OVERVIEW
“Nurses’ holistic view of their role and responsibility
in the health care system and their knowledge, based on research
and experience is invaluable to the evolution of any health
care system. For this knowledge to affect the
provision of health care it must reach the policy makers,
and health policy must reflect the knowledge generated by
research and experience. It therefore calls for nurses’ active
participation in political action and policy development,
either as policy makers themselves or in cooperation with
policy makers.”
Asta Moller
|
Why a Nurse Politician Network?
The following issues have been identified with regards to status
of women and nurses politicians worldwide:
| a. |
few women are actively involved today in politics whether appointed
or elected at any level – provincial, national, regional.
The Nordic countries have the highest number with female
representing 40.8% of elected officials. The rest of Europe shows
a rate of 17.45%, close to both Sub-Saharan Africa and Asia - with
16.6% and 16.4% respectively while, in the Arab states, the rate
stands at 8.8%. |
| b. |
even fewer nurses are elected. For example, in Iceland and Norway
which belong to the country group with the highest rate of women
in politics, the nurse representation in the parliament is respectively
3.17%, and 2.95%. |
| c. |
nurse politicians, like nurses and women everywhere – often
shoulder responsibilities of home, family and career. This
means juggling personal, family and professional issues with those
of their constituents and party. |
| d. |
Further pressure comes from the health care system and the profession,
creating expectations that are sometimes unrealistic. |
| e. |
As women, nurses share same vulnerabilities to harassment. Moreover
their jobs often take them away from families for long periods,
creating separation and isolation. |
| f. |
As nurse politicians these women and men have valuable insights
to share with each other, and with nursing more broadly. |
For all these reasons, ICN established the NPN given the important role nurse
politicians have to play in influencing health and social policy.
What is the purpose of the Network
The ICN Nurse Politician Network (NPN) is designed to serve as a forum for
elected and appointed nurse politicians to communicate. As it, NPN is
the international link for nurse politicians to exchange information and learn
from each other. It can assist in the mentoring of new and/or aspiring nurse
politicians.
ICN will beneficiate from the network which represents an access to skilled
lobbyists and policymakers who can offer advice and help identify key current
and future issues.
MESSAGE FROM THE CHAIR - Asta Möller, Chair of the Nurse Politicians
Network
“Welcome to the ICN Nurse Politicians Network page! As Chair
of the Network and a nurse politician, I am pleased to be part of this
new initiative, one I believe will bring benefits to ICN and nurse
politicians alike.
For many years, the International Council of Nurses (ICN) has had
a strong interest in developing and strengthening the nursing influence
in health policy. This includes encouraging nurses to take an active
part in policy making and political decision-making processes.
The past few years have seen more nurses enter politics and today
several serve as Ministers of State, members of parliament, and as
provincial and state legislators as well as in positions in local government.
I personally became involved in 1999 when I was asked by
the Prime Minister of Iceland if I would be interested in running for
a seat in Parliament. As things evolved I was elected a
member of the Icelandic Parliament, Althingi, in May 1999. It
continues to be a stimulating and satisfying experience, and there
is no doubt that my preparation as a nurse and my experience as President
of the Icelandic Nurses Association - and as an ICN Board member -
have served me well.
The Network offers nurse politicians, often working in isolation,
a vehicle to share knowledge and experience and exchange and test ideas.
As well it provides new and experienced politicians with the opportunity
to develop mentoring relationships.
The Network is primarily a safe place for nurse politicians to meet.
Aside from this page, nurse politicians have access to a restricted
space for information sharing and exchange.
In addition to being a vehicle of support to current politicians,
the Network members are invited to:
- Share their expertise in policy and advocacy with global nursing.
- Assist ICN in identifying and monitoring political trends and issues
affecting health care, nursing and society in general.
- Serve as a political opinion resource to ICN.
I hope to meet many nurse colleagues through the Network and look
forward to Network members sharing ideas and advice with the broader
ICN membership.
With best wishes,”
Asta Möller MP, Iceland.
