On Jan. 30, 2019, the Executive Board of the World Health Organization (WHO) declared 2020 “The Year of the Nurse and Midwife (YONM)” in commemoration of the 200th birth anniversary of Florence Nightingale. The WHO has shared the following in anticipation:
“Nurses and midwives play a vital role in providing health services. These are the people who devote their lives to caring for mothers and children; giving lifesaving immunizations and health advice; looking after older people and generally meeting everyday essential health needs. They are often, the first and only point of care in their communities. Quite simply, the world will only achieve universal health coverage by recognizing the critical role they play and by investing more in the nursing and midwifery workforce.
“The year-long global focus on nurses and midwives is a unique opportunity to get involved! Campaign assets will be made available.”
In terms of healthcare organizations employing nurses, the opportunity exists for nurses to be rightfully honored for their place in the global health delivery system, and for their employers to create a new vision of what nurses can accomplish in the 21st century.
More than Cannon Fodder
If healthcare leaders were to question nurses regarding their working conditions, recognition, and how valued they feel, they would doubtless hear that nurses feel like so much cannon fodder crushed beneath undue stress, poor staffing, high injury rates, and the threat of aberrant behavior by both patients and staff.
In a study published in late 2018 by the Bureau of Labor Statistics (BLS), nurses were shown to experience high rates of work-related injuries. To wit:
“Many of the approximately 3 million RNs working across all industries face workplace hazards in performing their routine duties. RNs spend time walking, bending, stretching, and standing (exposing themselves to possible fatigue, as well as slips, trips, and falls); often lift and move patients (becoming vulnerable to back injuries); and come into contact with potentially harmful and hazardous substances, including drugs, diseases, radiation, accidental needlesticks, and chemicals used for cleaning (which can cause exposure-related injuries and illnesses). In 2016, workplace hazards for RNs resulted in 19,790 nonfatal injuries and illnesses that required at least 1 day away from work, at an incidence rate of 104.2 cases per 10,000 full-time workers (private industry).
“Since the workplace injuries and illnesses of RNs bear monetary and societal costs, understanding those injuries and illnesses can help combat future hazards through improvements in policy and technology. RNs are the keystone of the healthcare system, and injury and illness prevention strengthens the system at its core and improves patient care."
Regarding workplace violence, the BLS concluded:
“While violent events accounted for only 12.2 percent of all injuries to RNs in 2016, the incidence rate — 12.7 cases per 10,000 full-time workers — was approximately 3 times greater than the rate of violent events for all occupations (3.8 cases per 10,000 workers).”
These and other statistics help us recognize nurses being on the edge. According to the National Institutes of Health, “some nurses graduate and start working and then determine the profession is not what they thought it would be. Others may work a while and experience burnout and leave the profession. Turnover in nursing seems to be leveling off, but only after years of steady climbing in rates. Currently, the national average for turnover rates is 8.8% to 37.0%, depending on geographic location and nursing specialty.”
Recognize, Reward, and Improve Nurses’ Experience
If nurses are more than just cannon fodder who we throw to the wolves each day, how can leaders utilize YOTN in order to improve nurses’ experiences and decrease attrition from the profession? In the face of an increasingly older population, nurses must be valued and retained, not just worked to the bone and replaced by the next group also destined to burn out.
There are any number of strategies to employ, including but not limited to:
- Improving staffing, especially in relation to nurse-patient ratios
- Instituting anti-bullying initiatives to weed out nurse bullies who prey on colleagues
- Improving nurse compensation and benefits
- Increasing educational opportunities, including humane loan forgiveness programs
- Succession planning funneling high-performing nurses into leadership
- Leveraging available technologies to decrease nurses’ injuries that far outstrip injury rates of construction workers
- Moving beyond Nurses’ Week platitudes like tote bags and monogrammed coffee mugs
- Training nurses robustly in assertive communication, conflict resolution, leadership, and delegation
- Increasing salaries for nursing professors in order to create nursing schools’ capacity; too many qualified candidates are turned away every year due to lack of instructors and space
An Opportunity Not to be Squandered
The Year of the Nurse could be a watershed moment for nurses around the world, or the opportunity could be squandered by legislators and healthcare leaders who fail to do what must be done. Nurse attrition is real, and if bullying, staffing, injury, violence, and unsafe practices remain the norm, we will continue to see massive attrition and worldwide nursing shortages.
As the largest segment of the healthcare workforce, nurses are the backbone and lifeblood of care delivery. Woe to us and the public we serve if we fail to improve the lot of nurses and provide for them the recognition, opportunities, compensation, education, and safety they deserve.
