OPINION | Invest in nursing for strong, resilient health systems

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  • International Nurses Day emphasises the importance of nurses in maintaining resilient health systems that can cope with emergencies like the Covid-19 pandemic.
  • Nursing education institutions have the responsibility to invest in the training of future nurses. 
  • Politicians and healthcare leaders also need to identify and put measures in place to invest in nursing and nurses.

On Thursday 12 May, we celebrate International Nurses Day (IND). The theme for 2022 is Nurses: A Voice to Lead – Invest in Nursing and respect rights to secure global health. This year’s theme emphasises the significant contribution nurses make to developing and maintaining resilience in health systems. It also underscores the need to invest in nursing so that the profession can continue to help promote, restore or maintain the health of millions of people around the world.

Nurses have been the drivers of transformational change; they have led significant improvements in the delivery of many services at all levels of the system, from policy to practice. Nurses contribute to service delivery, supervise and develop other members of the team; work with and advocate for patients, their families and communities; and collect data and inform the development of evidence and research. Their work always has a critical impact on patient outcomes.

The importance of nursing at all levels, including at governmental and policy levels of the health system, must be recognised. Nurses play a key role in the improvement and strengthening of health systems to restore and maintain health.

Strengthening healthcare systems

Leaders in nursing have the responsibility to invest in the younger cadre of nurses by encouraging, motivating, showing exemplary leadership and transference of critical skills that will ensure the core values of the profession is sustained. Nurse leaders who are involved in health system capacity building help to provide solutions or strategies that can address national priority needs, thus contributing to positive health outcomes.

In addition, nursing education institutions have the responsibility to invest in the training of future nurses and to develop critical thinkers who can be innovative, creative and co-problem solvers, and who can contribute positively to the knowledge economy and the strengthening of healthcare systems.

Furthermore, it is of the utmost importance to identify and champion global and national strategies to address health workforce maldistribution and migration. These strategies should be evidence-based and tailored to the local context. They should aim to address regulation for nursing education, skill mix, working conditions and environments, continuous professional development, and career structures.

Nursing regulatory bodies, nurse associations, private, governmental and non-governmental organisations should join forces to co-create solutions to address the working conditions, training, ethical recruitment strategies, national policies on migration and immigration, and other challenges nurses in the country face.

Addressing the shortage of nurses

Investment in nursing research related to Human Resources for Health (HRH) in health systems research should be prioritised. Nursing research will play an important role in HRH planning and development and in addressing health system and policy questions required for health systems strengthening. Within the healthcare profession, more awareness of the benefits of health systems’ research is needed to highlight the importance of nurses’ participation this area.

Politicians and leaders in healthcare need to identify and put measures in place to invest in nursing and nurses by addressing issues like wages, salaries and benefits for nurses and ensuring that the workplace is sufficiently resourced in order to deliver optimal care. Furthermore, there is an urgent need to address the nursing shortage in the country. According to the National Department of Health’s 2030 Human Resources for Health Strategy in South Africa, it is projected that by 2025 there could be shortage of 34,000 professional nurses in primary health care alone.

Urgent investment in human resource planning, training, talent requisition, development and retainment of nurses is required to prevent this from happening. The budget allocated to funding nursing education and filling vacant nursing posts should be a priority for the government.

Resilience against health emergencies

The shortage of specialist nurses, especially critical care nurses, who were the worst affected by the Covid-19 pandemic, and the training of these nurses must be addressed as matter of urgency. The training of specialist nurses, which could not be done in the past two years due to the phasing out of specialist legacy qualifications, is posing a serious threat to the optimal functioning of the health system.

The health of the population depends on a strong health system which, according to the World Health Organisation, comprises six interrelated building blocks namely: service delivery, fielding a well-performing health workforce, maintaining a functioning health information system, providing access to essential medical products, vaccines and technologies, and provision of adequate financing and ensuring leadership and governance.  

Since such a system cannot be achieved without a well-performing health workforce, we need to invest in nurses and other health professionals. Investing in nurses and the nursing profession is worthwhile for strengthening health systems and making them more resilient against health emergencies such as the Covid-19 pandemic.

*Prof Portia Jordan is the Executive Head of the Department of Nursing and Midwifery in the Faculty of Medicine and Health Sciences at Stellenbosch University.

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