Celebrating the Year of the Nurse and Midwife in primary health care

Welcome to this special issue of Australian Journal of Primary Health, created to celebrate the World Health Organizations’ International Year of the Nurse and Midwife. This recognition is timely for nursing and midwifery in general, but for nursing and midwifery in Australian primary health care (PHC) it is particularly special. It is two decades since the policy and funding changes that drove the employment of nurses in general practice in Australia. Now nursing and midwifery is well established within Australian PHC. Internationally, in countries like New Zealand and the UK, the role of PHC nurses continues to develop and push boundaries in the way in which PHC is delivered. During the International Year of the Nurse and Midwife, it is important to recognise and celebrate the achievements of PHC nurses and midwives and the important contribution they make to the health of the community.

The papers included in this issue provide a snapshot of the diverse nursing and midwifery roles within the broad field of PHC. Additionally, it explores the contribution that they make in building a strong PHC system and to the delivery of quality PHC practice and policy in both Australia and New Zealand. From preconception to postnatal care, lifestyle risk modification, family violence, and rural and remote nursing, PHC nurses and midwives can be seen to enhance access and availability of health care in the community.

Once considered a doctor’s handmaiden (Foley et al. 2005), PHC nurses are now core partners in the provision of person and family-centred care. Their practice has evolved to encompass independent and interdependent roles and they are strategically placed to work collaboratively with medical and allied health professionals to meet unique health care needs in local communities. The diverse roles of PHC nurses encompass the management of complex chronic health conditions, health assessment and education, and the coordination and delivery of evidence-based interventions (Australian Nursing and Midwifery Federation 2014). This issue of the Journal showcases the pivotal role PHC nurses and midwives play in addressing national health priority areas, professional and workforce development issues and access to appropriate and affordable services.

Within this issue, James et al. (2021) highlight the barriers experienced by nurses regarding lifestyle risk-factor communication in Australian general practice. The COVID-19 pandemic has brought these barriers even more to the fore. Despite the public health crisis of the global pandemic, nurses and midwives in Australian primary health care were reporting job losses and feeling underutilised (Halcomb et al. 2020). This occurred as a direct result of health system funding constraints and a lack of agility in primary health care, particularly general practice services to transform business models to optimise nursing staff utilisation and service delivery. With the devastating rise of mental illness, illicit drug use and domestic violence occurring secondary to COVID-19 lockdown measures (Nelson and Adams 2020; Usher et al. 2020), it is vital that all health professionals are supported to work to the extent of their scope of practice to ensure that health services are appropriate, affordable, accessible and available to all those in need.

In his editorial early in 2020, Duckett (2020) observed that as a result of COVID-19, ‘innovation has been unleashed’. Let’s ensure that following the Year of the Nurse and Midwife we use the disruptive innovation of the pandemic to recognise the contribution that PHC nurses and midwives make to the health of individuals and families, communities and populations. As our health system is reimagined and we move towards a new normal, we must ensure that the voices of all health professionals are heard and that new ways of functioning facilitate each and every health professional to work to the full extent of their scope of practice. Such advocacy will ensure that we achieve the Declaration of Astana goals (World Health Organization 2018) to build a sustainable PHC system.

E. Halcomb, S. McInnes and A. Williams were guest Associate Editors for this special issue.