Disease, natural disasters and armed conflicts have always been a part of human existence. And throughout history, we have sought means of mitigating the effects of these realities on individual and societal level. To keep people healthy as well as provide care and comfort to victims of any of the aforementioned situations has always fallen to other individuals or groups of individuals both skilled and unskilled, depending on the prevailing circumstances. This health maintenance practice has remained the focus of nursing, even though its forms have evolved with societal influence and changing needs through the ages. (National Open University of Nigeria, 2004, pg.6)
American Nurses Association (2012) webpage explains nursing as “the protection, promotion and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities and populations. while the World Health Organization (n.d.) posits that “Nursing encompasses autonomous and collaborative care of individuals of all ages, families, groups and communities, sick or well and in all settings. It includes the promotion of health, the prevention of illness, and the care of ill, disabled and dying people”.
Education, Training & Specialties
From the various understanding of what the concept of nursing is, methods have been developed for the formal training and authorization of individuals interested in modern practice of nursing who undergo diverse courses of study that includes such topics as:
Anatomy and physiology, Microbiology ,Pharmacology and medication administration, Psychology, Nursing ethics , Nursing theory, Nursing practice, Legal issues in nursing practice with detailed clinical training in Maternal-child nursing , Pediatric nursing, Adult medical-surgical nursing , Geriatric nursing, Psychiatric nursing and other specialty courses (Stone, n.d.).
In order to make them proficient in advocacy – the cornerstone of nursing that entails advocating for patients (individual, family, group or community), causes (Health, safety and rights), profession (contribution to practice, education, administration and knowledge development) in addition to collaboration with other health professionals and the public in promoting community, national and international efforts to meet health needs (Mathews, 2012)
Together with skills enhancing manipulation of evidence during practice, critical and analytical thinking, enhanced resource management and effective safe practice. (WHO, 2009a.pg.23.)
Challenges, Achievements and Importance of Nursing to Man
According to WHO (2009b. pg.8), “Nurses and midwives make up the greater part of the global healthcare workforce with an estimated population of over thirty five million worldwide, and they contribute substantially to health delivery systems in primary care, acute care and community settings”. And they have played significant parts in the maintenance of global and individual life and health. However, there is there still is a serious shortage of personnel to meet the needs of the world.
Some factors listed by International Council of Nurses (2006, pg. 15 & 16) as contributing to this global challenge of nursing shortages includes – “poor quality of work environment, inadequate staffing and heavy workloads; excessive overtime; inflexible scheduling; exposure to occupational hazards, violence and abuse; lack of autonomy; poor HR management practices and leadership; lack of access to necessary supplies, medication and technology; inefficient incentives, and poor career development opportunities” all of which have negative influence on the quality of nursing practice.
Amidst these unfortunate challenges, nurses and midwives have remained determined in giving their best no matter the situation, guided by the nursing ethics. Many have paid the ultimate price for the greater good, while others continue putting their lives, safety and security, physical and emotional wellbeing on the line to ensure the objectives of the nursing profession is achieved.
Hampered by diverse antagonistic national health policies, work related hazards and numerous other challenges, the importance of nursing to mankind is showcased as regard global health maintenance in situations involving diseases, disaster and armed conflict.
The endorsement by the World Health Organization in December, 1980 of certified records indicating the global eradication of smallpox in 1979 by an international commission of doctors and scientists marked a global milestone in the battle against global infectious diseases. (Wikipedia, Vaccine preventable diseases. n.d.). This wonderful achievement was not without the inputs of nurses and midwives all around the world carrying out their duties of mass immunization of vulnerable groups worldwide.
Vaccines are available for Rubella, Cholera, Meningococcal disease, Influenza, Diphtheria, Mumps, Tetanus, Hepatitis A, B & E, Tuberculosis, Pneumoccocal disease, Typhoid fever, , Poliomyelitis, Varicella and herpes zoster, Human papilloma-virus and few others more, yet Neonatal tetanus, Haemophilus influenza serotype b, Measles and pertusis were responsible for 98% of vaccine-preventable deaths. These preventable deaths are usually caused by a lack of access to the vaccines or failure to obtain the vaccine in a timely manner.
