Strength, trust, leadership, and willingness to take risks enables the professions of nursing and midwifery to drive changes to improve global health.
On the eve of International Nurses Day, around 30 people attended a breakfast hosted by the Rosemary Bryant AO Research Centre with Dr Rosemary Bryant AO and other key South Australian stakeholders in the fields of health, nursing, politics and research. Rosemary is the namesake of UniSA’s Rosemary Bryant AO Research Centre and Chair of the Centre’s Steering Committee.
With the strength of nurse leadership presenting as a key theme throughout the morning’s event, Dr Bryant drew on significant experience, including her roles as Director of Nursing at the Royal Adelaide Hospital, Executive Director of the then Royal College of Nursing, Australia, President of the International Council of Nurses (ICN), and Australia’s first Commonwealth Chief Nurse and Midwifery Officer.
Beginning her keynote address, Dr Bryant covered many salient points, touching on the current political landscape and situation faced by nurses, midwives, and the professions more broadly. Rosemary highlighted the effect of climate change on global health, not only from the increasing prevalence of bushfires, droughts, and flooding, but also acceleration of zoonotic disease spread arising from warmer global climates and habitat destruction. She also noted that beyond climate related events impacting our global health the invasion of Ukraine and other humanitarian crises should be at the fore of our minds as we support those who have suffered loss and displacement and consider the implications of war on global health security.
Turning to home, Rosemary spoke about the challenges we have encountered and that we continue to grapple with, after over two years of the SARS-CoV-2 pandemic.
The implications of the pandemic are more wide-reaching than addressing the immediate health consequences of the virus. These include the increasing reports of domestic violence, changing landscape of the acute and primary healthcare system, and the moral and distress-related impacts felt widely throughout the health workforce and population more broadly.
Within the nursing and midwifery workforce the prevalence and impact of burnout has been highlighted by ANMF members in their responses to the ‘COVID-19 and your wellbeing survey’, undertaken by the RBRC. The findings of this survey are just one part of a greater story proving it is critical that nurses and midwives have a say in planning for and responding to emerging challenges across the health environment, so that as a nation we can move forward healthily and sustainably together.
While Rosemary acknowledged that the professions have come a long way over the last few decades, there are still barriers to nurses and midwives in taking on key leadership roles at all levels of health and decision-making, including in government.
Reflecting on this point and her time in taking on the role of ICN presidency in 2009, Rosemary drew on her watch words of ‘access’, and the complementary and enabling factor of ‘equity’; identifying that nurses and midwives are key to addressing barriers to access and equity of healthcare, and that this requires nurse and midwifery leadership at all levels.
Rosemary commended Australia’s universal healthcare system, but as a large nation with a relatively small population largely condensed into metropolitan areas, there are still barriers to healthcare for many people – especially those living in regional and remote areas and people in low socioeconomic status groups. Further, while the work of nurses and midwives is widely regarded as essential – particularly throughout the pandemic, she commented that it is key we build a commentary that promotes nurses as the critical asset that they are rather than a financial liability to the health and aged care system.
In highlighting opportunities to address health disparity in issues of access and equity, Rosemary discussed the role of primary healthcare nurses and midwives, particularly as they look to support Aboriginal communities, and others living rurally and remotely.
Notably, in relation to midwives, Rosemary highlighted a need for greater support to birth close to home and for Aboriginal women to birth on country, with a quarter of all women being required to birth away from home with the closing of midwifery services nationally. New midwife-driven models of care will be required to turn this tide and increase access to birthing and other health services in rural and remote communities. Similarly, in an ageing population, the role of the nurse in providing and innovating healthcare to older Australians as they seek to live at home for longer will be invaluable.
It is not only in addressing issues of access and equity however that the role of the nurse and midwife is critical, at all levels, nurses have been increasingly recognised as key leaders. Pertinent examples raised were in those of infection prevention and control, and communication and education in health literacy and evidence-based practice; an awareness and understanding of which are critical to the delivery of safe and quality healthcare, and a healthy population.
Further, in the face of workforce shortages, the key role of nurse educators in supporting the development of our next generation of nurses will be crucial as will be access to ongoing nurse education and opportunities for continuing development. In summarising the changing face of healthcare in a post pandemic world, Rosemary noted finally that we are more technologically driven than ever – with telehealth and data sharing a mainstay of modern health initiatives. However, as this change continues it is the nurse and midwife that will lead the blending of technology with the humanity of the professions.
The role of nurses and midwives, Rosemary said, cannot be ignored, and as we move forward in the wake of the pandemic, facing growing risks to health locally and abroad it is nurses and midwives now and in the future that continue to emerge as leaders. These nurses and midwives, demonstrating not only strength and trust in their leadership across all aspects of healthcare, are also willing to take a risk. And a risk, Rosemary noted, and as can be seen in the legacy of her career pioneering nurse leadership, can be the catalyst to change – one that advances the profession and delivery of healthcare for all.
Returning finally to her colleagues and those present, Rosemary reflected on her time witnessing nurse leadership at all levels, from the ward to her time as Chief Nursing and Midwifery Officer. Rosemary congratulated and commended all nurses and midwives for their hard work, determination, and commitment to delivering the highest quality healthcare.
The Rosemary Bryant AO Research Centre is a partnership between the University of South Australia and the Rosemary Bryant Foundation. The Centre aims to strengthen the role of the nursing and midwifery profession across the health system through the development of a research-driven, evidence-based platform of healthcare. To achieve this, the Centre has developed a comprehensive research program focused on advancing the discipline of nursing and midwifery, and patient care in the domains of population and public health, workforce reform, safety and quality, clinical practice, patient outcomes, and integration into education.
Casey Marnie works at the National Policy Research Unit (Federal Office), Australian Nursing and Midwifery Federation (ANMF) and the University of South Australia, Clinical and Health Sciences, Rosemary Bryant AO Research Centre.