International Year of the Nurse and the Midwife

Florence Nightingale, the founder of modern nursing, would be 200 years old this year. To celebrate, the World Health Organization has declared 2020 the Year of the Nurse and the Midwife.

These days, we don’t often talk about Nightingale’s achievements, but she was an inspiring female leader and a true pioneer, not just in nursing but in health care overall. She was a social reformer and advocate, helping to abolish prostitution laws and championing women’s rights; a researcher, using systemic observation and evidence to improve patient outcomes; and she was a statistician, using maths and data to provide proof of her research findings and, ultimately, change public policy.

Nightingale was a visionary and I think that if she were alive, she would be thrilled to see what has become of the professions of nursing and midwifery today.

Nurses and midwives account for nearly 50% of the global health workforce.¹ They provide care in a range of settings: from hospitals, aged care facilities and primary healthcare settings, to care in the home, in schools and on the street. While both are rewarding careers, they incur emotional, physical and intellectual demands.

Nightingale knew that health care had to continuously evolve, and with changing patient demographics, this is even truer today. For example, in a country like Australia, it is not uncommon to care for a refugee who may have experienced trauma and speaks no English, or for an older mother with a chronic condition having her first child at 43 years of age. This, coupled with ongoing technological advances that Nightingale could not have dreamed of, means that nurses and midwives are now having to acquire specialist skills, develop new knowledge and practise their craft in new ways.

A major challenge for nurses and midwives is to continuously stay up to date. The half-life of knowledge is decreasing, and nurses and midwives must constantly update their expertise because it is being superseded. Rather than understand everything, they must know where to access the right information and knowledge. As Nightingale said, ‘Let us never consider ourselves finished…we must be learning all our lives.’²

As health care evolves, so too do our care models with more and more care being provided at home and increasingly remotely via telehealth. This leads to new and emerging challenges for these high touch professions as we develop and learn new ways to be with our patients.

Another challenge affecting nurses and midwives is that increasingly, contemporary health care is provided by a multidisciplinary team. Traditional professional hierarchies and task distribution are losing relevance, with teams seeking to maximise the strengths and skills of each team member to provide the best outcome for patients.³ Internationally, emphasis has been placed on ensuring that every member of the healthcare team works across professional and organisational boundaries making the best use of the skills and knowledge that each profession and each person has to maximise their contribution to patient care. Professionally, this is a wonderful opportunity, but it also means nurses (Registered Nurses, Enrolled Nurses and Nurse Practitioners) and midwives need to be supported to work to their full scope of practice in all settings.

According to Roy Morgan,⁴ nursing has been the #1 trusted profession for 23 years running. This isn’t a fluke. But it doesn’t mean the public understands what nurses and midwives do. Unfortunately, many people still think of them as handmaidens, and assume they are professions only for women. It’s essential we change this perception and encourage the public to view nurses and midwives as knowledge workers, individuals who are highly educated with a desire to make a difference in people’s lives. Nursing and midwifery are conscious career choices for both men and women who are professionals with expert knowledge and skill; people who want a challenging career working in diverse teams committed to enhancing the health and well being of both individuals and populations.

In 2020, the Year of the Nurse and the Midwife, we have a once in a lifetime opportunity to showcase the work of these professions. Like the inimitable Florence Nightingale, they are carers, educators, scientists, researchers and advocates and are often ahead of their time.

The author declares no competing interests.