The reduction in occurrence of these vaccine preventable deaths in developing countries especially in Africa bears testament to the importance of nursing. Here, nurses and midwives are at the forefront of community and home-based care programmes and village health worker programmes. With a “typical Primary Health Care (PHC) team comprising of two or more primary care nurses, an environmentalist, village health workers, a counsellor, a nurse assistant, a public health nurse, a laboratory technician, a pharmacy technician and possibly a physician and support staff.” (WHO, 2013a. Pg.50). The involvement of such PHC teams, together with other nurses in the field and hospitals, champion health promotion, disease prevention and early detection and treatment. Such sustainable interventions contributes immensely to the global priority in the battle to reduce the risk of communicable diseases and Non Communicable Diseases (NCDs), which presently is the leading cause of morbidity and mortality with dire impact among the poor and vulnerable worldwide.
The gains recorded regarding the health related Millenium Development Goals (MDG) now Sustainable Development Goals, bears testament to the importance of nursing to global health as reported by WHO (2015) on MDGs that there was:
– A global reduction rate of 49% for infant mortality from 12.7 million in the year 1990 to 6.3 million in the year 2013.
– 38% decline in global new HIV infection was recorded between 2001 and 2013.
– The proportion of births attended by skilled personnel – crucial for reducing perinatal, neonatal and maternal deaths – is above 90% in 3 of the 6 WHO regions. However, increased coverage is needed in certain regions, such as the WHO African Region where the figure was still only 51%.
– Also, the global measles immunization coverage was 84% with a decrease in death rate by 74% in 2013.
– Significant achievements have been recorded in the fight against malaria, tuberculosis a medically diverse group of tropical infectious conditions caused by a variety of pathogens like human African Trypanosomiasis, Dracunculiasis, leprosy, visceral leishmaniasis Lymphatic Filariasis, which were the targets of goals 4, 5 & 6 of the United Nations Millennium Development Goals.
Discounting the geographical and hydro-meteorological natural disasters before the year 1900, the myriad hurricanes, tsunamis, Flooding, landslides, earthquakes alongside man-made technological disasters such as industrial pollution, nuclear release and radioactivity, toxic waste, dam failure, transport industrial or technological accidents (explosions fires spills), and other secondary disasters arising from such incidents, leave an aftermath of death, destruction, injuries and hazardous conditions ideal for the spread of diseases.
Nurses, alongside other emergency management teams worked extremely hard to contain the dangers posed to health and life by putting their disaster preparedness and response training to practice through – rapid situational assessment, coordination of patient triage, care and transport; evaluation of the environment and mitigation of health hazards; as well as providing emotional support and empathy to all victims and families in order to fast-track survivor convalescence and rehabilitation. (Disaster nurses, 2011)
The history of organized nursing cannot be complete without noting the influence of how armed conflicts facilitated its evolution. Armies, during armed conflicts strive to reduce casualties among their own rank and file. Thus, wounded soldiers needing immediate medical attention and care must be treated near battle fields. This necessitated the formation of nursing corps to serve the military on campaigns. The early nursing practice was crude, unorganized and almost inhumane, until reforms began with the advent of modern nursing influenced by Florence Nightingale (Military nurse history, n.d.).
These armed conflicts erupting within contained environments or escalating into full blown wars cutting across countries and continents were frequent, resulting in large scale destruction of lives and properties. Its devastation on combatants and civilian populace spurred the formation of organized and well-established army nursing systems for casualties’ together with safe and protected institutions to accommodate and treat those who were wounded on the battlefield. Thus the International Red Cross and Red Crescent Movement came into being, consisting of several distinct organizations that are legally independent from each other, but are united in the fight to protect human life and health, to ensure respect for all human beings, and to prevent and alleviate human suffering. Wikipedia (International Red Cross and Red Crescent Movement, 2012).
As a result of the grave danger posed to life, health and welfare of populations in affected zones, the International Committee of the Red Cross and ICN (2013) urges that In the event of armed conflict, ICN, Red Cross and national nursing associations implore respect to international law and ensure the immediate provision of humanitarian assistance, including health care, to refugees and displaced persons and to facilitate open and coordinated access of international humanitarian organizations in the affected areas.
The implication is that nurses and other volunteer humanitarian workers repeatedly brave grave danger to self among other incidental challenges in order to assist victims of such conflicts without ample support or recognition. This however, does not deter them from being altruistic in giving their all to the promotion of health, the prevention of illness, and the care of ill, disabled and dying people worldwide.
