Nurses need to be “equal partners” at the policymaking table, rather than being given a seat as a token gesture, global nursing leaders have urged.
In an exclusive opinion piece for Nursing Times, Howard Catton and Judith Shamian, International Council of Nurses (ICN) chief executive and former president respectively, said more must be done to give the profession a meaningful voice across the world.
“Having a nurse present is merely a tokenistic gesture, it can do the profession more harm than good”
Howard Catton and Judith Shamian
They said nursing was often still perceived as a profession with little power, and that its importance remained frequently downplayed in some countries.
“In recent decades and in many parts of the world, we have seen an increase in managerialism in healthcare, with health being treated as a commodity that can be bought and sold,” they said.
“As a consequence, the roles of nurses and other healthcare professions have been squeezed, and in many places they have been marginalised and removed from the management of healthcare organisations.”
And, Mr Catton and Ms Shamian said, even when nurses are given a position of power, it does not always carry meaningful influence.
The pair warned that, in some countries, the position of government-level chief nursing officer (GCNO) was merely a token one – not a post with respect, resources and the power to enact necessary change.
They said: “Having a seat at the table implies that our first job as nurse leaders is to make sure that we are in the room when policy decisions are made, and in addition, assumes that by occupying a seat we are actively involved and influencing discussions and decision making.
“But is that necessarily always the case? To continue the dinner table metaphor, it is the guests who actively participate and make an impact that are remembered and invited back again.
“Just having a seat, rather than being actively involved and contributing to the discussions is never going to be enough. In fact, if having a nurse present is merely a tokenistic gesture, it can do the profession more harm than good.”
They advocated for an “executive” model of a GCNO to be used in all countries: one which has authority over nursing and/or midwifery, and that can shape health policy.
But they said this was not always the case when GCNO posts are created.
Mr Catton and Ms Shamian explained that, sometimes, GCNO positions were, instead, merely a “puppet” post which is doomed to failure by not being given any actual authority.
When this happens, the pair said, it sets nursing back: “Governments will only give us one chance, and rest assured, that if the first GCNO is ineffective, they will not be replaced, setting nursing back a generation.
“‘Puppet’ GCNO roles with no budget or staff are doomed to fail and to produce an ‘I told you so’ reaction from those in authority who do not want to give nursing (a gendered profession) a seat of power.”
They urged nurses to “take the opportunities afforded them when they are sat in policymaking forums” and governments to ensure nurses are “equal partners” at the table.