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Tuesday, August 9, 2022

‘NURSING THE WORLD TO HEALTH’

A PAPER TITLED ‘NURSING THE WORLD TO HEALTH’ BY DR. LOUIS BROWN  OGBEIFUN1 TO THE WORKSHOP ORGANIZED BY THE NURSING DIVISION OF WARRI MEDICAL ZONE, NIGERIAN NATIONAL PETROLEUM CORPORATION MEDICAL SERVICES (NMSL), MAY 12, 2022.

PROTOCOL

With a high sense of gratitude to God, the all-knowing and everlasting Living Father, I stand before this great gathering to present this paper to your Excellencies on this auspicious occasion of the International Council of Nurses (ICN) Day 2022. I consider it a great privilege to be honored with this presentation in the place where I started my career spanning over thirty years with the defunct Nigerian National Petroleum Corporation (NNPC), now known as NNPC Limited.

I also sincerely appreciate the Medical Manager Services, Dr. Folake Idris, and her team, especially the Deputy Manager of Nursing Services, Mrs. Grace Amina Kolo, who deemed me suitable to present a paper to my colleagues on this auspicious occasion. I will never take it for granted. Once again, thank you for the privilege of service.

The theme for this year’s May 12, 2022 celebration, “Nursing the World to Health,” is apt for so many reasons. First, in early 2020, the world woke to the stark reality that global leaders were more prepared for kinetic warfare than medical insurgencies and medical warfare. Secondly, the revelation that threw the world off-balance is called COVID-19. Today, some parts of China are still on lockdown while the world is grappling with the COVID-19 socio-economic challenges. Thirdly, the Lady of the Lamp, Florence Nightingale, whose birthday falls on this day, also partook in fighting the cholera epidemic in her days. Fourthly, some of the basic foundations of good health jingles on our electronic media to practice good hygiene and sanitation were essentially part of the prescriptions to prevent infectious diseases by Florence Nightingale.

Flowing from the central theme, the organizers of today’s event assigned me a sub-theme, ‘Having A Voice To Lead: Invest In Nursing And Respect Rights To Secure Global Health.’ The theme, in my opinion, is about galvanizing healthcare professionals, governments, Civil Society Organizations, stakeholders, and clients to value Nurses and the invaluable services they render to society. It also stresses the need to invest in rebuilding our broken global health systems. Undoubtedly, nurses would fill honored and valued when the authorities in various medical settings and governments treat them with respect and make provisions for the equipment they need to perform their professional duties.

In addition, Nurses and other healthcare professionals require guaranteed safety, acknowledgment, and respect for the enormous responsibilities within the healthcare team and their frontline roles during social crises and emergencies. The Nurse’s essential and frontline medical war duties came to light during the COVID-19 Pandemic. The arduous tasks, which the Nurse faces in warlike situations, were displayed in Florence Nightingale’s Crimean War experiences.

In recognition of Nightingale’s achievements, May 12 of every year is a day chosen to celebrate her and nurses for their frontline roles in the healthcare system. Florence Nightingale, “The Lady With the Lamp,” was born on May 12, 1820. She was born in Florence, Italy. History has it that she was a British nurse who was ardent in keeping records of her cases and is said to have served in the Crimean War. One of the many remarkable things about Nightingale is that she partook in caring for infectious diseased patients during her days, which we can compare to today’s Pandemic. She studied her patients in-depth to have identified the practice of cleanliness and sanitation to reduce the spread of contagious diseases and reduction strategies.2

The modern-day nursing practice is an offshoot of Nightingale’s character of tenacity, commitment, diligence, patience, and forbearance in the 1850s. Her ideas, social reformer status, and experiences could be said to have laid the foundation for modern-day healthcare delivery hinged on due diligence, morality, obedience, cleanliness, and exemplary attitude.3

Nursing the world to health means that the ICN wants Nurses to function in all facets of care assigned to them optimally. But Nurses can only care for others when they are by themselves well enough, have stable mental and physical stability, and are adequately prepared to face acute stressful situations like the COVID-19 scourge. To enable the Nurse to provide the care expected of the profession and function optimally, every healthcare planner and institution should deliberately put strategies and policies to invest in and support the nursing profession. When the stakeholders do this, they will have commenced strengthening healthcare systems from the local to the global stage. The power of freedom does not usually come without a struggle, seeking or working for it.