MEMBERS OF THE NPN STEERING GROUP
Asta Moller, Chair of the Network
Asta Möller has contributed considerably to nursing and health care in
Iceland as a nurse and politician. She served as president of the Icelandic
Nurses Association between 1994 and 1999. She became involved in politics when
she ran and won a seat in Parliament in May 1999. Since then she has sat on
various committees and, since 2005, has chaired the Icelandic Delegation of
the Inter-Parliamentary Union. Aste served as a Board member of ICN and
subsequently as Second Vice-President.
Mo-Im Kim
Mo Im Kim, ICN Past President, is recognised internationally for her contribution
as a practitioner, educator, politician and policy leader. She is considered
the architect of Korea’s primary health care system. In 1981,
she became the first nurse elected to the Korean parliament where she influenced
national health policy and legislation. She also served as the Minister
of Health and Welfare and was President of the Korean Women’s Political
Caucus in 2003.
Laila Davoy
Laila Davoy, a former ICN Board member, has a long career in government and
politics. She served as a State Secretary and Deputy Minister before
becoming President of the Norwegian National Nurses Association. She
served as an ICN Board Member 1997-1999 and in government was twice appointed
Minister: Minister of Labour and Government Administration and Minister of
Children and Family Policy. Since October 2005 she is an elected member of
the Norwegian parliament.
Rowaida Al-Ma’aitah
Rowaida Al-Ma'aitah is a Senator in the Upper House of the Jordanian Parliament
and also serves as a consultant on health and social development to HRH Princess
Muna Al-Hussien and as a member of the international women parliamentarians
steering committee on child protection. She formerly served as Minister of
Social Development, Minster of Government Performance, and President
of Hashemite University as well as Vice President and Secretary General of
the National Council for Family Affairs.
“There has never been a greater need for nurses to
get involved in the political and and policy process. Nurses
are needed to ensure that shrinking resources are best used
for the health of the nation, to find ways to provide affordable
access to health care for all and to promote the debate about
the relationship between broad social factors and health”
Rains, J. W., & Carroll, K. L. (2000). Journal of Nursing
Education, Vol. 39, No.1 37-40.
|
MEMBERSHIP
Membership is open ONLY to:
- Nurses presently or previously elected or
appointed at national, provincial/state and supranational levels.
Members need to have access to the internet and, presently, to be
able communicate in English.
Membership benefits
NPN benefits include:
- Opportunity to gain knowledge of political working worldwide.
- Up-to-date knowledge on nursing and health trend and issues.
- Support from colleagues in other countries.
- Access to efficient lobbying on key issues.
- Strategic links with other elected people
"I know from my own experience that if nurses do not
accept the responsibility and enter the battle field to
fight in favor of the social support systems that make
the life of families and individuals better and benefits
the whole society, others would eagerly and happily step
in do so, sometimes for the worse.”
Asta Möller
|
To become a member of the NPN, nurses elected or appointed
at national and supranational levels you will need to fill in the form
below.
EXPERIENCES OF NURSE POLITICIANS
An interview with Asta Moller
http://www.icn.ch/inr_111.pdf
SPEECHES/PAPERS
Influencing Health Policy, Asta Möller
speech, NPN Chair
ICN Council of National Representatives in Copenhagen, Denmark in June 2001
Ten years ago, then a fairly new president of a nurses association
in Iceland, I wrote an article on Nursing and Politics in our Nursing
Journal. The main purpose of the article was to encourage nurses
as individuals and as a profession to take an active part in policy
making and the political decision making process and by doing so, contribute
their knowledge and expertise to mould the society they live in. I
stated that nurses have an obligation to do so for the benefit of the
society. I argued that the nursing profession in its research and in
its work with clients in various settings, is in a unique position
to get valuable insight in the needs, expectations and interests of
the people who are the most vulnerable in the society, the sick, the
disabled, the elderly, the poor, young families, drug addicts and alcoholists
to mention a few. This gives nurses an exceptional opportunity
to experience and evaluate the quality and effectiveness of the basic
societal systems. I stressed that if nurses would not take
the torch and influence health and social policy, others would eagerly
and happily step in to do so, for the loss of the society.
