I originally wrote this reflection on the hottest day ever recorded in the United Kingdom, my adoptive country, whilst my Spanish homeland burnt. Climate change, the rise of drug-resistant infections, and inequities in healthcare and society are some of the most serious threats to our species and every other species on earth. That observation spurred my thinking.
I am a clinical and academic nurse. I have always been curious about the interplay of social and individual determinants of decisions and behaviours about healthcare-associated infections and antimicrobial stewardship, including policy influence, patient health literacy, and healthcare worker education. Hopeful to connect with Sigma colleagues who were also interested in political skills and astuteness, policymaking and reform, and health diplomacy, I posted on The Circle. I was uncertain whether the post would gather much attention, having failed to do so elsewhere before.
But I should have known better with Sigma members. A good number of colleagues responded in the forum and some through private messages—all eager to know more, collaborate, and share experiences. Shortly after, the first online catchup was up and running, and it was terrific.
If your nursing education was like mine, it is unlikely that any notions of political skills would have been obvious in the syllabus. But there was very little to no content about how policies and legislation are negotiated or passed, or the opportunities for nurses to contribute. As a result, you may believe the political arena is hardly a typical workplace or area of influence for a nurse, but I believe otherwise. In fact, I have no doubt that at its very core, nursing is, and should always be, a political discipline.
It would be worth remembering that “political” activity is much more than “partisan” activity, and one could spend a whole nursing career devoted to very effective and disruptive political activities, policymaking, and activism, outside and away from political parties.
The root of “politics” is polis—broadly, the rights of people, the form of government, and the city, but really, the society. As nurses, we constantly treasure and claim that our evidence-informed practice embraces the biological, psychological, and social reality of patients or communities. The typical ethical code of practice would also emphasise the need to advocate for equity and social justice in resource allocation, access to healthcare, and other social and economic services.
I was funded not long ago to work with nursing colleagues at Shifa Tameer-e-Millat University in Pakistan, where I was fortunate not just to teach but to learn more about the policymaking skills that nurses have in the country, aiming to develop supportive interventions to enhance and strengthen their capacity.
With time, I recognized that many of the skills they, and I, demonstrated every day as a nurse—active listening, communicating clearly, problem-solving, critical thinking, influencing, conflict resolution, and negotiation, to name a few—are transferable to practice in policy-sensitive arenas, in national roles, or as part of working groups advising policymakers or international agencies and organisations. I feel passionate about this topic because it allows me to direct my nursing gaze in any direction.
And the directions are many—perhaps too many. The last couple of decades have afforded us dozens of stress tests—unexpected, painful, and yet very useful—to learn about the interconnectedness of our way of living, working, and producing. The 2007-2008 financial crash, followed in some countries by austerity measures that began in 2010, ripped through communities with immense consequences for health, health systems, and health workers, with effects still felt. The recent COVID-19 pandemic once more unveiled unsuitable social protection mechanisms with ever-growing income inequalities and social injustices, insufficient capacity slack in health services and staffing, and disappointing vaccine diplomacy efforts.
And then we came to 2022, during which I began to write this article. Flights were disrupted as landing strips melted, and floods followed the fire in many global regions. Why, I wondered, did so many national policies seem not to take the climate emergency seriously? As I watched the recent catastrophic floods in Pakistan and recognised their devastating impact, I realised we need to do more. As human beings, we are interconnected. And we are responsible for where we go from here.
Our interdependence should be reflected in the solutions offered by nurses and nursing for the planetary challenges affecting the lives of patients and communities. This demands we demonstrate politically oriented skills and efforts. And there is room for everybody!
Perhaps some of you would prefer to improve your working conditions and facilities, including increasing nursing/patient ratios or expanding professional competencies and specialisation, as part of efforts from learned societies or unions. We often see those claims for improvement, pegged to data about benefits for patient outcomes—an area where we seem to feel comfortable to engage with decision and policymakers.
Maybe you would find it more attractive to join other nurses and colleagues addressing the right for emancipation of the nursing profession and its struggle for power with other disciplines. You could demand that existing social and cultural structures which oppress, discriminate, and harm certain population groups be dismantled, and work with these very groups toward abolishing these barriers as Professor Calvin Moorley so beautifully and powerfully expressed during his recent keynote at Sigma’s 33rd International Nursing Research Congress in Edinburgh, Scotland.
If you are interested in gaining or improving your political astuteness and overall skills in policy reform, there are plenty of opportunities with Sigma. For example, these courses are all free to Sigma members:
A timely Sigma opportunity that offers exposure to policymaking is serving as a United Nations (UN) youth representative or liaison. These positions, which are currently open for submissions, allow members to participate in UN events and activities, progressing Sigma’s influence and presence on the global stage.
In addition to courses and volunteer options, I cannot overstate the value of participating in Sigma’s many international meetings and conferences. The recent expansion of events into the virtual realm means travel is not necessary to take advantage of the valuable research and resources that are shared through these events, although I do appreciate the cultural awareness and personal connections one can gain in person. Upcoming international events include Sigma’s 34th International Nursing Research Congress in Abu Dhabi in July 2023 and the Sigma European Regional Conference in 2024.
Finally, I invite you to attend my upcoming Sigma webinar on political skills and health reform on 4 October 2022. We hope to engage with many colleagues worldwide seeking to increase our impact on the crucial challenges affecting the health, well-being, and happiness of the people we care for. Hope you see you there!
Enrique Castro-Sánchez, PhD, MPH, BSc, RGN, DipTropNurs, PgDip, PgCert, DLSHTM, FHEA, FEANS, is an associate professor in infection prevention and improvement at the University of West London in England, United Kingdom; lecturer in Planetary Health, UOC, in Barcelona, Spain; and visiting faculty, Shifa Al-Tameer Millat University in Islamabad, Pakistan. He is a member of Sigma's Phi Mu Chapter.
| Note: Sigma is a diverse, global organization that welcomes members of varying backgrounds, interests, and beliefs. Based on a guiding principle set forth by the Board of Directors, Sigma is a politically neutral organization. Individual members (such as Enrique) are welcome and encouraged to express their personal opinions and politically advocate for themselves and their patients, institutions, and global healthcare. |