The his­tory and fu­ture of nurs­ing

The Standard (St. Catharines) - - National Nursing Week - By Jane Pinzhof­fer

Nurs­ing Week rec­og­nizes the ded­i­cated reg­is­tered nurses, nurse prac­ti­tion­ers, and reg­is­tered prac­ti­cal nurses, who pro­vide qual­ity care for their pa­tients, clients, and long-term care res­i­dents and is al­ways held from the Mon­day to the Sun­day of Florence Nightin­gale’s birth­day, who was born May 12, 1820. This year marks the 200th an­niver­sary of the founder of modern nurs­ing’s birth­day and 2020 is des­ig­nated as the “Year of the Nurse and Mid­wife” by the World Health Or­ga­ni­za­tion (WHO). This des­ig­na­tion seems al­most prophetic in the midst of the COVID-19 pan­demic when now more than ever, the knowl­edge, courage, and com­pas­sion of those in the nurs­ing pro­fes­sion has never been more im­por­tant or more ap­par­ent.


Florence Nightin­gale was a true trail­blazer who played a sin­gu­lar role in chang­ing the poli­cies around proper med­i­cal care. At a time when med­i­cal treat­ment was con­sid­ered a lux­ury only for the wealthy, Nightin­gale im­proved med­i­cal stan­dards for all.

In 1854, she and a team of 38 nurses were ap­pointed to a Bri­tish mil­i­tary hospi­tal to tend to sick and fallen sol­diers dur­ing the Crimean War. When they ar­rived, they were ap­palled by the hor­ren­dous con­di­tions. The hospi­tal was built on a sewer, which con­tam­i­nated the wa­ter and the build­ing it­self. Even the most ba­sic sup­plies like soap and clean wa­ter were scarce as the num­ber of wounded and ill in­creased. In fact, more men died of in­fec­tious diseases like cholera, ty­phoid, and malaria than from bat­tle wounds. Nightin­gale and her nurses vastly im­proved the un­san­i­tary con­di­tions, which re­duced the death count by two-thirds. Known for car­ry­ing a lamp while mak­ing her nightly rounds as she min­is­tered aid to the wounded, they called her, “the Lady with the Lamp.”


The theme of Na­tional Nurs­ing Week this year is Nurses: A Voice to Lead — Nurs­ing the World to Health. De­vel­oped by the In­ter­na­tional Coun­cil of Nurses (ICN), the theme was in­tended to show­case how nurses are cen­tral to ad­dress­ing a wide range of health chal­lenges. “Physi­cians of­ten over­shadow the im­por­tant work that nurses do un­less you’ve been in the hospi­tal and ex­pe­ri­enced the 24/7 care they pro­vide,” says RNAO Pres­i­dent, An­gela Cooper Brathwaite. “Nurs­ing is a prac­tice-based, knowl­edge-driven, art and science pro­fes­sion. Ev­ery nurse is a leader who en­acts dif­fer­ent do­mains of prac­tice: teacher, prac­ti­tioner, re­searcher, and ad­min­is­tra­tor.”

2020: Year of the Nurse was meant to spot­light the im­por­tance of univer­sal health care cov­er­age and the risks as­so­ci­ated with nurs­ing short­ages. Although many of the events and cel­e­bra­tions that were planned to raise the pro­file of the pro­fes­sion have been can­celled, the Reg­is­tered Nurses As­so­ci­a­tion of On­tario (RNAO), is launch­ing a so­cial me­dia cam­paign to help show grat­i­tude and ap­pre­ci­a­tion for nurses. On May 12th, RNAO will re­lease the En­hanc­ing Com­mu­nity Care for On­tar­i­ans (ECCO 3.0) Re­port, which ex­am­ines the health­care sys­tem in On­tario.

The short­age of nurses is a very real threat. Not only is the pop­u­la­tion in­creas­ing, so is the age of the pop­u­la­tion. Un­less dras­tic ac­tions are taken, WHO es­ti­mates a world­wide de­fi­ciency of 9 mil­lion nurses and mid­wives by the year 2030.

As 2020 be­gan, the In­ter­na­tional Coun­cil of Nurses (ICN), which rep­re­sents 20 mil­lion nurses world­wide, was set to press gov­ern­ments around the world on the im­por­tance of mak­ing mas­sive in­vest­ments in nurs­ing to en­sure global health into the next decade. As a world­wide pan­demic un­folds in front of us, we’re wit­ness­ing just how cat­a­strophic a short­age of nurses would be.


COVID-19 has called at­ten­tion to the amaz­ing con­tri­bu­tions nurses make, putting them­selves at risk on the front lines ev­ery day to help oth­ers. But it’s also shone a light on the short­com­ings in our health­care sys­tem; per­haps most ev­i­dently in our long-term care fa­cil­i­ties and pri­mary care. In­ad­e­quate staffing and a flawed fund­ing model were al­ready threat­en­ing the qual­ity of care avail­able in many of On­tario’s long-term care homes.

There has been a marked in­crease in res­i­dent com­plex­ity since ad­mis­sion cri­te­ria changes in 2010. Peo­ple are com­ing into long-term care fa­cil­i­ties at a later stage of cog­ni­tive and phys­i­cal im­pair­ment, mean­ing their needs are more com­pli­cated and they re­quire more care. Com­pound­ing this is­sue is in­ad­e­quate staffing lev­els and an in­ap­pro­pri­ate staffing mix to keep res­i­dents healthy and safe.

Cur­rently there is no leg­is­lated min­i­mum staffing ra­tio and many fa­cil­i­ties em­ploy a high ra­tio of un­reg­u­lated staff. RNs rep­re­sent only slightly more than 10% of the nurs­ing care staff in long term care homes, while RPNs and PSWs ac­count for 18% and 71%, re­spec­tively. Due to the in­creas­ing health com­plex­i­ties of the longterm care pop­u­la­tion, RNAO ad­vo­cates a care model that as­signs a pri­mary nurse provider for each res­i­dent to im­prove health out­comes.

“The prob­lems ex­isted be­fore COVID oc­curred, but it has been a wake-up call to all health­care providers,” says An­gela Cooper Brathwaite, “It’s time to ad­dress the prob­lems and loop­holes in On­tario’s health­care sys­tem.”

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