When I wrote that article in 1991, I could not in my wildest dreams,
imagine that eight years later I would be elected to my national Parliament
and in the position of having to prove my case, being placed at the
core of the political arena.
In my presentation today I have decided to share with you some thoughts
on nursing involvement in influencing health policy and political decision
making. The background paper on the issue has been distributed and
you should have it before you for your reference in the discussions
in this forum, and in my presentation I will touch on some of the points
made there.
Why should nurses want to have political influence?
Politics affects all aspects of life. Political decisions determine
the quality of life of people, their human rights and security, the
economy of a nation which affects every household; housing and working
conditions, education, social support, health and well being of individuals
and families. Strategies to affect these determinants of the
standard of living of people involve policy development and political
action.
The nurses holistic view on their role and responsibility in the
health care system and their knowledge based on research and experience
is valuable for the ongoing evolution of the health care system. For
this knowledge to affect the provision of health care it must reach
the policy makers and health policy must reflect the knowledge generated
by research and experience. Many of the most significant advances in
public health policy can be made only in the context of political debate
and it is in this forum that experience and research are transmitted
to policy. It therefore calls for active participation
on the nurses behalf in political action and policy development, either
as a policy maker her- or himself or in cooperation with policy makers.
(1)
Rains and Carroll (2000) stated that “..there has never been
a greater need for nurses to get involved in the political and policy
process. Nurses are needed to ensure that shrinking resources
are best used for the health of the nation, to find ways to provide
affordable access to health care for all and to promote the debate
about the relationship between broad social factors and health” (2)
Public funding for health care services is in constant competition
with funding for other sectors of the society, some equally important,
such as social services and the educational system, some less. Decisions
taken in the political arena decide the distribution of funds to different
sectors of the society and also the division of funding and therefore
priorities between various sectors of the health care system. In
order to influence decisions and safeguard the interests of nurses,
the profession and the service they provide, nurses will have to influence
decisions on all levels of the society, from top governmental level
to “the floor level” in order to preserve the priorities
and projects the profession emphasises, including their own affairs
such as working environments and salaries. To to so we
will have to place ourselves in a position to get message through by
using information, personal and political connections and other traditional
and innovative political methods.
But what are the nurse contributions to health policy and in politics
in general.
Discussion on the importance of nurses involvement and active participation
in the political arena and in policy making is not new. Actually,
the discussion have been on for decades, with a slow progress, probably
though slightly accelerating recently due to increased self-esteem
and new understanding, interest and opportunities of nurses, as well
as women in general, to take active part in policy making and politics.
Nurses are the largest group of health professional and most often
also the largest (individual) professional group of women in most countries. That
gives them an impressive and important power base, the nursing
profession has to value and make use of.
One senior nurse-politician was quoted saying that becoming involved
in the political process to promote sound policy for nursing practice
and health care is an extension of the nurses role as a patient advocate.
She said that the patients we care for deserve safe, quality care and
as we continue to face political policy on health care issues that
affect nursing practice and patient care we must make our voices heard. (3)
Another nurse politician was quoted saying that “ Nursing has
something special to bring to policy. Health policy is nursing
practice” (4) Unfortunately, however, I must say that this
is a cliché. Affecting health policy is usually not included
when nursing practice is described. Nurses do not regard health
policy as an integrated component of their profession and it is not
a natural part of their professional identity. I think
I can generalise and say that nurses have not yet realised how strong
their powerbase actually is.
It has been stated that nurses bring a unique quality to politics. In
their research on 27 nurse politicians, Gebbie, Wakefield and Kerfoot,
conclude that nurses bring a special knowledge and skills to the policy
arena, which they have gained in their nursing education and in practice. They
specify clinical observation skills along with interpersonal communicational
skills that enable them to assess and analyse situations, to face different
interests, to reduce tensions and solve conflicts and to mobilise people.
