A Bleak Future Awaits Nurses in Traditional Employment Worldwide: Insights on Practice and Career Alternatives

Authors

  • Tracey McDonald Consultant Clinical Gerontologist, Professor and Chair of Ageing (retired 2018), Editor, International Nursing Review, the official journal of the International Council of Nurses (ICN), Geneva, Switzerland.

DOI:

https://doi.org/10.60099/prijnr.2023.262280

Keywords:

Capacity building, COVID-19, Employment policy, Health services management, Human rights, Nurse leadership, Models of practice, Political leadership, Politics, Workforce issues

Abstract

The COVID-19 pandemic has tested world leaders’ capacity to manage, and they have been found wanting. Traditional, institutionalised health services will shortly be unsustainable due to unconvincing leadership and inept managerial capacity to identify and alleviate risks to nurses and other workers on the pandemic front line. The aim of this paper is to share insights on nursing career and practice options to provide nursing services to our communities; and canvass anticipated resistance to nurses choosing autonomous practice models in independent business approaches to health care provision.
From analysis of the evidence and literature, it was found that the systematic ill treatment and mismanagement of nurses during the COVID-19 pandemic is appalling. Nurses are exiting hospitals and health systems across the globe. Some are leaving nursing itself. On any measure, the situation is a wholesale disaster and a wanton waste of skilled and dedicated people. When hospital and health systems become too toxic for nurses and nursing services to function fully and thrive, and when government officials and politicians trivialise and disrespect the work and value of nursing, it is time for nurses to consider other employment and practice model options. In conclusion, A groundswell of support is needed for nurses to remove normalised policies that bind them to medical control, and to break medical monopoly on universal health insurance funding to permit access by nurses to sufficient specified items to earn a wage as independent practitioners.
The implications for nursing and health policy makers are: nurse safety and practice integrity need to be central to policy deliberations that affect spending on risk management and reduction. Policies that put nurses and patients at increased risk encourage those with a choice, to abandon unsafe health system employment. Administrative accountability for staff and patient safety affected by their decisions has long been neglected in health systems around the world. It is time for a reckoning.

References

McDonald T. Getting the COVID‐19 pandemic into perspective: a nursing imperative. Int Nurs Rev. 2020a;67: 305-317. doi: https://doi.org/10.1111/inr.12608

Brissenden N. - Poor time to slash COVID funding: nurses. PerthNow 16 November 2022. https://apple.news/AYnqCyZSTSVmDaCiGOmNVAw [Accessed 23 November 2022].

Zollino A. - Are robots the answer to a nursing shortage? Reuters Now post 19 January 2023. https://www.news.com. au/national/are-robots-the-answer-to-a-nursingshortage/video/e65bd426f8c99785f94665797c32bcc1 [Accessed 20 January 2023].

Graham-Harrison E. - Economists hail end to zero Covid in China but huge human toll is feared. The Guardian Australia. 11 December 2022. https://apple.news/A6svByGqoT_6JAtQ9deAhxA ]Accessed 1 January 2023].

Pulrang A. - Things high risk people need now to fight Covid. Exploring disability practices, policy, politics, and culture. Forbes https://apple.news/AZaUDfR2ERouPLLzqrGjSEg [Accessed 10 January 2023].

McDonald T. Speak truth to power and consolidate the nursing visibility gained during COVID-19 Int Nurs Rev. 2022;69:255–260. http://doi.org/10.1111/inr.1276

Esterman A. - Thousands more Australians died in 2022 than expected. COVID was behind the majority of them. The Conversation 12 December 2022. https://apple.news/AWPw7HXLkRymy2w10jCseQA [Accessed 11January 2023].

Young E. - The Pandemic's legacy is already Clear. The Atlantic 30 September 2022. https://apple.news/AONPVCW1hS8-xJb4-JoEy6A [Accessed 23 November 2022].

McDonald T. Are we there yet? A guide to achieving endemic status for COVID-19 and variants. Int Nurs Rev. 2023; 00: 1-6. https://doi.org/10.1111/inr.12823

Finnis, A. - When will I test negative for Covid? How long Omicron infection can last and when are you the most contagious? Apple News 24 April 2022. https://apple.news/ASBDF_NcCTTWbVDT9c68cwQ [Accessed 10 January 2023].

Kavanagh A, Dickinson H. & Baxter N. - Doing away with COVID isolation rules means increased isolation and risks for people with disability. The Conversation 14 October 2022. https://apple.news/A0cue24yATdKbxpUMjHDQrg [Accessed 11 January 2023].

