politics in nursing profession essay

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Nurses as heroes, warriors and political activists

Karen h. morin.

1 College of Nursing, University of Wisconsin‐Milwaukee, Milwaukee WI, USA

Diana Baptiste

2 Johns Hopkins University School of Nursing, Baltimore MD, USA

What a better time to address nurses as heroes and political activists than on this, the 200th birthday of Florence Nightingale and in the year of the nurse and midwife? Who better to serve as the model for what nurses must be—guardians and advocates of patients’ welfare? Nurses’ experiences during COVID‐19, visibly documented during nightly news broadcasts, have raised the public's awareness of what nurses do on a daily basis. Such awareness has resulted in the public labelling nurses as heroes. In other words, the public recognises nurses for their courage, bravery, commitment, knowledge, resilience, advocacy and persistence in the face of incredible adversity. Consequently, the public now has a better idea of nurses’ work. However, it is important to acknowledge nurses’ work has not changed; rather, it is public perception that has changed.

One often thinks of heroes as wearing a uniform—think capes, for example. Since the global outbreak began, images of nurses wearing N‐95 masks, face shields and other personal protective equipment (PPE) have quickly spread across news media platforms fostering a newly established public image for nurses as heroes. Nurses have always worn uniforms and PPE; however, their current apparel is now being perceived as life‐saving and critical to the public's health. Heroism in the nursing profession is not a new concept. Nurses across the globe have served as humanitarians, lifesavers and advocates for more than two centuries. Visionary nursing leaders such as Florence Nightingale, Mary Seacole, Mary Mahoney, Adelaide Nutting and Lillian Wald have paved the way for modern‐day nurses to be champions of health care and social justice. Nurses have always answered the call to serve their communities during times of crisis (American Nurses Association,  2020 ).

As nurses continue working in a healthcare arena drastically changed by the COVID‐19, antecedent issues intensify during these unprecedented times. Nurses have stepped forward to identify and formally address threats to patient and nurse safety. They have taken to the streets to protest the lack of needed equipment and safe working conditions. When nurses in the United States marched on the White House protesting lack of PPE, they risked having their employment terminated. Nurses in a healthcare facility in California were suspended for refusing to care for COVID‐19 patients without appropriate equipment—fortunately, they were reinstated and able to return to their usual duties. In Chicago, nurses gathered 6 feet apart outside of a hospital demanding more PPE and safer staffing ratios. Nurses have also engaged in counter‐protests, facing protesters rallying for lifting lockdown and stay‐at‐home orders and reading the names of nurses who have been infected with COVID‐19 and have died while working to care for people infected with COVID‐19. These nurses are to be applauded for taking a stand—for being activists at a time when support from leaders and colleagues may be limited, and even absent.

What does their behaviour mean for the rest of us? Terry and Bowman ( 2020 ), examining nurses’ environmental activism, found that activism was triggered by threats to human health. The COVID‐19 experience epitomises threats to human health. Historically, nurses have always served as advocates and warriors for social justice. Consequently, now is the time to revisit and reinforce our professional commitment to being advocates for patients and communities by increasing our political activism. Importantly, it is time to take risks by voicing loudly issues threatening patient safety in healthcare organisations and in the larger public arena. It is the time to support public health efforts to address pandemic concerns. It is time to confront elected officials about their commitment to addressing the social determinants of health and social justice. It is time for nurses to be politically sophisticated (Jaurigue & Schmidt,  2020 ), to seek and serve on district, state or national organisations, to run for political office. Nurses during COVID‐19 demonstrated unwavering courage—that courage needs to be made operational through political activism. To do less devalues our commitment!

• American Nurses Association (2020). ANA response to COVID‐19 pandemic . Retrieved from https://www.nursingworld.org/practice‐policy/work‐environment/health‐safety/disaster‐preparedness/coronavirus/ana‐covid‐19‐statement/ [ Google Scholar ]
• Jaurigue, L. , & Schmidt, C. (2020). Political activism: Preparing future nurses to impact healthcare policy . Arizona Nurse , 73 ( 1 ), 10–12. [ Google Scholar ]
• Terry, L. , & Bowman, K. (2020). Outrage and the emotional labour associated with environmental activism among nurses . Journal of Advanced Nursing , 76 , 867–877. 10.1111/jan.14282 [ PubMed ] [ CrossRef ] [ Google Scholar ]

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'We all need to be political'

Lucy shares her opinion on the vital role of politics within nursing

When you think of nursing and politics, what springs to mind?

Maybe it’s nursing pay? Certainly you can’t have missed it. Or maybe you think about health policy and how that might have an impact on your working day, or your patients and the care you can give them?

Perhaps you think of safe staffing levels and retention? Mandated vaccines for health care workers? COVID policies? Maybe mandated hours spring to mind or placement availability. Or student funding?

Indeed, these are all things which can have an impact on the lives of nursing staff, and sometimes, consequently, on the lives of our patients. But they are also just the obvious ways that politics has an impact on nursing.

Wanting the best

When you’re a nurse, you want what’s best for your patients. Part of your job is to advocate for that.

With the NHS, health care is free for all at the point of access. It doesn’t matter if you’re unemployed, or a child, if you work a 40-hour week, if you’re a CEO or a minimum wage worker, if you drive a Porsche or catch the bus, you should get the same treatment, right?

When you're a nurse you want what's best for your patients 

Unfortunately, in reality this isn’t always true. Numerous studies have shown poorer health outcomes for different groups of people.

People from minority ethnic backgrounds tend to have poorer health outcomes. So do people living with low socio-economic status. As do those people who have learning disabilities or mental health conditions – beyond that of the physical illnesses that may be a part of their conditions.

And it is also true of patients who identify as LGBTQ+.

Access, experience and outcomes can be influenced by where people live in the country – not just how close they are to a hospital or how many GPs there are – but in less noticeable ways too.

Health inequalities

It’s important that we understand the causes and impacts of health inequalities so we can do what’s in our power to help our patients. While so much is systemic, often, the factors affecting inequalities can be changed.

Can we support our patients to make changes which will positively affect their health, such as quitting smoking, or exercising more? And can we tailor this to their individual circumstances? 

Let’s take someone with depression who came to hospital with diabetes. Let's say they are overweight, they do little exercise, they frequently miss their insulin dose.

If we just give them advice to exercise, eat better, and take their insulin, are they going to do this? Maybe. But it’s also possible that their depression is having an impact on their eating and exercise behaviours, and their ability to look after themselves.

For this person we might want to add in work with a therapist, or maybe they can visit a day centre where they’ll get help to make sure they take their insulin and receive mental health support. This is also political because the government might have cut funding for mental health services. Maybe they’ve cut funding for exercise programmes too.

We have the knowledge, the skills, the lived experience

Can we do something on a larger scale? Political decisions about the focus and scale of funding of public services has meant that often services which can help people have been cut back, meaning that the patients who really need the help may no longer be getting it.

There are also issues to do with housing, the cost of living and access to healthy food.

Nursing staff and students can help with these things through the way we tailor care, and through signposting, and outreach initiatives, but resolving socioeconomic determinants of health doesn’t stop with us. It’s not “just” a nursing issue, it’s political.

And that’s why all nursing staff should be political. We have the knowledge, the expertise, the lived experience – we see how health inequalities affect our patients. We can make our voices heard. Sign petitions. Write to MPs.

When we think about what is best for our patients, does that stop when they are discharged, or do we want it to continue?

Let’s stand for that change.

We are the future of nursing.

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