They say, and I quote:“ If you know how to get kids to take their
medicine, you can work with a lot of people”. The
quality of adding real life experiences to quantitative information
when health policy decisions are also taken as valuable assets of the
profession. Furthermore, the similarities of the basic
process of nursing, which is a problem-solving process, to the basic
process of democratic government; that is gathering information on
a problem, to identify probable actions or solutions to the challenges
presented, and to get widespread support and actions from many actors
to get the problem solved. These similarities of the working methods
are to the advantage of nurses in policy development and politics. Other
important skills mentioned are the ability of nurses to be flexible,
to have an overview of a situation, to be prepared for the unexpected,
to work under pressure and to balance competing priorities. These
qualities are inseparable parts of the nursing practice. (5) These are qualities
that nurses have, that are also valuable in another context and nurses
will have to make use of it.
It is of concern that nurses are reluctant to reveal their identity
as nurses when they present themselves as politicians. It has been
articulated that nurses are sometimes perceived as being on less intellectual
than other professionals, so that their input is discounted. Furthermore
it is reported that nurses do not seem to value their own and other
nurses´ political involvement and input and therefore weaken
their collective power. Sadly, I have to confess that I believe
that these scenarios are somewhat true and point out that many nurse
politicians do not use their R.N. title, compared to, for example,
physicians who always add their title to their names, and quite
many nurses choose a new and different track in their education for
the purpose of increasing their credibility as politicians and policy
makers.
Why have nurses not been active in politics and in policy making.
Many factor contribute to the fact that nurses have been inactive
and relatively powerless in general in influencing health policy and
politics on a national level. .
I will now place me in the position of a devils advocate and name
a few ot theses factor, as I know that these will stir you. :
- The socialisation of nurses as under-ordinates of other health
professionals.
- The oppression of nurses as a group.
- The fact that the majority of nurses are women and women tend to
view power and politics negatively.
- The working hours of nurses and domestic responsibilities in their
homes that often rely on women, prevent them from political activism.
- The difficulty of nurses to describe the nature of their
profession and its valuable contribution to the well being of people.
- The invisibility of nursing in the media.
- Lack of health policy education and political socialisation in
the nursing curriculum.
- The history of the nursing professions to be reactive rather that
proactive in national policy setting.
- Possible weak organisation of nurses at professional and union
levels.
In conclusion I would like to introduce you to the way Icelandic
nurses in recent years went about to strengthen their position as an
influential force in health policy development.
In 1994 the two organisations of registered nurses that had been
functioning separately for some years merged into one. The
new association, The Icelandic Nurses Association, with the strong
support and solidarity of Icelandic nurses, has been able to establish
itself as a powerful professional and organisational body of nurses
in the country. Since then, the association has been able to
raise the salaries of nurses considerably, changed the pension fund
for nurses for the better and formed new Code of ethics for Icelandic
Nurses. Furthermore in 1997 the agenda of the Icelandic
Nurses’ Association in nursing and health affairs was passed. The
policy, which results from many years of work, describes the principal
theories of the profession regarding nursing and the patients, the
education of nurses, the their role in society and the future vision
of the health service in Iceland. This policy created stronger
grounds and stronger voice for the leaders of the association to increasingly
form a position on the matters of the day in the society and for actively
participating in discussions on nursing and health issues in the country
with the objective of influencing policy decisions on these matters. This
stand is also mirrored in the new code of ethics of Icelandic nurses
that were passed in 1999. The rules state the following on nursing
and the society: “The registered nurse initiates and actively
participates in policy formulation and strengthening the health service”.
According to this policy, the Icelandic Nurses’ Association
has in recent years prepared several reports on health issues and related
matters that are being discussed at any given time, or on matters which
the nurses are interested in casting a light upon. The association
has also conducted studies, for example, on the shortage of manpower
in nursing and research of violence against the healthcare staff, and
on the workload and job satisfaction of registered nurses. The
results of these studies and surveys have been used to draw attention
to the working conditions of nurses and on measures to improve them. The
conclusions and ideas of the Association have been introduced to both
the national authorities and the general public through the news media,
as well as to the nurses in general through association’s professional
journal. The objective is to actively participate and affect
debate and decision-making in society - for the benefit of the
patients, society and the nursing profession.
