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12 May 2022

A call to action for nurses and the systems surrounding them

  • VCCC Alliance
  • Peter MacCallum Cancer Centre

Professor Meinir Krishnasamy, Director, Academic Nursing Unit, Peter MacCallum Cancer Centre and the VCCC Alliance Research & Education Lead, Cancer Nursing.

The theme of this year’s International Nurse’s Day - Nurses: A Voice to Lead - invest in nursing and respect rights to secure global health - demands an investment be made in nursing to secure equity of opportunity for health - for all people wherever they are and whatever their circumstances.  To achieve this, the voice of nurses and nursing must be strengthened at hospital, community, and policy levels.  

The World Health Organisation’s State of the World's Nursing 2020 report says nurses are fundamental to achieving global health, but to secure our capacity to deliver health for all requires advocacy and investment from governments, business leaders, entrepreneurs, the community and health care leaders. As nurses, generating robust data to demonstrate our impact is key to strengthening our voice to lead and enable others to advocate with and for us. 

The direction is data 

Nurse-led research is critical to addressing the focus of this year’s International Nurses Day. Without data, we lack the essential ingredient to make our voice powerful within a global health context. 

With evidence and data as our platform, we can use our voice to advocate for those people who are at the greatest risk of health disadvantage. There are 28 million nurses across the world. We contribute in all environments, from birth to death, and so our capacity to address inequity, through data, through understanding, and through amassing and coalescing our message is incredibly powerful. 

When we think about the 17 sustainable development goals of the United Nations, nurses and nursing work has influence across all of them, to different degrees. We have the capacity to make an unimaginable difference to the global health of the world. But to do that, and to gain traction and resources, we need evidence to demonstrate our capacity and capability. 

Untapped value of proximity to patients, education and mentoring 

There is so much to be achieved from nurse-led research – so much potential and opportunity. But there are still fundamental barriers that constrain our potential to lead global health improvements.
 

“Despite being the largest health workforce with the closest proximity to patients, the time available to ask questions and translate that data back for the benefit of individual patients, the system, and our profession is lacking.”  

To build a robust and capable research workforce, nurses need time to develop skills and knowledge to undertake research, as well as the support, resources, and advocacy to implement change at patient, organisation and system levels.

We need health systems, funding bodies and governments to invest equitably in nurse-led research and evidence-based practice so that we can benefit from the contribution of nursing intervention across the trajectory of health, illness, recovery, and end-of-life care. 

Research education and training needs to be embedded into clinically based education teams; not as an optional extra, but as a fundamental imperative. Research-informed and enabled nurses save lives, create efficiencies and drive innovation in care delivery. 

Nurses need access to clinically embedded research mentors. We need to see colleagues succeeding as nurse clinician-researchers and clinician-scientists - “you cannot be what you cannot see”.  To secure respect for global health, nurse-led research-informed care needs to become the norm, not the exception. 

  “…enabling us to be able to think and amass data will empower and strengthen everybody.”

There is a strong bias in the system that we are doers, not thinkers, and that we are here to do the work rather than lead the work. There is the perception that, as 28 million workers, we are here to shore up the system and make sure that things get done – rather than disrupt the system to everyone’s benefit. 

Defining a 'Voice to Lead' 

Those of us advocating for leadership in cancer nursing research must first and foremost see ourselves as enablers. First, do the research. But beyond that, we need to help nurses to see themselves as generators of new knowledge and implementers of best practice. We need to understand our place in the system as translational enablers. 

Nurses recognise and champion the importance of new drug development, new surgical and technological advances to extend life and increase cures. But without our intervention, our capacity to educate, support, and help people self-manage the consequences of cancer treatments, people will not achieve the health benefits possible from the remarkable new approaches to cancer care. 

Many interventions fundamental to survival rely on networks of skilled and knowledgeable nurses within and across organisations. 

Implementation of the sepsis pathway is one such example. Nurses are the eyes and ears of healthcare settings. Strengthening our capacity to identify, act on and drive research within multidisciplinary teams is essential to attaining value-based health care and delivering learning health care systems.  But with a request for support, advocacy and infrastructure comes responsibility. 

The standards we demand of each other as clinicians must translate to our research efforts. To achieve this, appropriate, applied clinical research training needs to be embedded into hospital or clinical care setting education programs as a core requirement.

 

"Not every nurse will want to be a researcher, but every nurse needs to be a research advocate and end-user."

 

A voice to lead for global health requires us to look for the opportunity to explore, examine, understand, co-design and implement new approaches to and pathways of care that address the inequity in the system.  This needs to occur for people who most need our help - people who are homeless, people with mental health issues, culturally and linguistically diverse communities, our Aboriginal and Torres Strait Islander communities, and our colleagues in low and middle-income countries. 

Nursing has an essential contribution to make to a multidisciplinary community of health professionals addressing global health. Our voice to lead and contribute to this work needs a powerful message, and a powerful message needs evidence.

 

The VCCC Alliance is committed to developing research capability of nurses who work with people affected by cancer across the clinical member organisations and beyond. For more information about the program, please contact Sharon De Graves, Program Manager, e: sharon.degraves@unimelb.edu.au.

 

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