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Amid a Pandemic, Nurses Make a Vast Difference to Improve Global Public Health

Nurses have been described very often as a bridge to healthcare for people in their communities. They practise on the frontlines of primary care and acute care. Nurses have a long history in the prevention of illness.

Amy Ansehl, M.S.N., D.N.P., FNP-BC Padmini Murthy, M.D., M.P.H., M.S.

Nurse leaders such as Lillian Wald understood the value of the patient’s environment, and how their socioeconomic status, access to clean water, food and shelter contribute to the exacerbation of disease and mortality. Today this understanding of environmental impacts of disease is termed the social determinants of health.

At the dawn of this decade, the nursing profession is stepping up, once again, to meet the significant challenges of a new public health pandemic. The coronavirus pandemic has thus far recorded more than 3.6 million cases worldwide and greater than 250,000 deaths. Amid this pandemic, where nurses are heavily involved in the saving lives on the front lines of the fight against COVID-19, it is apropos that the World Health Organization (WHO) has designated the year 2020 as the International Year of the Nurse and the Midwife. This isn’t the first time the nursing profession stepped up to meet overwhelming public health challenges. Two hundred years ago, one of the nursing profession’s most notable, strategic and innovative leaders was born. Florence Nightingale was a social reformer, statistician and nurse innovator who changed the way nursing, medicine and public health practitioners used their skills in their practice to save lives. Ms. Nightingale challenged the long-established thought on patient care by implementing a novel approach to patient care that focuses on a trifecta of priorities: hygiene, sanitation and fresh air. The Crimean War served as an opportunity and platform for Nightingale to not only put into practice environmental sanitation and hygiene controls but advance strategies for integrating mental health and into the treatment and recovery plan. Back in 1853, Nightingale understood and trained a cohort of nurses to assess the patient holistically, with mental health status recognised as an integral component of patient wellness. Nightingale’s Notes on Nursing provided practical guidance for combatting sickness and disease, which included the need for fresh air and ventilation, sunlight, nutrition, hygiene and sanitation. She emphasised the importance of frequent hand washing and cleaning the patient and their environment.

“Nurses have a long history in the prevention of illness” Nightingale took her beliefs even further by advocating for policies that incorporated these beliefs so they could be implemented locally. She understood that if we do not translate these individual health promotion strategies and have local governments adopt them as policies, we will be unable to prevent the spread of disease.

Ms. Wald was an American nurse, an advocate of human rights, and innovator. She founded the Henry Street Settlement in 1893 which served as a beacon of light for the swelling immigrant population. The Henry Street Settlement, which is still in existence today provided social services, education and healthcare to hundreds of thousands of low income and economically disadvantaged families.

“More than ever, the global community needs to realise the important contributions made by the nursing workforce” Based on her work at the Henry Street Settlement, Ms Wald founded the Visiting Nurse Services of New York. Thus, creating an essential and sustainable home healthcare industry that employs nurses, doctors, physical therapists, occupational therapists and speech language pathologists worldwide. Wald advocated for children, women’s rights, minority populations and labour. She was instrumental in the founding of the NAACP (National Association for the Advancement of Colored People), the United States Children’s Bureau, the National Child Labor Committee, and the National Women’s Trade Union League. How is this applicable to the challenges facing us globally? More than ever, the global community needs to realise the important contributions made by the nursing workforce in their tireless efforts to achieve the targets of the United Nations’ goal to achieve sustainable development by ensuring health lives and promoting the wellbeing for all. Especially, amid the tremendous global challenges unleashed by the coronavirus pandemic, the first line of defenders are the health professionals. Physicians, nurses, home health aides and physician assistants are the most valuable resource in our fight to preserve public health in the wake of coronavirus. Thus, it is crucial that nurses, along with all first responders, get a seat at the table when public health policy is created, and guidelines are enacted. As appeared in Nursing Times on May 7, 2020.