Irish nurses must campaign politically for improved health services as well as providing nursing care, a conference in Dublin was told yesterday.
Dr Marla Salmon, chairwoman of the World Health Organisation's Global Health Advisory Group on Nursing, said Irish nurses must help shape national health policy. Nurses' professional responsibilities "go well beyond the bedside," she told a Bord Altranais conference on Communicating the Essence of Nursing.
"As nurses we should see ourselves as caring for the well-being of all people, not just those we see in our daily work," she said. "The health of people depends on all professionals being active at a societal level through their civic and political action."
Dr Salmon, who is the Graduate Dean and Professor of Nursing at the University of Pennsylvania, also said she was concerned about the worldwide trend towards cost-driven health-care reform, with price competition as the primary focus for health policy.
"Until governments effectively balance the health needs of their peoples with the pressures of saving money and encouraging private enterprise, we will not see major gains in the health status of people," she said.
"The gap between the haves and the have-nots is only increasing, with more and more people worldwide having no real access to the living conditions and services that promote health."
The director of the Department of Nursing Studies at University College Cork, Dr Geraldine McCarthy, told the conference that only degree-level education would provide nurses in Ireland with parity of esteem with other healthcare professionals.
However, she warned that the essence of "what it really means to be a really good nurse" must not be lost in the transfer of nursing education to the university sector.
A member of the Commission on Nursing, Dr McCarthy said most of the 3,000 registered Irish nurses consulted in the compiling of the report agreed that the profession had been sold short in being provided with a diploma as an initial qualification.
Prof David Sines, head of the School of Health Sciences at the University of Ulster, said that nurses must be prepared to act as advocates on behalf of their patients, sometimes confronting other health professionals and mediating between patients and doctors on important decisions.
Adopting this role posed a major challenge to today's nurses, who had been trained and inducted into a nursing system that upheld administrative protocol and hierarchical systems.
Some doctors opposed the idea of nurses becoming advocates for their patients and wished to relegate nurses to a subservient status. They presumed it was their responsibility to discuss issues relating to diagnosis and prognosis, and suggested that nurses were not adequately prepared for this responsibility.
"One of the reasons suggested for the failure of nurses to report either poor or unacceptable practice to their managers has been the potential fear of reprisals."
He said the advocacy role of nurses included upholding the rights of persons without prejudice or discrimination, acting always in the patients' best interests and acting as an intermediary between the person and those providing or seeking to provide services for that person.