According to the World Health Organization (WHO), nine million more nurses and midwives are needed to accomplish universal health coverage by 2030. A lack of resources, rising chronic illnesses and ageing populations mean we’re seeing a huge strain placed on healthcare professionals which only looks to continue to grow.
In response, WHO named 2020 as the Year of the Nurse and Midwife at the World Health Assembly in 2019. The initiative aimed to shine a spotlight on the work of nursing professionals across the globe, and encourage more funding opportunities to support them during the next 10 years and beyond.
Then the coronavirus pandemic hit, which meant the programme of events for the year had to be considerably altered. While the celebrations moved online, behind closed doors, nurses became even more in demand, with retired and student nurses joining their colleagues on the front line.
Despite the drastic changes to what would have been a year of recognition and celebration, Professor Aisha Holloway, Head of Nursing Studies at the University, explains how the pandemic, although devastating, has helped raise the profile of our nurses and midwives, “I imagine everyone knows a nurse; they are part of the fabric of society and are almost an invisible resource. What the pandemic has done is raise that awareness of the size of the profession – we’re the largest health workforce globally – and the scope of their practice and their reach.”
But it’s also emphasised many of the issues the Year of the Nurse and Midwife events were looking to highlight. Aisha elaborates, “It’s also positive for countries and their policy makers to fully appreciate the asset that they have, not just in terms of contribution to population and public health and outcomes but also to the economic growth and fabric of society.
“The pandemic has ensured countries are called to account in relation to a number of nurse workforce issues such as being under resourced, challenges with recruitment retention, working conditions, regulation and investment, to name a few.
“We’re now having those conversations at quite a high level because of Covid-19. I think the challenge for us will be ensuring that they result in long term outcomes and impact.”
Projects and partnerships
Despite everything that’s happened this year, Nursing Studies has been involved in more projects and partnerships than ever before. The Nursing Now campaign, although set up in 2018 as a result of the Triple Impact report, has played a key role in allowing Edinburgh to grow its work and research.
Aisha explains a bit more, “The Nursing Now campaign is moving to focus on advocacy and that’s a key area in terms of Covid-19, the enduring and current challenges that we’re experiencing around emerging areas of interest within our profession, for example planetary health. Ultimately the future of economies and population health is hinged on how much we can invest in our greatest workforce asset – nurses. Through advocacy we can strengthen our political voice for impact.
“We need to ensure that our future nurses have the skills, support, mentorship and ability to be able to operate across a number of landscapes. That includes clinical practice, policy influencing and development, research and evidence, leadership. It’s about redefining nursing.
So how can that be put into practice? Aisha explains a little more about the projects launched this year, “These partnerships are a culmination of quite a few years’ work. Because of the profile that nursing has gained over the last few years and my role as the Programme Director for Research and Evidence in the Nursing Now campaign there has been an opportunity to really capitalise on it.
Collaborations and support from within the University include a partnership with The Global Health Academy called Edinburgh Global Nursing Initiative which looks to work with institutes across the world to strengthen nursing education and contribute to the UN’s Sustainable Development Goals.
Outside of Edinburgh, this September saw the launch of new partnerships with both Harvard and The Burdett Trust looking to strengthen resources available for nurses and midwives. Earlier this year the Same You charity, founded by Emilia Clarke, an actress who suffered from an Acquired Brain Injury, has linked up with Royal College of Nursing Foundation (RCNF) to provide scholarships. “We have 30 scholarships for nurses who work in neuro rehab and care, with a particular focus on young people who’ve had stroke or acquired brain injury. These scholarships will be fantastic opportunity for nurses to engage with postgraduate education and potentially go further with study for a Masters and for some a PhD.” says Aisha.
Talking about these partnerships more generally Aisha explains how important it is for Edinburgh to lead on these kinds of projects, “This work goes on disparately around the world and we’re trying to pull it together under one umbrella within an institution that has the freedom and ability to engage and inform governments and policies through the provision of a strong research evidence base. We want to utilise the very essence and best of higher education institutions.
Sharing our vision
This is vital work that feeds into the University’s Strategy 2030, and the Sustainable Development Goals outlined within it. Aisha explains how this synergy has impacted these projects, “The work aligns to the University’s wider strategy around sustainable development goals. We are responsible for the future workforce, that’s one of our remits within a higher education institution so by working together across the University and pulling in the great resources that we have here, we have the potential to make a real difference.
“I think already we’ve seen that by people contacting us and wanting to partner with us because of the great reputation and also because of a vision and message that they can relate to.”
“It’s really exciting and we’re just at the beginning of this journey and we definitely will be making a global impact with the work that we have planned over the coming years.”
So what can we expect to see in the future? Aisha explains how recent events have prompted innovative solutions to longstanding concerns, “We’ve seen a workforce that is under huge pressure. We need to safeguard the mental health and wellbeing, not just of nursing and midwives but the whole health profession. There’s an emotional labour of caring and we have to ensure we look after our health professionals in order to ensure that they are able to care for others.
But this isn’t an isolated problem, this need for support is a theme that comes up again and again in her discussions with Edinburgh’s Partners. Especially so with Dennis Mukwege, an honorary doctorate within the University. A Nobel Peace prize winner and a world-leading gynaecologist in Congo, Nursing Studies will be working with him at Panzi Hospital.
Aisha explains more about the partnership, “It’s very much focused on supporting the nursing workforce in Panzi Hospital, ensuring they have mechanisms where they can support each other while they’re dealing with very traumatic cases and then on top of that supporting the clinical practice and the patient outcomes.
But Aisha is keen to stress their work is about collaborations and support, not about taking control, “Our work is with governments and other Universities and it’s all about sustainability – working with these countries, the UK included, to develop capacity and capability and empower the leadership of those nurses on the ground.
“The public’s perception has always been perhaps that countries like Africa really struggle, well they absolutely do, but they are pioneers in many ways. Because of the lack of resources in many health-related areas, they have to be innovative. Our role is not to take over, but to showcase their work while supporting and enhancing where we can. These low- and middle-income countries have to work in different ways and we have so much to learn from them.”
An example of this is the University’s collaboration with MACI, a charity in Liberia. With only six consultant gynaecologists in the country, they’ve had to be creative about finding a solution, “rather than think well then let’s just have some more doctors, they’ve looked at the potential of the scope of practice of their nurses and midwives,” says Aisha. “MACI have been training midwives to carry out caesarean sections and many other surgical practices that wouldn’t normally be seen within that scope.
“I think innovation like that where we’re really deconstructing the profession and focusing on a scope of practice that is much more contemporary and forward thinking and not looking at finding the same old solutions is vital. Alongside this we will be evaluating and developing the evidence base – that is what is going to give us the greatest impact in our engagement with policy makers. Having the evidence is the first step, harnessing that for change remains the challenge.”
But while these projects in Africa show the true scope of the impact of nursing, it’s important to recognise there’s work to be done at home too, “We need to challenge the public’s perception of what nursing is. I think we’ve seen a bit of it with Covid-19 but it’s very much still been hospital focussed.
“The majority of future care will be out in the community. We need to look at the role of a strong public health policy, prevention, health and social care integration and the impact of this on the wider society and ensure that nurses are front and centre. They’re integral to communities and they’re accepted within them – we hold a very unique and privileged position and we need to maximise this potential.”
So what’s next for Nursing Studies? Aisha has big plans, “We have such a fantastic University and resource as well as other disciplines that can get involved. We want to work across subjects and make it multidisciplinary and interdisciplinary.
“We really do want to challenge what nursing is globally and it’s so exciting. There’s so much potential and I know we can do so much more. We’re the smallest subject area in the University but we have the biggest ambition.”