2020: The Year of the Nurse and the Midwife

Pat Stricker, RN, MEd
Former SVP, Clinical Services
TCS Healthcare Technologies

The Executive Board of the World Health Organization (WHO)

Image Credit: World Health Organization

has designated 2020 as the “Year of the Nurse and the Midwife” to commemorate the 200th anniversary of Florence Nightingale’s birth and celebrate the vital role that nurses and midwives perform in providing healthcare services. In many countries, nurses and midwives account for more than 50% of the healthcare workforce and are often the only point of care in their communities. By 2030, they will also account for more than 50% of the shortage in the global healthcare workforce. This year WHO will be highlighting nurses and midwives  work and their ability to overcome challenges that, in turn, help WHO achieve its goal of universal health coverage (UHC). WHO will also be advocating for increased financial support for nursing and midwifery workforces. The Director-General of WHO, Dr. Tedros Adhanom Ghebreyesus noted that “Nurses and midwives are the backbone of every health system: In 2020 we’re calling on all countries to invest in nurses and midwives as part of their commitment to health for all.”

Dr. Ghebreyesus went on to say that nurses are the "bridge" of healthcare, essential links between the people in communities, and the healthcare team and the complex healthcare systems. He also noted that they are on the “front lines” of healthcare and the key to achieving universal health coverage, a WHO initiative to bring adequate healthcare to all people across the globe.

[Click here to watch Dr. Ghebreyesus’ inspiring speech.]

The World Health Organization (WHO)

The World Health Organization is a global institution that services the 194 countries belonging to the United Nations. WHO has one mission:  “to assist each country in achieving the most optimum health possible for their people.” This is accomplished by:

• Educating the government on health-related laws and programs
• Helping to strengthen disease prevention efforts
• Managing health programs to meet the needs of local communities

One of WHO’s goals is to ensure that all people across all communities and socioeconomic statuses get quality universal health coverage (UHC), focusing especially on lower-income citizens who don’t have the financial ability to get preventive care.  WHO defines universal health coverage as “the ability for all people and communities to use the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship.”

Dr. Margaret Chan, WHO Director-General, noted that “UHC is one of the most powerful equalizers among all policy options. The declaration says it best: 'To promote physical and mental health and well-being, and to extend life expectancy for all, we must achieve universal health coverage and access to quality health care. No one must be left behind.'” 

WHO has been a supporter of nurses and midwifery since its inception in 1948. A report entitled Nursing and Midwifery in the History of the World Health Organization 1948-2017, celebrates the contributions nurses and midwives have made and the critical role they will play in the future.

It is challenging for countries to develop a motivated, efficient, competent, quality, and well-supported health workforce. The workers are the foundation of the health system and need to be supported in their role to improve health, protect the patients, and prevent and/or manage health emergencies. Making up over half of the health workforce, nurses and midwives are the unsung heroes and backbone of the primary care system, determining and organizing how healthcare is delivered.

WHO recognized the nurses and midwives critical contributions and has worked to establish, clarify and increase their roles. It developed expert committees for both groups to provide advice on solving critical challenges, such as the acute shortage of skilled personnel, recruitment and training needs, and employment standards. In addition, WHO planned, coordinated, and managed quality, cost-effective nursing and midwifery care programs and other initiatives, such as fellowship programs and people-centered care, which helped expand services and achieve an appropriate mix of skills. WHO continues to highlight the critical role nurses and midwives will play in the future.

In the beginning attention was given to developing basic health services, then it transitioned to primary health care within the community, and today it continues to focus on improving primary health care. It is safe to say that WHO has influenced the development of nursing, and midwifery and nursing and midwifery have influenced the development of WHO.

There were other leading healthcare executives who also commented on the roles of nurses and midwives and the significance of the “Year of the Nurse and the Midwife”:

Annette Kennedy, President of International Council of Nurses (ICN), noted that “This exciting proposal of the “Year of the Nurse and the Midwife” in 2020 will go a long way to raising the profile of nursing and highlighting the importance of the need for more well-educated nurses, of investing in recruitment and retention strategies and of removing the barriers to the development of advanced nursing roles that are proving highly effective at expanding healthcare coverage.”  She also said that “this is an important stepping stone for nurses for many reasons: it will promote an excellent standard of education for nurses, create better working environments to retain nurses in the field, and advocate for more advanced nurses, which in turn gets more people better healthcare coverage.”