Besides, choosing this year’s theme means that the ICN recognizes that global healthcare is broken and would require restoration to an ideal state. Nursing the world to health requires that nurses take a bold and collective step to diagnose the gaps through an evidence-based approach and identify areas for intervention. Achieving a complete turnaround for a broken global health system would require coordinated efforts to call the attention of stakeholders to the issues and challenges. One of the ways to achieve this would be using our voices to nudge governments, corporate organizations, and establishments to invest in structural healthcare reforms. Nurses and midwives account for nearly 50% of the global health workforce4 and, therefore, has the numerical superiority to galvanize others to act. The reforms should provide efficient, effective,

and accessible healthcare services appropriate to all individuals irrespective of status, race, age, religion, tribe, or gender.

The creator of the voice did not create it to soliloquize. We use the voice to communicate ideas, and emotions, to convey believability for others to listen to and understand us. Therefore, our voices must be loud enough for others to hear us clearly and soft sufficiently to meet our demands empathetically. For us to put the

Voice

The voice is a gift of nature used in communicating to reflect the articulation of our opinions on issues. Nurses can also collectively use God’s given voice to amplify the views of the voiceless and the oppressed in our society or others who do not have the opportunities to speak the way we do.

Lead

To lead is to be in front to show the way or influence others to follow a particular pathway.

Invest

To invest in something is the art of financially sowing into an endeavor with the hope of having a harvest or bountiful returns on the money spent.

Right

A right is a legal or moral entitlement to something.5

Secure

To secure is ensuring that an object or situation is free from harm, risk, danger, or threat6

Global Health

Global health is “the area of study, research, and practice that prioritizes improving health and achieving equity in health for all people worldwide.”7

In my opinion, the 2022 ICN’s theme seemingly urges Nurses, which have a numerical superiority within any healthcare service area, to do whatever it will take to ensure that the global citizen has a sound mind and a sound body, which is a prerequisite for economic development. To this effect, we should not be afraid to voice our concerns and lead other healthcare professionals to speak out for things that would result in the health security of the individual the world over. In addition, to this year’s theme, nurses have been urged to pull other healthcare professionals to advocate for improved funding and investments in the healthcare sector. Besides, nurses should collectively work for safety guarantees of healthcare practitioners, nurses’ individual and collective respect, and be rightly remunerated for the frontline roles they play in periods of Pandemics and socio-economic adversities.

As COVID-19 broke out and spread across from the end of 2019, it was vivid that world leaders were more prepared for wars of guns, missiles, bombs, rocket launchers, mines, and nuclear weapons but unprepared for the wars propelled by viruses. It also showed that only a fraction of the world’s population has adequate access to medicare. According to Geyman, “the COVID-19 pandemic has exposed long-standing system problems in US health care ranging from access barriers, uncontrolled prices and costs, unacceptable quality, widespread disparities and inequities, and marginalization of public health.’8 If this was true for the United States of America, one could only guess the situation in less developed countries.

From the breakout of the Pandemic to October 2020, which was less than one year of its spread, the International Council of Nurses chief executive Howard Catton, averred that 1,500 nurses across 44 countries had died from the scourge. The worrisome thing about this number is that it had equaled the number of nurses who died during WWWI,9 yet, the Pandemic was just about half the cycle of its spread.

The high death rates globally could allude to the unpreparedness and ill-equipped international community health systems. It brought to bear the inability of the global health systems to respond efficiently and effectively to the social crisis of medical origin on the global scale of the Corona Virus Pandemic. Sadly, paying lip service to healthcare development by the international governance system is also responsible for the brokenness of the global health system. For example, Nigeria budgeted N2,000 for the healthcare of each citizen in 202010. Other reasons for the high death rates include the push for private sector-driven government-backed Medicare subsidies and privatization of almost all the facets of the healthcare industry to a capitalist system that cares more about maximizing profits.

