamental to our healthcare systems – acts as a catalyst for change and greater recognition of the true value of nurses.