Florence Nightingale, the lady with the lamp, the best in her days, this generation and perhaps in the generation yet unborn. There might have been nurses before her days but none could conceptualise nursing during her time and even for the future as Florence Nightingale did. She laid the ground work for how nursing should be visualised, considered and developed in the future. She equally created a pathway that, eventually, made nursing to be considered as a profession hence, making it one of the largest and fastest growing professions, in terms of creating new fields or venturing into newer territories in the health care sector today. As with every situation in this world, Florence Nightingale will be both happy and sad with developments in the nursing field because, although, the profession has evolved a lot with significant changes, there are still lots of cracks that needs to be sealed. Below are some of the areas of concern identified and what Florence Nightingale’s reaction will be about these issues.
Nursing as a Profession
Florence Nightingale will be glad that nursing is now recognised as a discipline to be studied and a profession to be respected. She would be pleased that systems and structures are being put in place to train would-be nurses and to initiate them into the profession upon successful completion of their training. This upgrade has made nurses have a sense of independence, that is, not to feel they are under anyone but to have a sense of belonging in a team of staff who work together for the betterment of the clients in their care. To add to that many specialties have been developed in the nursing sector over the years to, primarily, support some sections of the health sector and to give nurses a variety of options to choose from. Florence Nightingale will also be happy with this development because nurses now have a feeling that they don’t only belong to the ward but can do more to help push the goal and agenda of bringing quality care to all and sundry in almost every department.
However, are nurses embracing these challenges? Are they constantly improving and updating on the new chapters that are being flipped every now and then? Though increased stress levels may make this task a bit difficult to accomplish, it is a challenge that we must take upon ourselves to ensure we reduce work place errors that may lead to unnecessary deaths and disabilities. For instance, in 2018, a study concerning medication administration errors at tertiary hospitals in Addis Ababa, Ethiopia in which 298 nurses participated; 203 (68.1%) nurses reported to have committed medication administration errors. Some of these errors were attributed to inadequate training and unavailability of guidelines for medication administration. Nurses can do more to improve their knowledge especially in this age of information technology where every form of training seems to be available on the internet if the right source is sought.
Florence Nightingale would say kudos to the sort of attention that nursing, as a profession, is getting nowadays. She would be happy about the number of compassionate hearts that have joined this noble profession with a noble cause. As a field that is ever growing and ever expanding to infiltrate more areas of the health care sector, there is the need for more and extra hands to care for the sick and comfort the dying and it seems the world is responding to this need by heeding the call to come and sacrifice their time, efforts and hearts to the cause of this profession. At the center of the Crimean war where Florence Nightingale rose to fame, there were just a few of them at that time caring for the wounded soldiers. Some books about her heroics even identified the fact that in the middle of the night she had to pick up her lamp and make rounds in the ward to care for those who needed help. I believe, in those days and even several years after the Crimean war, there were sick and wounded people who needed this kind of help but could not due to the number of nurses or carers that existed at that time. So, of course, she would be happy about the current population of about 20.7 million nurses which accounts for nearly 50% of the health workforce in the world today (according to WHO). However, she would also want more room for improvement with the numbers because there is a severe shortage of nursing staff across the globe at the moment which is likely to get worse is no action is taken. According to the National Center for biotechnology information, there are lots of factors that are fast dictating the falling numbers and shortages plaguing the nursing field. These factors include; projected ageing of the baby boom generation which means the need for more carers, ageing staff which also means majority of the workforce nearing retirement, nurses’ burnout and violence at the work place which are factors forcing lots of nurses out of the nursing field. These are all factors that are affecting the growing nursing shortages in the world today. When you flip the other side of the coin, thus, into the situation in the developing countries such as in Africa, there is currently a mass exodus of nurses, in search of greener pastures, into the Americas and other European countries largely due to poor working conditions and low remuneration of nurses. The COVID-19 pandemic equally added insult to injury by scooping a part of the nursing population. According to the international Community of Nurses, about 1500 nurses succumbed to COVID 19 in 44 countries. Obviously, Florence Nightingale will not be happy about this looming danger that is about to send her cherished creation (the nursing profession) into a state of oblivion or into a similar situation like the type which existed in her day and will want something to be done about it as soon as possible. Fortunately, authorities are doing their best to tackle this looming danger by instituting interventions such as the use of technology, staff empowerment through motivation and measures to tackle high stress levels, are being put in place to help solve these staffing deficit issues.
