Letter to the Editor by Lumchio Levis Murry, Poonam Joshi, & Yangchen Dolma to OJIN topic: “Delivering Nursing Care: Current Factors to Consider”

Delivering Nursing Care: Current Factors to Consider

December 9, 2021

Response by Lumchio Levis Murry, Poonam Joshi, & Yangchen Dolma to OJIN topic: “Delivering Nursing Care: Current Factors to Consider

Dear Editor,

The year 2020 was designated by the World Health Organization (WHO) as the “year of the nurse” to commemorate the 200th year of the birth of Florence Nightingale, the founder of modern nursing (WHO, 2020). During the same year, the International Council of Nurses (ICN) also aptly kept the theme of nurses’ day as “Nurses a voice to lead; Nursing the world to health” (ICN, 2021). Our question: “is it within the reach of Indian nurses to nurse the world back to health?”

Nursing is the largest occupational group in the health sector, accounting for approximately 59% of the total manpower (WHO, 2021). Nurses serve a critical role in delivering quality care on the promise of “leaving no one behind” and achieving the Sustainable Development Goals (SDGs). The United Nations member states adopted the SDGs in 2015. The SDGs include 17 goals as a universal call to end poverty, protect the planet, and ensure prosperity and peace by 2030. SDG 3 is specifically related to health (United Nations, 2021). The SDGs are interlinked with each other and the progress in one goal has influence on the progress in another. Investment in nurses not only contributes to attainment of health-related SDG targets, but achieving universal education (SDG 4), gender equality (SDG 5), decent work assignment and stable economic growth (SDG 8) (The Lancet, 2020). In the present scenario, “Nurses a voice to lead; nursing the world to health” appears to be an ambitious statement; it is feared to be unattainable in most of the developing countries, like India, under the current circumstances.

In India, nursing has been regarded as an inferior profession. There is an inherent stigma attached to the nursing profession which is stereotyped as a physician subordinate role or an assistant. This image is partially self-created by nurses and partially due to neglect of the nursing representation at the policy level. There is also a lack of public awareness about what nurses do (Hoeve, Jansen, & Roodbol, 2014; Shariff, 2014). In order to lead, nurses need to speak with one voice, but this voice has been drowned out by intra- and interprofessional conflicts and a lack of seats at policy decision platforms. This has been seen in all aspects of nursing practice, from the bedside to the national level. Most of the key administrative positions in nursing at the national and state level are held by non-nursing personnel and nurses have their voices heard at the decision table, where it matters most (Varghese, Blankenhorn, Saligram, Porter, & Sheikh, 2018). Frontline nurses often resort to protests and strikes in order to make their voices heard.

Concrete and sustained efforts are required on the part of decision-makers to empower nurses and promote the goal of health for all. The nursing unions and professional organizations should harness their collective bargaining power in a proactive manner to work towards changes in nursing administration, education, and research. They have the advantage of being a public, collective voice heard by the higher authorities. We need to lobby for nurses to hold the key leadership positions in nursing and inclusion of nurses in healthcare decision-making bodies. Lobbying should also focus on the creation of research funding for clinical nurses. A national-level research centre for nursing is the need of the hour to promote and network nursing research activities.


Hoeve, Y. ten, Jansen, G., & Roodbol, P. (2014). The nursing profession: Public image, self-concept and professional identity. A discussion paper. Journal of Advanced Nursing, 70(2), 295–309. https://doi.org/10.1111/jan.12177

International Council of Nurses (ICN). (2021). Nursing the World to Health—ICN announces theme for International Nurses Day 2020. News. Retrieved from: https://www.icn.ch/news/nursing-world-health-icn-announces-theme-international-nurses-day-2020

The Lancet. (2020, April 11). The status of nursing and midwifery in the world [editorial]. The Lancet, 395(10231), 1167. https://doi.org/10.1016/S0140-6736(20)30821-7

United Nations (UN). (2021). THE 17 goals. SGD Knowledge. Retrieved from: https://sdgs.un.org/goals

Varghese, J., Blankenhorn, A., Saligram, P., Porter, J., & Sheikh, K. (2018). Setting the agenda for nurse leadership in India: What is missing. International Journal for Equity in Health, 17(98). https://doi.org/10.1186/s12939-018-0814-0

World Health Organization (WHO). (2020). Year of the nurse and the midwife 2020. Campaigns. Retrieved from: https://www.who.int/campaigns/annual-theme/year-of-the-nurse-and-the-midwife-2020

World Health Organization (WHO). (2021). Welcome to the National Health Workforce Accounts (NHWA) Data Portal. NHWA Home. Retrieved from: https://apps.who.int/nhwaportal/Home/Welcome