nursingforsocialjustice

The past 18 months has forced Canadians to navigate a health crisis unlike any most have seen in their lifetime. COVID-19 has challenged people around the world to change their behaviours to curb the spread of a virus. Canadians were challenged to work together, but the fight against COVID-19 has illuminated so many gaps in the healthcare and social welfare system. Nurses are front and centre in this fight. Erosion of nurse jobs is not a recent phenomenon, the push pull of valuing nurses while also cutting funding to ensure safe workplaces, adequate training, and support for them to competently practice within their full scope has been going on for the past century. 

A year ago, amidst lockdowns, and bombardment of new information about illness and death rates, the public was unsure and afraid of what the future would hold. The collective health of the nation was in flux, and a collective voice stood together banging pots and making noise when healthcare workers were leaving their shifts out of gratitude. 440 000 of these healthcare workers are nurses: Registered Nurses, Registered Psychiatric Nurses and Licensed Practical Nurses. But nurses need more than banging pots. Nurses need the public to listen to their recommendations, research, and reports about healthcare issues.

In the continuous scroll of social media there is public support for what nurses do, while at the same time ambiguous understanding of what nurses do. It is heartwarming to know that public perception is of nurses as the metaphorical heart of the healthcare system, but nurses are also the head, the arms, the legs and the backbone of the system. The COVID-19 crisis highlights the lack of understanding the public has about the nurses role.

The Canadian healthcare system is composed of many different healthcare staff, professionals and non-professionals, government regulated and staff who are not regulated. Each person in their role fulfills a necessary piece of the structure that works together to create a functioning healthcare system. Nurses are the most numerous piece of this structure. Nurses are plentiful at the bedside and direct patient care level, but are also clinical leaders, managers, directors, CEOs, educators and researchers within the healthcare system. Nurses carry out doctor’s orders, but, depending on the setting, level of education and scope of their role, nurses also make the orders, initiate them and lead care. 

ICUs and high acuity medical areas have been overwhelmed with people with COVID-19, and also victims of the opiate overdose crisis. Those same ICUs, medical units, Emergency Departments also provide care to all people who require those services. If a bus crashes or an apartment building fire happens the people needing healthcare are going to be brought to the same hospitals that are treating very sick people with COVID-19. The majority of clinicians in those settings are nurses. Nurses train for crisis, it is not unusual for patients to become critically ill in a hospital or urgent care setting. The difference with COVID-19 is the number of people that are becoming critically ill and the numbers of nurses that needed to quickly pivot to specialty areas that they were not previously working in prior to the pandemic.  

According to the 2019 Canadian Institute of Health Information (CIHI) report on nursing, there were 439,975 nurses registered to practice in Canada. The majority of them are under the age of 50, meaning they have not lived through widespread health crises like AIDS in the 1980s. New graduate nurses today are being welcomed into the profession with a very different experience. The moral distress that is experienced, the level of health crisis that they are being exposed to right from their student practicums into the beginning of their professional careers is rife with stressors to a much magnitude than the short staffing, resource limitations of yesterday, they are also exposed to a population in collective health crisis, a very vocal segment of the public distrusting the expertise and guidelines recommended by health professionals, and death and sickness in greater magnitude than anything experienced in recent years. While this might not be happening in every hospital in every city and in Canada, collectively nurses are feeling this. 

Nurses are at the frontline. Canada needs them there, in acute settings, in the community, in long-term care, because nurses are the first and persistent healthcare clinicians that are providing care, treatment, health interventions that save lives but also help people understand the healthcare system. Your thank-yous and appreciation keeps us going. But, we need more than applause and accolades for the compassion and care that we deliver, we need young nurses, experienced nurses, frontline nurses and nurse leaders to see that we are valued in all the roles that we work in throughout the healthcare system. We need the public to understand that our experience and our knowledge does not emerge from being kind and empathetic, although this is something that is integral to the care provided, it comes from education, training, and research that are integral to the sustainability, progression and innovation of the healthcare system.