The position and the influence of the nurses in Iceland are evidenced
by the fact that until recently and for the past 6 years the minister
of health was a nurse, and she was among 3 nurses out of 63 members
of the Icelandic parliament. A large number of nurses are
active in politics on the municipal level as elected politicians and
many of them hold leadership positions in this capacity. Nurses
hold important positions in the office of the Directorate General of
Public Health and in the Ministry of Health, where a nurse is
stand a in for the first in command in the ministry and nurses are
appointed to all governmental committees that deal with nursing and
health matters. Nursing director are appointed in all health institutions,
and nurses hold financial positions in several hospitals and health
agencies. This is not to say that we have won the war, we are
actually still fighting the same battles all of you are on the same
fronts, you all are.
In the ICN code of ethics for nurses says the following: “The
nurse shares with society the responsibility for initiating and supporting
action to meet the health and social needs of the public, in particular
those of vulnerable populations”
I believe that if nurses are determined to fulfill these responsibilities,
the nursing profession has to strategically empower itself politically
by for example integrating political socialisation in the nursing curriculum,
by providing nurses with opportunities to acquire and practice political
skills, by encouraging and supporting them to take an active part in
political parties and Nongovernmental organisations and to support
them to stand for a office in political elections at all levels.
The nursing profession has to realise that they command over a tremendous
political power if they care to make use of it. It is my firm
believe, that for the benefit of the people, nurses must take necessary
measure to activate the profession to political participation.
In conclusion I would like to quote Margaretta Madden Styles, the
former president of the ICN, and this is one of my favourite quotes
in this context. She said:"Victory will be won the day that all
nurses appropriately convinced of their social contribution and social
value, are filled with self-assurance and self-esteem, and take pride
in their profession, the day they announce without hesitation or equivocation, "I
am a nurse.".
| (1) |
Collins, C. ,Coates T.J. (2000) American Journal of Public Health
1389-90 |
| (2) |
Rains JW, Kelley, LC (2000), Journal of
Nursing education, Vol 3, 1, 37- ) |
| (3) |
Shumaker (1999), Making
our voices heard in the political arenas, AORN
Journal Jan 99, vol 69 p.8- |
| (4) (5) |
Gebbie KM, Wakefield M, Kerfoot K. (2000),
Nursing and health policy, Journal of Nursing Scholarship 3rd
quarter 2000, Vol 32,3, 307- ) |
| |
|
| Rains, J. W., & Carroll,
K. (2000). Journal of Nursing Education, 39, 37-40. |
************************************************************************************************************************
How can nursing influence politics and policy,
Asta Möller speech,
NPN Chair
ICN Congress, Taipei, Taiwan, May 2005
The issue here today is nursing, politics and policy. These
three words in a way describe my professional life for the past 16
years, the last six with particular emphasis on politics. In
1999 after having served as a president of the Icelandic Nurses Association
for 10 years I was elected a member of the Icelandic Parliament in
a general election. That same year I joined the board of
directors of ICN and became its second vice president two years later.
Let me start my presentation by stating that in every situation,
in every setting, leadership is needed and can be exercised.
I would like to share with you some snapshots of events and discussions
that have relevance to our discussions today.
Earlier this month I attended a meeting where a ministerial working
group was introducing its ideas on building of a new national hospital
in my country, which would replace its old buildings. The
group was lead by a nurse, who is the former minister of health and
social security. They were describing how the ideology of Practicing
Patient Centered care can be made come true in the architecture and
designing of a hospital. The message was “to put
care back into health care." , by designing the new hospital with regard
to the needs of the patients. These ideas were widely reported
in the media. It was an instant hit, the politicians, the public
and the health professionals bought it and loved it. This
is an example of nursing ideology derived from the core of nursing
influencing policy and political decisions.