Also problematic is that big businesses consistently connive with a segment of healthcare professionals to push for the digitalization of healthcare services in the healthcare industry’s value chain, which shall, in the long run, make the interface between nurses and their clients almost non-existent. In years to come, artificial intelligence, robotics, sitting behind transparent protective cubicles, and emphasis on pathology and treatment shall further widen the gulf between the Nurse and the clients, thereby destroying the people-centered approach, which underscores the importance of nursing as a profession.11 With the capitalists’ unending appetite for large profits, medical care suffers quality assurances, defective architectural medical designs, and poor policy implementations, which are partly responsible for the COVID-19 catastrophe.

Besides, the lack of adequate research incentives for Nurses globally, inadequate data for cross- functional and comparative cross-country analysis, ill-equipped hospitals, and lack of or insufficient personal protective equipment seem to be some of the challenges besetting us. Besides, the slow improvements in policy regulations added to the disappointing responses to the COVID-19 Pandemic. Other reasons for the death rates include work overload and burnout due to inadequate manning capacities and a lack of incentives.

The high death rates of Nurses and other healthcare professionals during the Pandemic underscores the urgency for Nurses to use the power of their numerical strength within the medical team to galvanize healthcare professionals to canvas for health for all individuals and the protection of Nurses.

If we had to see our dreams for efficient and effective medicare come to fruition in the next decade, we must put our hands on the plow. Secondly, we will need to get into the driver’s seat to lead advocacy for improvement in global medicare to protect every individual and the healthcare team. In the long run, such advocacies with the eventual positive outcomes shield medical professionals from untimely deaths seen with the COVID-19 Pandemic. Thirdly, nurses’ advocacies should use a multidirectional, cross-functional and multidimensional approach. Some of our advocacy approaches should deliberately target the alignment of our inter and intra- professional mechanics, shifting the Government’s focus to evolve into more purposeful healthcare planning and policy implementations.

Nurses’ practice area

  • Irrespective of our specialties, we should stand together as a resonant voice to lead in the advocacy for improvement in access to care, promoting a people-centered approach to health; and ensuring that we can influence healthcare policy planning and implementation processes.12
  • Nurses should rise to vent the mantra, “Mens Sana in Corpore Sano,” which means having a healthy mind in a healthy body as the only way the individual can positively contribute to a nation’s economic development.
  • Nurses should also advocate for the Government and all our social partners to put enlightenment campaigns in place for good eating habits by the citizens. These campaigns should commence from the lower levels of our educational settings in the creche, nurseries, and primary and secondary schools using catchy phrases like “eat to live.”
  • In asking others to follow us in our advocacy for improved public health for the global citizen, the Nurse should be capable of displaying exemplary behaviors and deep concerns for the wellbeing of the patient and colleagues.
  • Exhibit professional competence, confidence, and knowledge.
  • Build partnerships across the medical team’s value chain and seek the medical team’s support in the outreach for an efficient and effective healthcare system.
  • Every Nurse dealing with other health professionals and external clients must be a model resembling the attractive cover of a book, capable of attracting, influencing, and spreading the good news about the profession.
  • Every client that comes to the Nurse must feel a sense of tender loving care and empathy
  • Acquire soft skills to communicate with team members unambiguously.
  • A reinvention of the cardinal virtues of Florence Nightingale, which include ethical purity, care for the poor and seeking ways of taking them from poverty, commitment to the good of the patient, and knowledge-seeking endeavors,
  • Refrain from the petty jealousies, rivalries, and the pull-them-down syndrome, which some professions engage in to suppress the views of others
  • Use your voices, body language, and skills to teach and inspire the weak, the infirm, and those in grief. Your voice should motivate others to willingly follow, persuade and inform colleagues, medical team members, clients, and all that come our way to discharge our professional duties.
  • Nurses should Train, develop and sharpen their negotiation skills to get what investments flow toward the healthcare rebuilding process. Chester Karrass says, “In Business, as in life, you don’t get what you deserve; you get what you negotiate.”13
  • Carry out persistent advocacy to compel governments and healthcare institutions to:
  • Increase health financing, improve the recruitment, development, training, and retention of the health workforce in developing countries; work towards reducing the

