Today, we live in a world of uncertainty. More and more each day, we are inundated with negative news cycles covering new civil conflicts, increased migrant and refugee crises, violence and terrorist attacks, epidemics and outbreaks, and natural disasters. Simultaneously, our world is undergoing a rapid transformation with respect to technology, healthcare delivery, and transportation systems. This phenomenon is certainly not unique to the United States, but rather is an experience shared worldwide.
Over the course of my 50 plus years as a nurse, I have faced numerous instances of uncertainty, whether during my early days as an army nurse or today as nurse executive. Through these experiences, I have learned one thing: the importance of adaptation. In face of uncertainty, nurses have continuously faced it head-on. By learning from our experiences as well as our mistakes, nurses can adapt and evolve to fit the needs of the future.
This adaptation first started with the one and only Florence Nightingale, who rose to prominence following the fearlessness she expressed as a nurse manager and trainer during the Crimean War. In face of difficulty, she forever transformed the perception of the nursing profession, both internally and externally. Fast forward to today, and we see similar innovation in nurses across the globe. Difficulties such as climate change, mass migration, rising epidemics, as well as advancements to information and technology resources, will disrupt nursing and healthcare systems worldwide.
In face of uncertainty, I would provide the following three recommendations to nurses: (1) become more entrepreneurial, (2) embrace technological advancement, and (3) globalize your mindset and practices. We know that the power of nursing extends beyond bedside. Nurses are needed as educators, researchers, scientists, and policy makers. Becoming a nurse entrepreneur requires hard work, creativity, passion, and a degree of risk-taking and adaptability. Regarding technology, I have one thing to say: it is an unstoppable and unavoidable force. Technological advancements will undoubtedly impact our future educational, professional, and personal lives. Rather than push back, we as a profession should embrace technology and become leaders in its implementation into nursing and healthcare. Finally, our world is becoming more global each day. Globalization and migration are a fact of life, and communication and transportation technology are working to expedite these processes. We see this in nursing workforces worldwide. As regions face health workforce shortages, governments and health systems will begin relying more on health workforce migration to replenish starving workforces. We as nurses should not fear this change, but rather see the immense benefits that globalization has on our everyday lives.
The purpose of this issue is to highlight how nurses around the globe are adapting to uncertain times. The authors of the articles recognize the future realities of climate change, aging populations, and increased globalization, and present applicable examples of how nurses are working on the front lines to address these challenges for the future.
The article, “Nursing Practice and the UN Sustainable Development Goals,” by Rosa, Upvall, Beck, and Dossey is the perfect start for this topic. The authors rightfully acknowledge the fragility of global populations, societies, and the planet at large, and identify global nurses’ capability to contribute towards the mitigation of these challenges. Specifically, they address this topic within the context of the UN 2030 Agenda for Sustainable Development and its 17 Sustainable Development Goals. They move beyond rhetoric and offer key points of action that global nurses can take to fight poverty and inequality, improve global health, and preserve the well-being of both mankind and mother earth.
Cleveland, Motter, and Smith approach the topic of uncertainty through the lens of healthcare affordability in their article, “Affordable Care: Harnessing the Power of Nurses.” The authors present the passing of the Patient Protection and Affordable Care Act (ACA) as a disruptor to the U.S. healthcare system. They, too, recognize the innovation of nurses in times of uncertainty and discuss the profession’s impact on tangible health and policy outcomes such as national health cost reduction, value-based healthcare reimbursement, and healthcare quality.
In the article, “Trauma-Informed Nursing Practice,” Fleishman, Kamsky, and Sundborg discuss nurses’ role in transforming traditional healthcare education and practice through providing care in a way that prevents re-traumatizing patients and staff. Specifically, they discuss trauma-informed care (TIC), a form of care delivery that is grounded in an understanding of the impact of trauma on both patients and practitioners. Nurses are strategically positioned to lead the push for TIC implementation, especially in the realm of nursing practice.
In the next report, Anthony, Turney, and Novell take a deep dive into the fictional literature surrounding nursing and offer a comprehensive comparison and analysis of 18 nurse career novels published between 1932 and 1970. In “Fiction Versus Reality: Nursing Image as Portrayed by Nursing Career Novels,” they examine the role these novels have in influencing young men and women to enter the nursing profession. They then apply this study to our current age. Specifically, they discuss the challenges as well as the importance of motivating young men and women of the twenty-first century to become nurses in times of uncertainty.
Benton, Beasley, and Ferguson’s article, “Nursing Now! Learning from the Past, Positioning for the Future” nicely closes the initial posts in this OJIN topic. The authors introduce the Nursing Now initiative, a collaboration between the World Health Organization (WHO) and the International Council of Nurses (ICN) aiming to raise the profile of the nursing profession globally. The conclusion of the campaign in 2020 aligns with the WHO designated year of the nurse as well as the 200th birthday of Florence Nightingale. This study identifies how nurses, relative to the medical profession, are contributing to scholarship on universal health coverage (UHC) and explores opportunities to leverage current nursing research towards this agenda.
The journal editors invite you to share your responses to this OJIN topic by sending a Letter to the Editor or by submitting a manuscript that will further the discussion related to contributions of nurses in times of uncertainty initiated by these introductory articles.
Franklin A. Shaffer, EdD, RN, FAAN, FFNMRCSI
Dr. Franklin A. Shaffer is the President and Chief Executive Officer of CGFNS International, Inc. Dr. Shaffer earned a doctorate in nursing administration and education at Columbia University and has over 50 years of progressive and varied nursing experience which includes administration, education, clinical practice, and research. He is a frequent speaker and consultant at conferences and conventions around the world. Throughout his career, Dr. Shaffer has authored eight books and over 200 publications. He also serves on several leading professional journals and editorial boards, and most recently was selected as Chair of the International Advisory Board of the American Journal of Nursing. Recently, he was appointed Adjunct Faculty at the M. Louise Fitzpatrick College of Nursing at Villanova University and the Johns Hopkins University School of Nursing. Dr. Shaffer is a Fellow of the American Academy of Nursing, Sigma Theta Tau, Faculty of Nursing and Midwifery of the Royal College of Surgeons of Ireland, and Center for Health Outcomes and Policy Research at the University of Pennsylvania School of Nursing.