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Nursing Bodies: Learning from Global Examples (Part 2 of 2)

Angela Wignall RN, BSN, BA, MA

April 2021

In the first month of the second module of the Global Nursing Leadership Institute (GNLI) at the International Council of Nurses (ICN), we dove deep in to global nursing leadership and who gets to speak for nurses. With guest lectures from Annette Kennedy, President of the ICN; Elizabeth Iro, the World Health Organization’s first ever Chief Nursing Officer; Thembeka Gwagwa, second Vice President of the ICN; and Fatima Al Rifai, the “mother of modern nursing” in the United Arab Emirates and Advisor for Nursing Affairs to the Ministry of Health in the UAE, the voice of nurses in global health conversations has been front and centre. And the message is clear: divisiveness has no place in strengthening nursing voice and advancing nursing presence in health policy.

Globally, the steps toward stability for nursing participation in health policy are consistent. Nursing must first be housed within a regulatory framework that support self-regulation and nursing autonomy as a profession. Though the regulatory function serves to protect the public, a critical aspect of regulation is that through regulation, nursing articulates our unique contribution and the scope of not only our practice but our potential impact. Regulation must, therefore, concern itself with the entirety of nursing practice, not merely the bedside nursing practice that impacts the individual bodies of patients.

The second step is a strong professional association, dissolving division and speaking with a single, unified voice. Regional associations rooted in the experiences, needs, and issues of their members must connect to a national association that speaks to the highest levels of government with one voice. As Dr. Gwagwa astutely observed, many countries are facing instability in their national and regional associations. The challenge is not to disinvest from associations, mistaking this instability for irrelevance. The challenge is to dig deep in to what is happening for nurses regionally and nationally that would support this instability and then to bravely restructure the ways in which associations offer membership and advance the profession. Communicating this journey and attending to the distress, ethics, and social responsibility takes considerable effort but is an important part of stabilizing associations as the pathways for nursing voice from local to global.

Finally, nurses must be present at senior leadership tables within government, explicitly as nurses and resourced to bring the nursing voice forward at all health policy tables. In the UAE, this looks like a permanent position of Advisor on Nursing Affairs to the Minister of Health. In the WHO, this is the Chief Nursing Officer who is a member of the Executive Council. And now in the new administration to the South, we see nurses stepping in to roles like the Surgeon General and Advisors on Pandemic Response bodies. As I look to these global examples, what becomes clear is that while Canadian nurses are sought out internationally for our skill, knowledge, and leadership, we remain under represented in our own governments here at home. The Chief Nursing Officer role here in British Columbia is a mere two years old. Other provinces do not have this role at all. And the post of Chief Nursing Officer in our federal government remains unfilled and without clear direction on the future of the role. While our health systems are populated by nurses serving in many different roles, there is a difference between those hired for other work who happen to be nurses and having a chair marked Nurse at the table. Without this infrastructure for nursing leadership, we remain truncated in our policy impact as a profession within our own borders.

I am proud to be a Canadian nurse, self-regulated and a member of both my provincial and national nursing association. Over the coming months, my individual GNLI project will focus on how we can build out the important third step of policy nursing in Canada. I’ll examine the ways in which our provincial and federal nursing presence exists today and what we can do going forward to strengthen our nursing leadership infrastructure in health policy. Through the GNLI and the ICN, we have an opportunity to see Canada and Canadian nurses as both leaders and learners in the global conversation. We can learn from nurses across the globe who are wrestling with the same challenges and who are finding creative and innovative ways to serve patients, communities, and the world.

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