global maternal mortality ratio to less than 70 per 100,000 live births.14

  • Improve the capacity of Public Health Institutions globally; to recognize early warning signs of national and global health risks and proffer effective and efficient

risk reduction strategies and their Management.15

Role of the Hospital Management

  1. Nurses should prep hospital authorities to invest in purchasing medical equipment and consumables. It was embarrassing to see hospitals wean some patients of oxygen and other medical supplies from those perceived will not survive to those who have a greater chance of survival.
  2. Hospital authorities and the diseased control centers should strengthen data collection and report on infections, ill-health, and deaths among health and care workers16 promptly and promptly.
  • Use the lessons learned during this COVID-19 Pandemic to invest in the safety and protection of healthcare workers.
  • Deliberately invest in training and re-training healthcare professionals in an appropriate distributive manner, giving all team members a sense of equity and equality.
  • Seek grants to enable Nurses to research gaps in our healthcare systems and proffer evidence-based solutions, which would help restore clients’ health to pre-hospital visitation status.
  • Emplace an inclusive governance system that is fair, just, transparent, and accountable.
  • Emplace a mutually inclusive, and evidence-based nursing practice
  • Prepare Nurses and other healthcare professionals to build coping mechanisms and resilience to overcome burnout and social crisis associated with Pandemics in the future.
  • Provide social support, which would use early warning signs to arrange for the screening for mental health illnesses and early supportive interventions for high‐risk nurses. During periods of adversity and overwhelming workloads, hospital authorities should allow adequate rest periods and prepare healthcare systems, individuals, and nurses to respond better against future Pandemic recurrence.17
  1. Provide support for cross-functional team building and teamwork.

External Advocacy Role of the Government

Plan, enunciate and implement public health policies in an inclusive, mutually beneficial, apolitical, and evidence-based medical science approach.

  1. Invest in the qualitative expansion of healthcare facilities to accommodate the diverse mix within our medical and social spaces.
  2. Every political leader seeking elective office should commit to universal health coverage and people-centered care, which will involve nurses in planning and formulating policies related to their practice.18
  • The Government should Focus on the training and recruitment of proportionate healthcare professionals to man the organograms in every hospital setting
  • Discourage the brain drain syndrome that has crippled Nigeria’s healthcare sector by providing appropriate incentives to healthcare professionals.
  • Emplace deliberate training policies to attract more nurses into the profession
  • Involve nurses in the process of policymaking for them to vividly see the lacunae and galvanize their colleagues to bridge the gaps.

Networking with Civil Society Organizations

The Nurse and Midwifery Associations and Colleges of Nursing should cultivate networks from local to international forums across the socio-political spaces for continuous advocacy for governments to invest in multi-disciplinary healthcare teams to deliver on the commitments made in the 2018 Astana Declaration. The declaration encourages countries to ensure the development of patient-centered care, which is community-based and closer to the people.19 Once we can use advocacy to achieve these, it becomes easier to achieve universal health coverage.

The press is a veritable tool for advancing one’s views, agenda, and ideas. There is no doubt that we have not been visible enough, and this needs to change. People need to hear our voices on the electronic and print media from time to time

Politics

There is the need to cultivate better networking strategies with the political class and possibly become frontline politicians, which would avail us the opportunities to push for friendly healthcare legislation. To that effect, joining politics at the local, state, and national levels to sway the opinions of various State and National Assemblies would not be a bad idea.

Unfortunately, many of us see politics in Nigeria as dirty. My opinion is that politics is like any other profession. Politics is noble, but some politicians portray politics as unclean because of the do-or-die and win-or-scatter mindsets. When we run away for fear of being brutalized, those who do not wish us well will take over the turf. If we cannot because we think the turf is slippery, we can sponsor bills and use the lobby instrument. Not doing any of these will reduce our chances of making the world hear us.

