Nursing and Health Policy Perspectives


Is it time for nurses to write from their anger?

March 2013 is not a good time to be writing this editorial. By the time it appears in print, a new ICN President will have been elected at the 25th Quadrennial Congress in Melbourne, and his or her chosen theme made public. Other news from Congress will also be buzzing on the ICN website, and this editorial will seem to be ‘old hat’ and out of date.

One theme does however carry over during this ‘inter-regnum’ – that of nurses and policy-making, and how they make their influence felt. This was the subject of my editorial in the March issue, in which I emphasised how important is the assistance of governments in helping nurses when they develop innovations in practice, particularly in international partnerships.

In this issue however we have two papers that provide examples of potentially more malign national and international policy influences. I believe that nurses need to be aware of these influences and, arguably, to protest.

First, Dr Bill Holzemer's Guest Editorial (Global interprofessional education: is the time now? Pages 145–146) highlights how unequal nurses are in this project. From national policies to those of the World Health Organization, numerous issues of status and power marginalize nurses. As a result the idea of interprofessional education always assumes the physician as leader, and ignores the progress that nurse education has already made in many of the proposed areas under consideration.

The second paper is a Commentary (Courage and selflessness in professional actions: but are they enough? Pages 201–204) by INR Associate Editor Dr Je Kan Adler-Collins. Commenting on the Role of nurses in a nuclear disaster: experience of the Fukishima Dai-ichi nuclear power plant accident (Pages 196–200), Dr Adler-Collins emphasizes how vulnerable nurses and other health professionals were in this man-made disaster. Volunteers were apparently ill-protected for an event that no one had ever dared contemplate in all its horror. He concludes that failure to learn the lessons from Fukishima (which has been compared to the melt down of the Chernobyl Nuclear Power Plant in 1986) means that governments continue to develop and maintain similar initiatives with insufficient thought as to their possible consequences. Such consequences could once again put at risk the lives of thousands of people, and demand courage and self-sacrifice from ill-prepared and ill-protected volunteers.

What strikes me on reading these two papers is how passionate, indeed angry, are both these authors about the situations that they describe. This is a fairly unusual situation for nurses. More usually nurses keep their emotions, whether on failures in the workplace or in the wider environment, well hidden. Nurses have been trained not to show anger – for it is argued that this is counter-productive. Perhaps the time is now ripe for us to consider just how productive concealing our emotions has proved to be in the past, and whether a change of tactic might be necessary in the future.

This is my swan song – my fortieth and final editorial in 10 years of editing INR. Rather than ‘bowing out gracefully’ I leave with a challenge. Could nurses start publishing from their hearts as well as their heads and begin to address the policy issues that really matter for the health and well being of all?