The second scene was a telephone call that I received from a nurse,
who is the CEO of a non-profit umbrella organisation on welfare of
children with long term diseases. The subject was: How can we
influence a situation concerning a young man with long term illness
on a respirator living at home and needing a very complicated care? The
patient and his family identified 18 different people from the home
care centre nursing him over a period of one week. The
centre has the unwritten policy of not allowing the nursing personnel
to be too attached to the patients, which explains the number of people
caring for him. I think you can agree that this is an example
how nursing has failed to influence policy.
The third scene is a meeting of a group of nurses called upon to
discuss the editorial policy of the Icelandic Nursing Journal, on the
occasion of its 85th anniversary. One of the subjects discussed
where on to which extent the Journal would publish articles on policy
matters and statements from the nurses association on politics and
policy. The issue was in fact on to whether the nursing profession
wanted to use its own resources to have their voices heard in the society.
The fourth scene is one that I, as a nurse and a politician, frequently
encounter, which is to decide whether I want to intervene and
take part in a public debate on, for example,
- prostitution;
- on a possible opening of a shelter for battered women and their
children or for that matter a closing of it due to financial circumstances;
- on difficult situations of young mothers,
just to name few important subjects that concern the clients of nurses
and are important social matters. Many of you experience that
same urge to intervene, either personally or in the capacity of a position
you hold.
In all instances these scenes call upon leadership of nurses and
nursing and whether they as individuals or as a profession are able
and willing to take an active part in policy-making and the political
decision making process. They call upon them to decide whether they
want to accept the responsibility of contributing their knowledge and
expertise to influence the society they live in.
In my mind, there is no doubt. I believe that nurses have the
obligation to intervene and let their voices be heard for the benefit
of the society.
The nursing profession, in its research and in its work with clients
in various settings, is in a unique position to get valuable insight
in the needs, expectations and interests of the people who are the
most vulnerable in the society, the sick, the disabled, the elderly,
the poor, young families, drug addicts and alcoholics to name a few. This
gives nurses an exceptional opportunity to experience and evaluate
the quality and effectiveness of the basic societal systems.
It is also in accordance with the ICN code of Ethics for Nurses,
where it says, and I quote: “The nurse shares with the society
the responsibility for initiating and supporting action to meet the
health and social needs of the public, in particular those of vulnerable
populations.” 1
I know from my own experience that if nurses do not accept the responsibility
and enter the battle field to fight in favor of the social support
systems that make the life of families and individuals better and benefits
the whole society, others would eagerly and happily step in do so,
sometimes for the worse.
Why should nurses want to have political influence?
Politics affects all aspects of life. Political decisions determine
the quality of life of people, their human rights and security, the
economy of a nation or community which affects every household, housing
and working conditions, education, social support, health and well
being of individuals and families. Strategies to affect these
determinants of the standard of life people live in involve political
action and policy development.
The nurses holistic view on their role and responsibility in the
health care system and their knowledge, based on research and experience
is valuable for the ongoing evolution of the health care system. For
this knowledge to affect the provision of health care it must reach
the policy makers and health policy must reflect the knowledge generated
by research and experience. It therefore calls for active participation
on the nurses behalf in political action and policy development, either
as a policy maker her- or himself or in cooperation with policy makers.
Collins and Coates have discussed the relationship between science
and politics. They say that “Many of the most significant
advances in public health policy can be made only in the context of
political debate, but it has its most profound impact when it changes
the very nature of the national political discussion. The pertinent
question it not how to insulate public health research from politics,
but how to use research more honestly and effectively to inform the
politics of public health.” 2
It has been stated that “..there has never been a greater need
for nurses to get involved in the political and and policy process. Nurses
are needed to ensure that shrinking resources are best used for the
health of the nation, to find ways to provide affordable access to
health care for all and to promote the debate about the relationship
between broad social factors and health” 3
Public funding for health care services is in constant competition
with funding for other sectors of the society, some equally important
as health care, such as the educational system and social services,
some less. Decisions taken in the political arena decide the
distribution of funds to different sectors of the society and also
the division of funding and therefore priorities between various sectors
of the health care system. In order to influence decisions and
safeguard the interests of nurses, the profession and the service they
provide, nurses will have to influence decisions on all levels of the
society, from top governmental level to the floor level in order to
preserve the priorities and projects the profession emphasises, including
the working environment and their salaries. To influence the
political decision making process for the benefit of the cause the
profession is committed to, we have to put ourselves in a position
to get message through by using information, personal and political
connections and other traditional and innovative political methods.
