Nursing shortage knows no boundaries

September 13, 2010

Recent news coverage of the six-month anniversary of Haiti's devastating earthquake overlooked a terrible tragedy: the destruction of a nursing school filled with more than 100 students and teachers.

The horrific event is significant not only because of the appalling loss of life but because it diminished Haiti's current and future nursing workforce — already severely understaffed — at a time when nursing skills are needed most.

Haiti's loss underscored a larger problem plaguing countries worldwide. Almost every nation, regardless of its wealth and resources, faces a continuing shortage of nurses and an acute lack of nursing faculty available to educate more nurses. This dearth of practicing nurses and nurse educators is particularly critical in countries like Haiti and other developing high-risk, low-resourced nations.

According to the International Council of Nurses, the U.S. and the U.K. have about 1,000 nurses per 100,000 people. In developing countries like Chad, Gambia, Uganda and almost anywhere in sub-Saharan Africa, the ratio drops to a measly 20 nurses for every 100,000 inhabitants.

Reversing this global trend requires a global perspective and global nursing. Today, experienced nurses in every corner of the globe are helping nations build the capacity to provide not only nursing care but also basic health care to their populations. They work across national and geographic boundaries to educate more nurses, train other health care workers, conduct research, enhance health care practices and change national and local policies to improve patient care.

This new breed of global nurses is culturally sensitive and collaborative and realize that conditions like heart disease, cancer, obesity, diabetes and infection have no borders. They are broadly trained to provide all aspects of education and health promotion and to deliver care in critical areas such as immunization, disease prevention and crisis management. They also understand that what happens in one part of the world affects other parts, including the U.S.

The world's most serious health threats — swine flu, infection control, tuberculosis, malnutrition, cardiovascular disease, natural disasters and man-made conflicts — call for this global perspective and a renewed emphasis on health care capacity building and innovation that transcends national boundaries and overcomes political barriers.

Nurses are well positioned to be major actors on this global stage. Despite the growing nursing shortage, they remain the largest, most widely distributed and most respected group of health care professionals in the world, with an estimated 12 million nurses working to improve health in 125 countries. They are among the world's thinkers, decision-makers, innovators and trail blazers who are on the front lines in dealing with national and international health issues. And they are poised to address — and capable of resolving — the world's most pressing health concerns.

But we need more of them. Through global nursing, we can grow and expand the education and positioning of more nurses. These nurses will develop and lead health care delivery capacity — from systems-building to policy making. They will conduct the research essential to determining and measuring the best practices of nursing in an endless variety of settings and locations. They will partner with others to collaborate across borders and overcome obstacles. They will create global solutions.

Martha Hill is dean of Johns Hopkins University School of Nursing. Her e-mail is XX.

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