Why does it take a crisis to recognise the essential role of nursing?

Why does it take a crisis to recognise the fundamental and essential role that nurses play?


“Nursing is still considered a women’s job. This problem of chronic under-valuing is a gender issue.”

These are words spoken by Professor Cath Rogers, Dean of Health at Torrens University Australia in Brisbane, who has this week been continuing discussions with fellow nurses about future supplies of Personal Protective Equipment (PPE).

In the last few months, several attempts have been made to publicly highlight the extraordinary work of medical workers around the world during this pandemic. These PR-campaigns have included athletes posting videos of themselves with hashtags (The RealHeroes Project), artists in New York making explosive designs, celebrities, influencers, billboards.

However, today on International Nurses Day, in the International Year of the Nurse and the Midwife, Professor Rogers says she’s uneasy about the under-recognition of nurses and the false images the public hold about the nature and reality of nursing.

“It’s great to see nursing valued, but why did it take a pandemic to make us see this?” she said. “Nursing is chronically undervalued. Nurses are trusted and respected for their caring. But as a profession, their status among other medical professions is not as high, and we get a problem in attracting them into this field.

“It’s a gender issue. Nursing is seen as women’s work. It’s chronically undervalued. There’s an assumption that it’s a women’s job. We are incrementally changing it, and it’s good that journalists are shining a light on this issue now.”

Professor Rogers believes we need more nuanced portrayals of what nurses really do. In her role at Torrens University Australia, Rogers said she’s often untangling stereotypical images her students have when they arrive in their first year of nursing school.

“I call it the ER effect. They watch TV and think that’s how it is, that nursing is glamorous and exciting.” But rarely, she said, do we see the nurses who work in aged care or mental health clinics. “It’s as though everyone has a view about nurses because we’re often depicted, but these depictions are terribly stereotypical and inaccurate.”

When asked how we can get more recognition for nurses, she said we need to “promote diverse voices and present the diverse range of career options, so we can recruit the best students.”

“Educational institutions need to promote positive images of nurses. Nurses are the most compassionate and caring people. They are truly heroes. They’re often not depicted that way.”

Meanwhile, almost half of Australia’s primary health care nurses have revealed they don’t believe they’re able to fully utilise their skills.

A survey released by Australian Primary Health Care Nurses Association (APNA) to coincide with International Nurses Day, found that 45 percent of respondents feel that their skills aren’t being fully used often or most of the time, despite 81 percent of them being highly experienced with an average 21 years in nursing.

Currently, in Australia, there are roughly 388,000 practising nurses. Despite 2020 being the Year of the Nurse and Midwife, the pandemic has been the reason nurses have finally received an international spotlight. They are our essential workers, frontline responders in addressing this pandemic and are putting their safety and health at risk for the rest of the population, every day.

Karen Booth, President of the Australian Primary Health Care Nurses Association, believes the findings represent a lost opportunity for the Australian health system.

“Primary health care nurses are ready, willing and able to make a difference,” she said in a statement. “They must be empowered to work to their full potential as Australia faces the twin challenges of an ageing population and rising rates of chronic disease beyond COVID-19.”

“It’s worth reflecting on International Nurses Day, that nurses are rated by the Australian community as the most trusted and respected health professionals. Nurses are accessible, caring and nurturing. They are trained to make key decisions that affect the recovery and continued wellness of patients. So, what’s the hold-up?”

Booth spoke to Women’s Agenda over the phone and explained how patients are missing out on the best the nurses can offer.

“We have highly skilled nurses with postgraduate degrees and Masters,” she said. “They complain they’re not being utilised to a level they want, and it’s the patients who miss out on benefiting from their skills.”

“We have nurses who are used to managing complex care, and often they’re told there’s not enough time, or we don’t get paid enough. We just want you to do task-based activities.”

The survey was completed by more than 1,600 nurses in hospitals, general practices and other community health centres. Shockingly, more than half of respondents reported not having had a formal job appraisal in the past two years.

The APNA Workforce Survey also found that nurses were particularly interested in doing more chronic disease management and education with patients, but that many were not being encouraged to implement or exercise their skills.

Booth believes a change to the system needed, and that the reason nurses have seen their requests to do more refused, is a lack of financial incentives for the employer under Medicare.

“Nurses not only need the support of their employer but the system has to change too,” Booth said. 

Professor Rogers believes the profession of nursing will be highly altered by this pandemic.

“Substantial changes in health care in general will need to be made,” she said. “We now know how critical public health is, and the specialists. Their work has been highlighted during this pandemic.”

“This pandemic has shown we need public health capacity, community health, immunisation, high quality care in aged care, among other services. We know that if we don’t do these things, it can be catastrophic.”

In NSW alone, over 50,000 nurses and midwives work within state hospitals and health services. Research from the World Health Organization (WHO) shows that intervention delivered by midwives could advert over 80 percent of all maternal deaths. Professor Rogers believes expanding technologies for health-care providers will benefit the future of the nursing profession. 

“Good quality health care should occur outside of hospital environment. Services such as tele-health are being promoted and that’s good. There are so many virtual health technologies, like consultations via zoom and other video conference tools – being able to monitor people remotely. There’s so much development in that area that has potential to make a different to provision of care that has been sped up exponentially by this pandemic.”

The World Health Organisation declared 2020 the International Year of the Nurse and the Midwife and is encouraging countries to recognise and showcase the work of nurses and midwives to the health system around the world. This year’s theme was titled ‘Nursing the World to Health’, and today marks the 200th anniversary of Florence Nightingale’s birth.

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