But what can nurses contribute to health policy and in politics in
general.
Discussion on the importance of nurses’ involvement and active
participation in the political arena and in policy making is not new. Actually,
the discussion has been on for decades, with a slow progress, probably
though somewhat accelerating recently as the increased self-esteem,
understanding of the value of taking active part, new opportunities
and increased interest of nurses, as well as women in general, to active
participation in policy making, are opening new grounds.
Nurses are the largest group of health professionals and most often
also the largest individual professional group of women in a country. That
gives them an impressive and important power base that the nursing
profession has to value and make use of. However the fact
that in most countries the nursing profession is predominantly a women’s
profession does inevitably and unfortunately affect the status of the
profession and its ability to exert its political influence, whether
we like it or not.
One senior nurse-politician was quoted saying that becoming involved
in the political process to promote sound policy for nursing practice
and health care is an extension of the nurses´ role as a patient
advocate. She said that the patients we care for deserve safe, quality
care and as we continue to face political policy on health care issues
that affect nursing practice and patient care we must make our voices
heard. 4
Another nurse politician was quoted saying that “Nursing has
something special to bring to policy. Health policy is nursing
practice” 5
However, I must point out that affecting health policy is usually
not included when nursing practice is described. Nurses do not
regard health policy as an integrated component of their profession
and it is not an acknowledged or accepted natural part of their identity. I
think I can generalise and say that nurses do not yet feel how strong
their powerbase actually is. To empower nurses with more confidence,
health policy education and political socialization should be an essential
component of nursing curricula on graduate and postgraduate levels. It
is also important the NNA provides nurses with opportunities, in formal
or informal manner to acquire social and political skills such as public
speaking, to enable them active participation in the political arena. In
1997, when the members of the Icelandic Nurses Association, in which
I was a president at that time; were entering an industrial action,
the association organised a course in public relations for nurses that
were workplace representative in various settings. They were
given the opportunity to prepare themselves to write articles, hold
speeches and meeting the press. For example, each and every nurse
in the group experienced being interviewed by a reporter on a TV camera
and the group reviewed and criticised it afterwards.
Some have said that nurses bring a unique quality into politics. In
their research on 27 nurses politicians, Gebbie, Wakefield and Kerfoot,
conclude that nurses bring to the policy arena a special knowledge
and skills, which they have gained in their nursing education and in
practice. They specify clinical observation skills along with
interpersonal communicational skills that specially enable them to
assess and analyze situations, to face different interests, to reduce
tensions and solve conflicts and to mobilise people. “If you
know how to get kids to take their medicine, you can work with a lot
of people”. The quality of adding real life experiences
to quantitative information when health policy decisions are taken
were also taken as valuable assets of the profession. Furthermore it
must be pointed out that the basic process of nursing, which is a problem
solving process, is quite similar to the basic process of democratic
government; that is information gathering on a problem, to identify
probable actions or solutions to the challenges presented, and to get
a widespread support and actions from many actors to get the problem
solved. Nurses are equipped with and therefore familiar to skills and
working methods that are used in the political and policy making process. Other
important skills mentioned are the ability of nurses being flexible,
to have an overview of the situation, to be prepared for the unexpected,
to work under pressure and to balance competing priorities. These qualities
are inseparable parts of the nursing practice. 6
I think it is of great importance that nurses be encouraged to join
and actively participate in political parties, and whenever possible
should be encouraged and supported morally and/or financially to stand
for office in political elections on local or national levels. My
first step into the political arena was to enter student politics during
my university years. After that I took an active part in
a political party that is consistent with my conviction and political
ideas, first by being a member of the party’s committee of health
and social policy and later the chairman of that same committee. Being
elected as the president of the Icelandic Nurses Association enhanced
my political status and visibility and in 1999 I was asked to stand
for election in my national parliament and was elected. I would
like to mention that after the elections three nurses were members
of the Icelandic parliament out of 63 members and one became the minister
of health and social security.