Giannini D. & Mitchell A. - Ministers chastised for health advice snub. PerthNow https://apple.news/APTZolc DUTT6KF26d6haLGw [Accessed 6 January 2023].

Butler M. - Minister for Health and Aged Care Australia. Radio interview 3 January 2023 with Graeme Goodings,FIVEAA https://www.health.gov.au/ministers/the-honmark-butler-mp/media [Accessed 10 January 2023].

Tilo D. - NSW to repeal automatic compensation claim for COVIC-hit workers. HRD Newsletter international 16 November 2021. https://www.hcamag.com/au/specialisation/employmentlaw/nsw-to-repeal-automatic-compensation-claim-forcovid-hit-workers/ 316598 [Accessed 10 January 2023].

Lu D. - "They can't ignore us any more": five women on long COVID and medical misogyny. The Guardian 18 October 2022. https://apple.news/AlyvMqmcXQ1yYAkdsPt62ZA [Accessed 23 November 2022].

Ruya, Y. - Packed ICUs and crowded crematoriums: COVID-19 roils Chinese towns. Washington Examiner 24 December 2022. https://apple.news/AHYLa_eCoSlSZcMzifAfZJQ[Accessed 11 January 2023].

Anderson T. - Myths of the pandemic deniers. TheAltWorld https://thealtworld.com/tim_anderson/myths-of-thepandemic-deniers [Accessed 12 January 2023].

Shah R. - The Covid emergency is ending. Politico 2 November 2022. https://www.politico.com/news/magazine/2022/02/11/covid-emergency-ending-lull-what-next-00008156 [Accessed 10 January 2023].

O'Brien B. - More than 7,000 nurses go on strike in New York City. Reuters 10 January 2023. More than 7,000 nurses go on strike in New York City | Reuters [Accessed 11 January 2023].

Maclellan K. - UK Strikes to continue after govt's talks with unions fail. Reuters 9 January 2023. UK strikes to continue after govt's talks with unions fail | Reuters [Accessed 12 January 2023].

ICN - International Council of Nurses. Finnish nurses call for improved salaries and working conditions to address nursing shortage and patient safety ICN News 4 April 2022 Finnish nurses call for improved salaries and working conditions to address nursing shortage and patient safety |ICN - International Council of Nurses Accessed 19 January 2023. [Accessed 12 January 2023].

Yan Z, Li JA, & McDonald T. Nursing education development in China (1887–1949): influences on contemporary nursing. Int Nurs Rev. 2014;61(3): 380-388. doi: https://doi.org/10.1111/inr.12113

Harris H. - German doctor is jailed for nearly three years and fined £25,000 for illegally issuing mask exemptions…Daily Mail Australia. https://apple.news/ATeUVBrA3RiqCkFLZcniVIQ [Accessed 6 January 2023].

Butler M. - Minister for Health and Aged Care Australia. Radio interview 3 January 2023 with Graeme Goodings FIVEAA https://www.health.gov.au/ministers/thehon-mark-butler-mp/media [Accessed 10 January 2023].

Payne S. - COVID-19 responsible for 14.83 million deaths, World Health Organization. ABC News 15 December 2022. https://apple.news/ASw98i6KNQ3G4raLE4L 7yuQ 1/1/2023 [Accessed 12 January 2023].

Wang H, Paulson KR, Pease SA, Watson S, Comfort H, Sheng PO, Aravkin AY, Bisignano C, Barber R M, Alam T, Fuller JE, Nay EA, Phan D, Jones D, Frish ME, Abbafati C, et al. (COVID-19 Excess Mortality Collaborators). Estimating excess mortality due to the COVID-19 pandemic: a systematic analysis of COVID-19-related mortality, 2020–21. Lancet, Published online/ March 10, 2022 https://doi.org/10.1016/S0140-6736(21)02796-3

Wong J. & Claypool E. Narratives, masks and COVID-19: A qualitative reflection. Qual Soc Work. 2021;20(1-2): 206-213. https://doi.org/10.1177/1473325020973330

Tanzida Akther SDBMKKRDSIRMRP. How Inadequacies in the Nursing Field Deteriorate the Quality of Health Care in a Developing Nation. Ann Rom Soc Cell Biol [Internet]. 2021May23 [cited 2023Jan.27];25(6):3467-75. Available from: https://annalsofrscb.ro/index.php/ journal/article/view/6106 [Accessed 18 January 2023]

McNamara A. - Nurses across the country protest lack of protective equipment. CBSNews 28 March 2020. https://www.cbsnews.com/news/health-care-workersprotest-lack-of-protective-equipment-2020-03-28/ [Accessed 11 January 2023].