When it comes to service delivery, nurses have and will always make a statement because, though nurses are most of the times seen as a nuisance by some client’s and their relations, they remain resilient in discharging their duties as they should. It is not easy dealing with some humans as some patients will just try their very hardest to make life for their nurses uncomfortable. This, in my own view, could be attributed to the fact that nurses spend more time with the client than any other member of the health care team and secondly, to the fact that the law seems to focus largely on what the client goes through in the hands of the nurse than what the nurse goes through in the hands of the client. Nurses suffer varying degrees of abuses ranging from physical, verbal and sometimes emotional and even if the statistics don’t show, we can testify to the fact that there were lots of times where nurses had tears behind those beautiful smiles they showed while caring for their clients. Those smiles are not forced as some may think. They are smiles that say, "though you hurt me, I will still give you my best". Some may claim this is what we signed up for when we took the oath of this profession but anyone who experiences a quarter of what nurses go through will surely not think twice about going against the very oath they swore, on the day they decided to accept the call of this profession, by bowing out. This is not what Florence Nightingale would have wished for her nurses. The show of gratitude alone pushes one to give his or her best in terms of service delivery. Nurses have blood running through their veins too but unlike ordinary men and women, nurses are moved by the suffering of their clients and are ready give their all to ensure the speedy recovery and safety of their clients and sometimes journey through with the client to his or her life’s end to ensure that he or she has a peaceful death and rest. This gesture will be boosted if they can be treated with respect by their clients and relations. If this COVID-19 pandemic didn’t prove to the world the big role nurses play in the health care sector, then I don’t know what else will. Nurses who have families had to heed to the call of duty and some, in so doing, never returned, not even to bid their loved one’s goodbye. While other workers were safe and out of danger during lockdown, nurses laid down their lives to fight this pandemic and some did actually lay down their lives to rise no more. So as more is being done to help nurses contain themselves, that is, not to issue the same treatment their clients mete out to them, more can be done to give attention to the stress that nurses go through in the midst of these inhumane treatments that tends to threaten the very existence of this profession.
Nursing is an ever growing profession which will see changes year in and year out. Of course as I said earlier, Florence nightingale will be impressed with the sort of recognition given to nursing by making it a profession and the numbers that are currently in the profession but she would want more to be done in terms of the attention nurses receive while in the line of duty. She would also want nurses not to give up on their call. As the saying goes, "every cloud has a silver lining"; the silver lining of nurses’ efforts in the midst of all the difficulties they face is to see their clients get well. Despite the difficulties nurses go through, either in the hands of clients or the management, nothing can be more satisfying than the joy of seeing that you have accomplished your task, as a nurse, of seeing your clients get well and having another go at life.
As we celebrate the year of the nurse and midwife yearly, let’s be reminded of the vision of Florence Nightingale for the nursing fraternity. As she rightly puts it:
She constantly put her feelings and her visions into actions and through her works the world can boast of a close companion; one that can connect more than family in sickness and, though, the time of interaction may be for a limited time, will facilitate the healing process and leave a lasting impression which may be unbeatable for years to come. This companion is none other than the Nurse that cares so much for the sick and the dying.
Happy year of the Nurse and Midwife celebration to all colleague nurses and midwifes around the globe.
1. Wondmieneh et al, 2018, Medication administration errors and contributing factors among nurses: a cross sectional study in tertiary hospitals, Addis Ababa, Ethiopia, BMC Nursing, accessed 4th June, 202, https://bmcnurs.biomedcentral.com
2. ICN, 2020, ICN confirms 1,500 nurses have died from COVID-19 in 44 countries and estimates that healthcare worker COVID-19 fatalities worldwide could be more than 20,000, International Council of Nurses, accessed 4th June, 2021, https://icn.ch
3. WHO, Nursing and Midwifery- WHO Global Strategic Directions for Strengthening Nursing and Midwifery 2016-2020, accessed 4th June, 2021, https://who.int.
4. Haddad et al, 2020, Nursing Shortage, accessed 4th June, 2021, https://ncbi.nlm.nih.gov.