The importance of nursing and nurses to healthcare delivery can never be overestimated. Their provision of vital services amidst challenges at individual and organizational levels indicates they have surmounted great odds and altruistically sacrificed much for humanities sake, yet only seek enabling environment to practice and a little understanding by the world of the enormity of their tasks.
Gebbie and Summers (2006) aptly captures the irony of nursing realities as they highlighted the disparity in recognition and support to nursing and nurses compared to others in health related fields. Dismayed that modern nursing leaders having saved countless lives through innovations that have often cut against the grain of formerly accepted practice, and excellently done much to confer the greatest benefit on mankind, no Nobel Prize or comparable annual award in nursing exist, even though nurses deserves such recognition.
Given the records of nursing’s immense positive impact on world health, how much more would these bastions of healthcare delivery achieve if committed efforts by respective governments are made to boost their motivations through empowering policies, proper recognition and reasonable incentives? The answer is better experienced than imagined.
American Nursing Association. (2012). What is nursing. Retrieved August 27, 2016, from www.nursingworld.org/EspeciallyForYou/What-is-Nursing
Disaster Nursing. (January 20, 2011). Retrieved August 27, 2016, from https://pariharraj.wordpress.com/2011/01/20/disaster-nursing/
Gebbie. K., Summers, S. (December 8, 2006). Originally published in the Baltimore Sun. Retrieved August 29, 2016, from http://www.truthaboutnursing.org/news/2006/dec/08_nobel_prize.html
ICN, ICRC. (2013). ICN and ICRC address role of health-care personnel in armed conflicts and other emergencies. Retrieved August 27, 2016, from https://www.icrc.org/eng/resources/documents/feature/2013/hcid-icn-icrc-memorandum-understanding.htm
International Council of Nursing. (2006). The global nursing shortage: Priority areas for intervention. pg. 15 & 16. Retrieved August 27, 2016, from http://www.icn.ch/publications/the-global-shortage-of-registered-nurses-an-overview-of-issues-and-actions/
Mathews, J. (2012). Role of Professional Organizations in Advocating for the Nursing Profession. OJIN: The Online Journal of Issues in Nursing Vol. 17, No.1, Manuscript 3.
Retrieved from http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-17-2012/No1-Jan-2012/Professional-Organizations-and-Advocating.html
Military nurse history. (n.d.). Retrieved August 29, 2016, from http://www.military-nurse.com/militarynursehistory.html
National Open University Nigeria. (2004). Nature of nursing, NOUN, pg.6 Retrieved August 27, 2016, from http://nou.edu.ng/uploads/fileuploads/ZAxQ4w72tL1441635318.pdf
Stone, J. (n.d.). Importance of Nurses – healthcare community Nurses. Retrieved August 27, 2016, from http://www.streetdirectory.com/travel_guide/192057/nursing/importance_of_nurses___healthcare_community_nurses.html
Wikipedia. (2012). International red cross and red crescent movement. Retrieved August 29, 2016, from https://en.wikipedia.org/wiki/International_Red_Cross_and_Red_Crescent_Movement
Wikipedia (n.d.). Vaccine-preventable diseases. Retrieved August 27, 2016, from https://en.wikipedia.org/wiki/Vaccine-preventable_diseases
World Health Organization. (n.d.). Health topics – Nursing. Retrieved August 27, 2016, from
Paragraph 1 http://www.who.int/topics/nursing/en/
World Health Organization. (2009a). Global standards for the initial education of professional nurses and midwives. Page 23. Retrieved August 27, 2016, from http://www.who.int/hrh/nursing_midwifery/hrh_global_standards_education.pdf
World Health Organization. (2009b). Global standards for the initial education of professional nurses and midwives. Page 23. Retrieved August 27, 2016, from http://www.who.int/hrh/nursing_midwifery/hrh_global_standards_education.pdf
World Health Organization. (2013a). WHO nursing and midwifery progress report 2008 – 2012. Retrieved August 27, 2016, from http://www.who.int/hrh/nursing_midwifery/NursingMidwiferyProgressReport.pdf?ua=1
World Health Organization. (2013b). WHO nursing and midwifery progress report 2008 – 2012. Retrieved August 27, 2016, from http://www.who.int/hrh/nursing_midwifery/NursingMidwiferyProgressReport.pdf?ua=1
World Health Organization. (2015). WHO Factsheet on millennium development goals. Retrieved August 27, 2016, from http://www.who.int/mediacentre/factsheets/fs290/en/