International Nurses Day came and went this month. I had a great day seeing nursing teams and nurses from across the spectrum, starting at the airport, and taking in outpatient clinics, wards and senior nurse teams. I get a lift and a sense of joy from spending time with nurses.

My weekly email and the work here are never intended only for nurses but for all who toil and lead in healthcare. Nurses make up a large number of those working in healthcare, over 50% as a rough estimate. Nurses are frequently rated as one of the most trusted professions by the public. If you consider the worldwide responses to COVID-19, wherever you look, nurses have been there in the thick of it. There is no getting away from it, nurses and nursing are significant and essential contributors to the world of healthcare. It just wouldn't work without them.

Nurses have demonstrated that they do keep the place ticking along, stepping up, and really, very few people are aware of how much we are actually doing. Let's call out the great stuff we see other nurses doing that might go unrecognised or unnoticed. Let us learn to acknowledge all the things we do in a day rather than beat ourselves up for all we haven't done. Let us speak up when a nurse's contribution is disrespected, ignored or taken for granted.

However, It also wouldn't work without the ward clerks, the physios, the cleaners, the data analysts, the security team, the phycologists, the admin staff, the human resources teams, the doctors, the managers, the.......you get the point. The delivery of high-quality health care that purposefully, efficiently and equitably meets the needs of the community it serves needs all of that and more.

So I struggle here for a number of reasons. A nurse is who I am, I'm proud of my nursing skills, and that these skills now extend beyond what you'd traditionally call nursing and clinical skills. These have taken me far. My friendships that started as a student nurse are some of the strongest I have today (and that's a long time now). I see nursing as one of the most amazing careers you can have. With so many options and avenues to explore, turn back from, re-visit and re-create. I spoke of the joy that I get whenever I spend time with nursing teams.

Equally, some of my proudest moments have come from collaborative working across a multidisciplinary team. Particularly alongside medical staff. Teams where everyone's, voice, strengths and skills were harmonised for a common purpose. The collective voice and wisdom of a small group of committed people really can change the world where they are. I've had the privilege of being able to see glimpses of that possibility.

On the flip side, I've seen nurses drag down other nurses, be dismissive and rude, obstruct and undermine. I've seen them resist change or be unable to offer solutions when asked. I've heard them say they don't know why they bother, that no one listens or cares and that they feel unheard, not valued or respected. I've heard us be victims, our own worse enemies and sit complacently moaning rather than seizing the power and influence we do have. I've watched nurses question why they do what they do, planning the way out of nursing as it's just too hard. I've sat with nurses who have cried at the end of a shift as they couldn't do what they wanted to do for a patient. I've seen them be compliant and almost servant-like in responding to doctors. I've been with frustrated and angry nurses who feel the system doesn't consider them or what they have to offer.

And I've seen all that in pretty much everyone else who works in healthcare.

We are a group of humans who for a whole host of reasons find ourselves navigating the complexity of the delivery of healthcare. In multiple settings, with environmental, financial and resource constraints. With increasing demand, complexity and expectations the world of nursing is very different to the one that I started in (many years ago). That's the opportunity in front of us all right now. COVID-19 taught us what can be achieved together when we have a common purpose and clear direction.

I re-read what I have written in this email over the past few years as International Nurse Day rolls around and my struggle with it remains. I struggle because I don't want to be seen as 'just a nurse' or to be a token nurse in a group. Equally though for nurses to have a voice we have to be included in all aspects of healthcare delivery, nursing is involved in all aspects so needs to be represented as such. I struggle because the more we draw boxes and silo who we are and what we do, the more barriers are built and that defeats and destroys what we are working to achieve for our communities, populations and patients. If we only think in terms of nursing and nurses we shut out so much other great stuff, people and voices. Nurses alone become just that, alone. I struggle because when we are excluded and doors shut the place of influence is with other nurses. Only one of these previous emails ever made it to the website, so this year I’m feeling courageous and posting this publicly as well.

2020 was declared the year of the nurse by the WHO. I think given what 2020 has brought us it has allowed nurses and nursing to shine, but also to suffer. The change that is required for nursing to be all it can be, for all nurses to feel that sense of inspiration, engagement and agency to contribute is still needed. The Nursing Now campaign describes what is needed for the change to occur. I agree with their mission and goals, they are well-described and give clarity and purpose. Nurses are not in this alone though, we do need a stronger voice and we need to raise and include all those who contribute and work with us as rising together will make us all stronger and increase the successes and benefits for those in our communities.

Nursing Now

The health challenges of the 21st Century cannot be overcome without strengthening nursing. It's time to give nurses more recognition, investment and influence.

Nursing Now is a worldwide campaign and has 5 goals for 2020. Read Why Nursing Now is needed. The 5 goals below are supported by workstreams, pledges, groups and engagement across the world. Nurses truly are remarkable and when working in partnership with others will be able to achieve remarkable things.

Greater investment in improving education, professional development, standards, regulation and employment conditions for nurses.
Increased and improved dissemination of effective and innovative practice in nursing.
Greater influence for nurses and midwives on global and national health policy, as part of broader efforts to ensure the health workforce are more involved in decision-making.
More nurses in leadership positions and more opportunities for development at all levels.
More evidence for policy and decision-makers about where nursing can have the greatest impact, what is stopping nurses from reaching their full potential and how to address these obstacles.