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• W4313340065 abstract "Firstly, a profound “thank you” for your compassionate, unrelenting work over the past nearly 3 years. I acknowledge your resilience and your exhaustion. Unapologetically, however, I am going to suggest something more for you to do. Not everyone will take up this challenge now, but it is important you read on and think carefully about the issues raised. What I ask you to think about is politics and the inextricability of politics and our caring for patients, families and the health of communities. Let us begin with what I know you know. Every preservice nursing programme introduces students to definitions of nursing. The words “strength, will and knowledge” are an indelible trilogy etched into our professional identity. They are our foundations of preventative and restorative health care—those attributes which we lend to people who, temporarily, cannot perform for themselves the necessary health-related activities. I'm sure we can all reel off the four domains of our profession: nurse, person, health, environment or some slight variation of wording therein. We know about social determinants of health and the negative sequelae for health of poverty, poor education, lack of meaningful work, dislocation from place and more (Marmot, 2005). We know about the sustainable development goals and that health is inextricably linked to all other 16 goals—clean water, sanitation, clean air, clean energy, etc. (https://sdgs.un.org/goals). We know specifically about climate change and its impact on low-lying areas, particularly of the Pacific Rim and its impact on food source and production, on heat exposure and dislocation from traditional lands “disproportionally affecting marginalised and underserved communities” (WHO, 2021). We KNOW an awful lot of important information that relates directly to our job as health professionals, but in what way do we bring forward this knowledge to shape our conscious actions. Are we as guilty as the person to whom we have provided specific patient education but for whom there is no behaviour change? They KNOW, but still they do not DO. We may remember two of our domains of knowledge are Health and Environment but how often do we return to these and explore their meaning for contemporary practice? We may remember Virginia Henderson's “strength, will and knowledge” but do we also recall her going on to speak of nurses as “the mouthpiece for those too weak or withdrawn to speak” (Henderson, 1955). Do we speak up, do we use our individual and collective voices making loud and clear that which we know about health? I challenge myself and you all to contemplate how we can and should use this professional knowledge for personal and professional action—for change—for political praxis. If politics is the influence on the negotiation, contested rationing and allocation of scarce resources at every level—the unit, the health service, the state, the country and globally—then every action, or inaction, is inherently a political act. How do we more authentically join the dots between what we know, what our mandate from society is in relation to health and illness, and what our everyday actions demonstrate? As nurses, we are the great disposers. We determine what is waste and where it goes. We choose what goes in “clinical waste” bins, in recycling bins and general waste. We disconnect the IV tubing and throw it… somewhere; we discard the dressing pack with only minimal contents used. We contribute to the decision that all ER patients have cannulas “just in case” they are needed, leaving the majority unused and binned. We contribute millions of tons to landfill and the disposal of expensive “clinical waste” (five times more expensive to dispose of). There are simple things nurses all around the world are beginning to do in relation to hospital waste and recycling. Hospitals and health services are signing up to organizations such as the “Global Green and Healthy Hospitals” (https://greenhospitals.org), coordinated in the Pacific region by Climate and Health Alliance (https://caha.org.au) and nurses are often the local champions leading these initiatives. For example, at Fiona Stanley Hospital in Perth, Australia co-mingled syringe and PVC recycling bins are used to collect materials which are granulated and made into pellets for repurposing. Royal Melbourne Hospital, Australia operating theatres have separate bins for cardboard and paper, for glass and plastics, for aluminium, batteries and PVC leading to significant financial savings and material repurposing. Starting simple and educating for mindfulness in everyday actions and making it easy for busy staff to do the right thing seem to be secrets to success. There are actions we can, and some do take in relation to climate change but what do we do about the other health-related crises where what to do seems more complicated than local individual action: domestic violence, street and gun violence, the plight of refugees, mental health and the health effects of poverty. If we are to honour our role as nurses acting with and on behalf of the health of our communities—to live the espoused professional values, we need to individually and collectively do more to be heard and heeded. Political action is about active engagement in hard conversations, in shining a light on the dark underbelly of violence, and neglect—the hard problems that predispose to illness and distress. Collectively, nurses can and do take action through our professional bodies and unions and they in turn to their international counterparts. The International Council for Nurses (ICN), for example, has been very active on the global stage in relation to climate change, refugees and the ethical recruitment of nurses. What more can we do locally to support this action? In our daily lives, we read about and talk about the importance of renewable energy sources, the effectiveness of solar panels, the environmental damage of cars which use fossil fuels, air conditioners which we crank up to ‘stun’ on hot days rather than look to effective ventilation and appropriate clothing. Given what we KNOW about health effects of climate change as nurses, to what extent do we “join the dots” in our personal behaviour at home? To what extent do we as citizens explore and seek to influence the local, state and national members of parliament about their policies that directly relate to health, i.e. health, education, domestic violence, gun control, social and affordable housing and cast our vote accordingly? Imagining the power of 27 million nurses globally asking critical questions of their politicians and speaking publicly about the links of their actions to the health and well-being of the communities in which we live. Imagine the power of nurses standing for election at all levels—school boards, local government, state and federal government. Imagine the change in the conversation. And it is happening. Here in Australia, a nurse independent member of parliament has been largely responsible for the passing of legislation for a national integrity commission to monitor the behaviour of politicians ensuring transparent and appropriate distribution of government resources. Another of our Australian nurse politicians has recently become the Assistant Minister for Health and Aged Care and her influence in the health conversations is already apparent. In the United States, a nurse Congresswoman co-founded and co-chairs the Black Maternal Health Caucus and is a member of the Gun Violence Prevention Task Force and has been responsible for the passing of several health-related initiatives. We have four people with a nursing background in the UK House of Lords. Many countries are seeing nurses stand for political positions, and we need more. National nursing organizations across the world are agitating about climate change, refugee safety, health and well-being. In Australia, our national nursing organization has been highly instrumental in pushing the federal government to hold a Royal Commission into Aged Care, Aged Care facilities being the site of an unfortunate proportion of deaths during the Covid-19 epidemic. Thankfully, the Commission has recently legislated to ensure registered nurses are employed in aged care facilities 24 h a day. Joining the dots between what we as nurses KNOW and what we as nurses and community members DO has the potential to change our communities, our nations and our world. As Henderson said nurses are: “the mouthpiece for those too weak or withdrawn to speak” (Henderson, 1955)—those who may not have the strength, will or knowledge to act for health promotion and illness prevention. We have a professional responsibility to speak up and to act and in doing so the realize the power of our 27 million voices. We can change our worlds if we join the dots between nurses, nursing and political action." @default.
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• W4313340065 date "2022-12-31" @default.
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• W4313340065 title "Nurses, nursing and political action—Joining the dots to realize our power" @default.
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