Koy V, Yunibhand J. & Turale S. "It is really so exhausting": Exploring intensive care nurses' perceptions of 24‐hour long shifts. J Clin Nurs, 2020;29(17-18):3506-3515. https://doi.org/10.1111/jocn.15389

Bae SH, Pen M, Sinn C, Kol S, An B, Yang SJ, Rhee HY, Ha J & Bae S. Work hours and overtime of nurses working in Cambodian hospitals. Int Nurs Rev. 2022;69(2): 150-158. https://doi.org/10.1111/inr.12720

Koy V, Yunibhand J. & Turale S. Comparison of 12 and 24‐hours shift impacts on ICU nursing care, efficiency, safety, and work‐life quality. Int Nurs Rev. 2022;69(1): 38-46. https://doi.org/10.1111/inr.12715

Fontaine D. & Behring S. - Understanding the American nursing shortage. Healthline 11 August 2021. What's Causing the American Nursing Shortage? (healthline. com) [Accessed 18 January 2023].

Ellis D. - Doctors and nurses highlight what is needed to fill gaps and future-proof the healthcare system. Doctors and nurses highlight what is needed to fill gaps and futureproof the healthcare system (news-medical.net) [Accessed 18 January 2023].

Daniel D. & Thompson A. - Nurse job vacancies doubled during pandemic Sydney Morning Herald 16 July 2022. https://apple.news/AAqAL6zz7Tm27UwLLf9Vx5w [Accessed 10 January 2023].

Busby M. - Protesters march for fair pay for nurses and other NHS staff. The Guardian 8 August 2020. https:// www.theguardian.com/society/2020/aug/08/hundredsmarch-fair-pay-nhs-nurses-coronavirus [Accessed 18 January 2023].

Allegretti A. & Stacey K. - NHS workers could be banned from striking, No. 10 suggests. The Guardian 8 December 2022. https://www.theguardian.com/society/2022/ dec/07/nhs-workers-could-be-banned-from-strikingno-10-suggests [Accessed 16 January 2023]

United Nations - Articles 4 & 12. (1948) Universal Declaration of Human Rights https://www.un.org/en/ about-us/universal-declaration-of-human-rights [Accessed 16 January 2023].

Shapiro S. Solving the shortage: Give nurses a voice and provide opportunities for growth. Johns Hopkins Nursing. 2008;6(2) https://web.jhu.edu/jhnmagazine/summer 2008/features/solving.html [Accessed 30 January 2023].

Peek N, Sujan M, & Scott P. Digital health and care in pandemic times: impact of COVID-19. BMJ Health & Care Informatics. 2020;27(1):e100166. doi: 10.1136/ bmjhci-2020-100166 PMID: 32565418; PMCID: PMC7307522.

Ferguson A. & Gllett C. - Sleeping patients billed by doctors in latest case of Medicare rorts. Posted online 22 October 2022. https://www.smh.com.au/national/ sleeping-patients-billed-by-doctors-in-latest-case-ofmedicare-rorts-20221021-p5brt4.html [Accessed 16 January 2023].

McDonald T. Quo Vadis: A question of historical awareness. Int Nurs Rev. 2020b; 67(2): 1-6 June Issue. https:// doi.org/10.1111/inr.12575

Practice Builders - Increase your medical practice revenue by up-selling and cross-selling. Website Practice Builders posted 19 January 2018. https://www.practicebuilders. com/blog/increase-your-medical-practice-revenue-byup-selling-and-cross-selling/ [Accessed 16 January 2023].

Yanatma S. - Doctors' salaries: Which countries pay the most and least in Europe? Euronews 3 January 2023. https:// apple.news/Ad6SR3xg9RmuRr7uJJPp7EQ [Accessed 6/1/2023]

Breadon P, Romanes D, & Fox L. - How do you fix general practice? More GPs won't be enough. The Conversation 7 December 2022. https://apple.news/AIWW27Lt0To 2V68gkuV21wA [Accessed 7 December 2022].

Downloads

Published

2023-04-07

How to Cite

1.
Tracey McDonald. A Bleak Future Awaits Nurses in Traditional Employment Worldwide: Insights on Practice and Career Alternatives. PRIJNR [Internet]. 2023 Apr. 7 [cited 2024 May 14];27(2):201-12. Available from: https://he02.tci-thaijo.org/index.php/PRIJNR/article/view/262280