Hard-working nurses the backbone of our health-care system
Many aspects of their jobs are invisible to the uninformed, says Hazel Magnussen.
National Nursing week
(May 8-14) coincides with International Nurses’ Day today (May 12). It’s the birthday of Florence Nightingale, nursing reformer, author and educator.
Nightingale founded a nursing school in 1860 at St. Thomas Hospital in London, England after serving as chief nurse in the Crimean War.
Much has changed in society and health care since then. However, just as Florence Nightingale set high standards for care when treating soldiers on the battlefield, modern nurses, often on the front lines of health care, advocate for safe and ethical service for their patients and communities.
But their concerns might not always be taken seriously. For example, when nurses raised their voices about troubling surgical deaths of babies at a Winnipeg Hospital in 1994, they were told their nursing opinion didn’t matter.
The authorities finally paid attention when a senior physician refused to refer any more patients to the cardiac program. In the subsequent inquiry, Justice Murray Sinclair concluded the problems confronted by the nurses “appear to reflect the historically insubordinate role that the nursing profession has played in our health-care system.”
Nurses collaborate with other health professionals but are, in many ways, the backbone of the system. However, aspects of their work may be invisible to uninformed observers.
When cuts to health care occurred in the 1990s, nursing layoffs led to an exodus of registered nurses out of Canada and ultimately to a nursing shortage.
Since much of nursing knowledge and practice, such as assessment and communication with patients, families and other members of the health-care team, isn’t easily measured, it may not be included in healthcare data collected for fiscal purposes.
With a task-oriented view of nursing, staffing models that replace registered nurses with unregulated personnel have been introduced in some hospital settings. As a result, registered nurses are responsible for a greater number of patients, many of whom may require complex care.
In a joint position statement in 2015, the Canadian Nurses Association and the Canadian Federation of Nurses Unions highlighted how workload and staffing models and work environments have affected patient care, nurse and organization outcomes over the preceding two decades.
Shifting toward more homeand community-based services, cost-effective initiatives led by nurses are providing health information and assistance for clients and families. For example, Alberta Health Services has recently added a Dementia Advice service to its Health Link helpline (#811).
Isolated by the demands of caring for loved ones with dementia in the home, caregivers can now speak with a specialized dementia nurse who, after a phone assessment, provides support, advice and links callers with appropriate community services.
Navigating the convoluted health-care system can be challenging. When support isn’t readily available, patients may make extra visits to doctors’ offices or emergency departments.
According to a Globe and Mail report (April 15, 2017), private companies are emerging to provide advocacy, navigation and support services (at significant cost to patients) to fill this need. This nursing service ought to be an integral part of public health care.
A Conference Board of Canada report, co-sponsored by the Canadian Nurses Association (March 2017), warns that as the population ages, the demand for regulated nursing services will increase at a faster pace than the supply of nurses. It states: “As providers of acute, chronic, rehabilitative and palliative care, regulated nurses are at the front line of care and support for seniors.”
Recognizing the vital role they play, health-care leaders must take steps to ensure that adequate numbers of nurses are consistently available to serve Canadians.
Support of ethical practice and psychological health and safety in the workplace is also essential for the health and well-being of the nursing workforce.