Howard Catton, CEO of ICN, emphasized, “This celebration offers a platform to recognize past and present nurse leaders globally, raise the visibility of the nursing profession in policy dialogue and invest in the development and increased capacity of the nursing workforce. Nurses, who make up approximately half of the health workforce and who are intrinsically linked to the ability of countries to address health priorities and achieve the Sustainable Development Goals (SDGs), will turn the ambition of achieving health for all people into a reality.”

[NOTE: A Sustainable Development Goal (SDG) is “a global goal adopted by all United Nation Member States as a universal call to action to end poverty, protect the planet, and ensure that all people enjoy peace and prosperity by 2030.” There are 17 integrated goals with each one having the ability to affect outcomes in another, so they must balance social, economic, and environmental sustainability. While WHO works on all of them in some form, the goal most closely aligned to WHO’s health care goals is SDG3 – Good Health and Well Being.]  

Image credit: United Nations

Ernest J. Grant, President of the American Nurses Association (ANA), noted that nurses are “the largest group of health care professionals in the U.S. and the most trusted profession……There are opportunities to increase understanding of the value of nursing in order to expand investment in education, practice and research, as well as increase the numbers of nurses who serve in leadership positions. We look forward to working with partner organizations to communicate a contemporary and accurate view of nurses and the critical work they do, as well as challenge boards and other influencers to commit to nursing and nursing leaders in order to improve the nation’s health.”

Goals for the “Year of the Nurse and the Midwife”

WHO’s goals for the year-long effort are to:

• Amplify, promote, and celebrate the nursing and midwifery professions and their important contributions to healthcare
• Raise the status and profile of nurses and midwives
• Highlight the challenging conditions they often face
• Advocate for increased global government investments in nursing and midwifery workforces
• Educate others about the world’s need for 9 million more nurses and midwives by 2030 in order to achieve WHO’s goal of universal health coverage (UHC)

The NursingNow! Campaign was conducted from 2018-2020 by WHO and the ICN to improve global health by raising the profile, status and achievements of the nursing profession, and helping nurses to maximize their contribution to achieving universal health coverage. As of June 2019 there were 266 Nursing Now groups active in 89 countries. 

The campaign is also culminating this year with the release of WHO’s first State of the World’s Nursing report, due to be released in April. The report will describe the world’s nursing workforce (number and types of nurses, education, regulation, practice, leadership, and gender issues) and its role in helping to deliver UHC and to achieve WHO’s holistic 17 Sustainable Development Goals (SDGs). The report will highlight the policy goals for the next 3-5 years and how nurses will specifically help WHO achieve its “Triple Billion” goals to: 

• Promote Healthier Populations – 1 billion more people enjoying health and well-being
• Address Health Emergencies -  1 billion more people better protected from health emergencies
• Achieve Universal Health Coverage - 1 billion more people benefitting from UHC

Lord Nigel Crisp, the co-chair of the Nursing Now campaign, had very positive comments about “The Year of the Nurse and the Midwife” and the nurse’s role in healthcare: “Nurses are at the heart of most health teams and by enhancing and promoting their role, countries across the world will improve health outcomes for all people.”

Key Facts of Nursing and Midwifery
WHO recognizes that Universal Health Coverage is key to achieving all its other health targets (SDGs). That is why WHO has worked closely with nurses and midwives through the years to achieve one of its most strategic development goals (SDG3 – Good Health and Well Being) that is designed “to substantially increase health financing and the recruitment, development, training and retention of the health workforce in developing countries.”  Achieving these goals depends on having the appropriate number of well-trained, educated, regulated, and well-supported nurses and midwives, receiving pay that is proportionate with the services and quality of care they provide. Nurses and midwives are often the first and/or only health professional that people see in their communities, so their assessment, care and treatment are vital. WHO understands the significant contributions nurses and midwives make in ensuring patient-centered care in the community, as part of multi-disciplinary health care teams. They are essential in helping WHO achieve its goals for global UHC. That is why WHO has supported and championed these groups to assure they are able to continue to grow and prosper. 

The following facts and statistics show why WHO is working to strengthen nurse and midwifery workforces throughout the world.

• There were 43.5 million global healthcare workers in 2013 and 20.7 million were nurses and midwives.
• Today 50% of the countries in the world are experiencing shortages of nurses and midwives to accomplish WHO’s goals.
• We will need to add 9 million more nurses and midwives by 2030 to be able to achieve WHO’s UHC and SDG goals. That amounts to about 2,457 new nurses every day for the next 10 years.
• According to a report by WHO, investing in nurses is a good monetary value because it delivers a triple return for improved health outcomes, global health security and economic growth.  

While WHO is primarily focused on global healthcare, similar situations are also occurring in the U.S.