It is however of concern that research on nurse-politicians has shown
that nurses are reluctant to reveal their identity as nurses when they
present themselves as politicians. It has been reported that nurses
are sometimes perceived as being on a lesser intellectual plane than
other professions, so that their input is discounted. Furthermore
it is reported that nurses do not seem to value their own and other
nurses´ political involvement and input and therefore weaken
their collective power. I am sorry to say that I believe that
these scenarios are somewhat true and point out that many nurse politicians
do not use their R.N. title and quite many add a new and different
track in their education for the purpose of increasing their credibility
as politicians and policy makers. To stress the point I am making: Physicians
who are politicians usually make a special effort to introduce themselves
with both titles, which other professionals, nurses included, rarely
do.
But how can we increase the credibility and visibility of nurses
in politics
I believe that one of the most important factor that can contribute
to enhancing the image of nurses and nursing is to assure that the
educational level of registered nurses is comparable to that of other
health professionals. If
their education is on a lower level than other health professionals in general,
there is a lesser chance that they will be accepted in their own right.
For the voices of nurses to be recognised and regarded in a collective
way, it is important that National nurses associations formulates
their policy on issues, publish the policy and present them to nurses,
the authorities and the general public. The NNAs must also take
the initiative in the debate on politics of health and social issues
that are currently in the public eye or need to be brought to the public
and political attention. In the process the association must
present its view in a high standard in the evaluation of circumstances,
reasoning and presentation of its view. High quality discourse
has its returns in increased respect for the opinions of the profession
and increasing influence in political decision making.
It is also of high importance that nurses demand that their expertise
in the field of nursing and organisation of health care services be
recognised within the system, by calling for inclusion of nurses on
the staff of health ministries and committees on health policy making. I
would also like to stress the importance of nurses working with other
health professionals, such as physicians, on issues that are of mutual
interest. It increases the credibility of both the issue and
the groups involved.
In conclusion I would like to tell you about a new initiative that
ICN is planning, which is a ICN nurse politicians network. Membership
is open to nurse politicians currently or previously elected or appointed
at national level. The aim is to organise a forum of nurse
politicians, where they have the opportunity to meet virtually on the
internet and/or in person and benefit from it personally and politically. We
will also look upon them to act as advisors to ICN and nursing globally
by identifying key health and social issues that need attention. I
would like to use this opportunity to urge you to contact me and forward
names of nurses that are or have been member of their national parliaments
in your country. My mail address is on my last slide.
I will finish with a poem, made in the time of the Vikings, around
the year one thousand and was preserved in the Icelandic Sagas. In
the context of this presentation I would like to say: Nurses
command over a tremendous political power if they care to make use
of it. It is their moral obligation to activate their profession
to political participation for the benefit of the people - and
remember - No battle is won in bed.
The early bird
Wake early if you want another man´s life or land
No lamb for the lazy wolf
No battle´s won in bed
| 1 |
ICN code of Ethics for Nurses. www.icn.ch. |
| 2 |
Collins, C. ,Coates T.J. (2000) American Journal of Public
Health 1389-90 |
| 3 |
Rains JW, Kelley, LC (2000), Journal of Nursing education,
Vol 3, 1, 37- |
| 4 |
(Shumaker (1999, Making
our voices heard in the political arenas,
) AORN Journal Jan 99, vol 69 p.8- |
| 5 |
(Gebbie KM, Wakefield M, Kerfoot K. (2000), Nursing
and health policyJournal of Nursing Scholarship 3rd quarter
2000, Vol 32,3, 307- ) |
| 6 |
Gebbie KM, Wakefield M, Kerfoot K. (2000), Nursing
and health policy Journal of Nursing Scholarship 3rd quarter 2000, Vol 32,3,
307- |
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