I want to end this paper by saying, God Has Given You a Voice. Don’t Waste It.20 Thank you, and God bless

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FOOTNOTES

1Dr. Louis Brown Ogbeifun, is a former President, States School of Nursing, Warri, Former President, Bendel State Schools of Students Nurses and Midwife Association of Nigeria, former National Treasurer of the Student Nurses Association, former President, Petroleum and Natural Gas Senior Staff Association of Nigeria (PENGASSAN), former 1st Deputy President General of the Trade Union Congress (TUC) and former President, Institute of Mediators and Conciliators of Nigeria (ICMC). He is a trained Nurse and a certified Nurse Anaesthetist. He is a CEDR (UK) and MTI (USA) accredited Mediator, a Workplace Trainer and Manager of Workplace Conflict. He is currently a Mediator on the Panel of Neutrals at the High Courts of the Federal Capital Territoty and Edo State. He retired from the services of the NNPC as Manager, Employee Relations (ER) in 2015.

2https://www.mcalesternews.com/news/local_news/5-things-to-know-why-was-florence-nightingale-important-

to-the-nursing-profession/article_228621f0-08cd-5e00-b44f-7fc8d9e7fcf5.html

3 https://www.iaspaper.net/international-nurses-day/

4 World Health Organization (2022). Nursing and Midwifery. Accessed May 07, 2022 https://www.who.int/news- room/fact-sheets/detail/nursing-and-midwifery

5 www.yourarticlelibrary.com/essay/law-essay/rights-meaning-features-and-types-of-rights..

6 https://dictionary.cambridge.org/dictionary/english/secure

7 https://en.wikipedia.org/wiki/Global_health

8 Geyman, John (2021). COVID-19 Has Revealed America’s Broken Health Care System: What Can We Learn?. Accessed April 23,2022. PubMed https://pubmed.ncbi.nlm.nih.gov/33435794/

9 Nursing Times (2020). Known Covid-19 nurse death toll ‘is now equal that from WW1. Accessed May 02,2022. https://www.nursingtimes.net/news/coronavirus/known-covid-19-nurse-death-toll-now-equal-that-from-ww1-27-10-2020/

10 Dataphyte (2019) Nigeria budgets N2,000 for the healthcare of each citizen in 2020. Accessed, May 03, 2022,

11 Nurselabs (2018): ICN: ‘Nurses a Voice to Lead – Health is a Human Right’ https://nurseslabs.com/icn-nurses-a- voice-to-lead-health-is-a-human-right/

12 Nurselabs (2018): ICN: ‘Nurses a Voice to Lead – Health is a Human Right’ https://nurseslabs.com/icn-nurses-a- voice-to-lead-health-is-a-human-right/

13 Karrass L. Chester (n.d.): ( http://leadershipquote.org/you-get-what-you-negotiate/

14 United Nations In India (.n.d) SDG 3:           Good health and Well-being. Accessed on May 07, 2022 https://in.one.un.org/page/sustainable-development-goals/sdg-3-2/

15 United Nations In India (.n.d) SDG 3:           Good health and Well-being. Accessed on May 07, 2022 https://in.one.un.org/page/sustainable-development-goals/sdg-3-2/

16 World Health Organization (2021). Health and Care Worker Deaths during COVID-19. Accessed May 03, 2022.

https://www.who.int/news/item/20-10-2021-health-and-care-worker-deaths-during-covid-19

17 Galani Petros et.al (2022). Nurses’ burnout and associated risk factors during the COVID‐19 pandemic: A systematic review and meta‐analysis. Accessed May 03, 2022 https://www.ncbi.nlm.nih.gov/pmc/articles/P MC8250618/

18 Nurselabs (2018): ICN: ‘Nurses a Voice to Lead – Health is a Human Right’ https://nurseslabs.com/icn-nurses-a- voice-to-lead-health-is-a-human-right/

19Wass         Val         (2018):         The         Astana        declaration        2018.         Accessed         May        7,         2022, https://www.tandfonline.com/doi/full/10.1080/14739879.2018.1545528

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