• There are 3.8 million registered nurses in the U.S., but only 84.5% (3.2 million) of them are currently in the active workforce, according to the 2017 National Nursing Workforce Survey.
• Researchers project that 1 million RNs will retire or leave the profession by 2030.
• The RN workforce is expected to grow to 3.4 million by 2026.
• It is estimated that nearly 11.6 million health care workers will be needed in the U.S. between 2016 and 2026 to fill new jobs (3.5 million) and replace workers who leave the occupation or retire (8.1 million).
• Annually, more than 135,000 registered nurses will be needed to fill new or vacant positions.
• Nursing programs currently graduate 155,000 new nurses every year (2015).
• An additional 203,700 new RNs are expected each year through 2026 to fill newly created positions and to replace retiring nurses.
• There are 12,300 nurse midwives in the U.S. based on 2019 statistics from the American College of Nurse-Midwives, however WHO does not have any statistics on midwives for the U.S.

How To Participate in the “Year of the Nurse”

As you can see, the World Health Organization, one of the largest international health care organizations, is definitely committed to furthering the nursing profession and is encouraging world leaders to do the same. It is gratifying to see it devote the entire year to nurses and invite others to join in the celebration and find ways to celebrate the “2020 Year of the Nurse and the Midwife.”

The ANA has already announced that they will be expanding National Nurses Week from one week in May to the entire month of May so there is more time to celebrate nursing and elevate the profession. The entire ANA Enterprise (ANE), consisting of the American Nurses Association (ANA), the American Nurses Credentialing Center (ANCC), and the American Nurses Foundation (ANF), said they will be celebrating the “Year of the Nurse” by promoting nursing excellence, encouraging leadership and supporting innovation in a wide range of activities, promotions, and contests that will be scheduled throughout the year.

One of the ANA activities is to encourage nurses to share their own stories to shine a spotlight on the beauty of the profession, the warmth and gratitude expressed by patients and their family,  and the joys and tribulations of lending a helping hand to others on a daily basis. This is a great time for us to show what the skill, science, and art of nursing can do to help others in navigating the healthcare landscape. If you want to share your story use hashtag #YON2020 or #YearOfTheNurse or sign up to follow them.

Another ANA activity is the “Year of the Nurse” poster. It is an official poster that will feature nurses from across the country. The idea is to send in a picture that defines you as a nurse. It can be a picture from home, work, or play; a selfie, group picture, or family snapshot. You could be chosen to be on the official 2020 Year of the Nurse poster.  Click here to upload your photo!

You can also still join Nursing Now by clicking here!

Look for other creative, innovative ways to get involved in your workplace or community to: 

• Raise awareness of the “Year of the Nurse.”
• Educate the community about the nurses’ role and contributions; plan community events.
• Work on a Nurses’ Week committee to plan fun events and gifts for the nurses.
• Improve nurse compensation, benefits, and training, if you have the ability to do so.
• Encourage gifted nurses to move into leadership positions.
• Encourage or conduct research that helps determine where nurses can have the greatest impact.
• Sharing examples of best nursing practice.

Conclusion

Nurses are the largest group of healthcare professionals in the U.S. They are the backbone and lifeblood of the care delivery system, and the heart of the healthcare team. They are the first, and often only, healthcare profession that people see, especially in less populated areas, so their assessment, care, and treatment are vital. They have a unique role in managing the needs of patients throughout their entire life and in all settings; providing community, primary and emergency care; and handling health promotion, case management, and disease prevention issues. And they do all of this while providing low-cost interventions and high-impact positive outcomes. Because of these roles and accomplishments, nurses are indispensable and essential to WHO and to all others who depend on them.   

These positive attributes are also seen by the American public who has a very positive view of nurses. According to a recent Gallup poll, the nursing profession is ranked as the most honest and ethical profession. Eighty-five percent of Americans rated nurses’ honesty and ethical standards as “high” or “very high”. The next ranking profession for honesty was engineering, which only had a 66% rating. And this is not the first time nursing has received this type of rating. Nursing has been rated as the most ethical and honest profession for the last 18 years in a row!  That is amazing, but not surprising! Nurses are terrific!  

ANA’s president, Ernest Grant, said he was “extremely proud that nurses everywhere have been bestowed this wonderful accolade by the people whose lives they touch every day. The fact that nurses have been consistently voted the most honest and ethical professionals is a testament to the public’s trust…I couldn’t think of a better way to enter into the “Year of the Nurse.”

Congratulations to all nurses everywhere!

Sstay tuned into CMSA Today publications as we recognize nurses and nurse case managers throughout the year!