Tuesday, November 28, 2023
Laura A. Stokowski, RN, MS, Staff Nurse, Inova Fairfax Hospital for Children, Falls Church, Virginia; Editor, Medscape Ask the Experts - Advanced Practice Nurses
Disclosure: Laura A. Stokowski, RN, MS, has disclosed no relevant financial relationships
Global Nurses Respond to Our New Year Survey
At the start of this year, we invited Medscape nurses to participate in an online survey. We asked about the most important issues in nursing from the past year, and about their hopes for the nursing profession in 2012. More than 20,000 nurses from 144 different countries around the world responded to the survey. In this slideshow, we highlight the responses from nurses in countries outside of the United States.
Pictured (clockwise from top left):
Ukeme Umana (Canada)
Gillian Smith (United Kingdom)
Deane Johnson (Australia)
Leanne Glennie (Tasmania)
Alfonso Flauto (Italy)
Liked Best: A Job That Makes a Difference
Could the Chinese philosopher Confucius have been talking about nursing when he said, "Choose a job you love and you will never have to work a day in your life"? Perhaps. Most nurses (74%) from outside the United States expressed their continued passion for nursing in selecting "a job that makes a difference/passion for nursing/patient care" as what they liked about being nurses in 2011.
An eloquent nurse from New Zealand hopes to "remember the moments that matter -- making a difference to one person and their family and running the whole unit or department so I can make a difference to many." Another young nurse said, "While I am still a nursing student, I look forward to making a difference."
Pictured: Betty Ter Horst (Canada)
Liked Best: Continuous Learning
Runner-up among reasons that respondents liked being nurses in 2011, selected by more than one half (58.6%), was the ability to continuously learn and be challenged in one's daily work. A nurse from Singapore observed that "patients and relatives are better educated, so we need constant updating of our knowledge and skills."
However, financial cutbacks have threatened continuing education for nurses. A nurse from Canada finds it challenging to "continue a quality of care for our patients in an environment that tries to cut pennies from the education and advancement of nurses."
Pictured (left to right): Maria Margarita and Natalie Taylor (United Arab Emirates)
Liked Best: Interactions With Other Members of the Healthcare Team
Nurses clearly love being part of a team, and interacting with colleagues is one of the things nurses around the world enjoy. As a nurse from Canada explained, "Good communication and teamwork make the job that much easier and enjoyable," and another from Canada is grateful for "the support of the team in advancing and using my skills." One nurse from Australia values the "personal satisfaction of being appreciated" by coworkers as well as patients, and another loves "having a great job with a great team."
Pictured (left to right):
Maria Roiella B. Simbre, Siara Sibal, and Rashell Rivera (Philippines)
Liked Best: Having a Job
Nurses appreciate having regular employment, especially considering the economic uncertainties faced by many countries. One nurse from Australia was thankful for "at 62 years, being able to remain employed." However, many nurses informed us that they were still having difficulty finding a job in nursing, like the nurse from the United Kingdom who said, "I was made redundant."
Pictured: Jane Palmer (Canada)
Liked Best: US vs Non-US Nurses
We thought it would be interesting to compare the responses of nurses within the United States to those living in other countries. It turns out that nurses around the world have a lot in common. The responses of nurses to the question "What did you like best about being a nurse last year?" were remarkably similar between US and non-US nurses. The biggest gap was for the choice "regular employment in a tough economy," selected by 56% of US nurses and only 38% of non-US nurses.
What Else Did Nurses Like? Opportunity
Nursing offers opportunities across the full spectrum of healthcare. Nurses from many countries enjoy the flexibility and diversity of opportunities in the nursing for specialization and advancement.
A nurse from Australia likes the "portability" of nursing -- "the ability to move and know there will be no problem getting another job." Another Australian nurse is "an occupational health and safety nurse at a theme park, which has to be the best job in the world."
A nurse from Guam encourages nurses to "find your place in our profession because when you do you will be productive regardless of people you work with or even benefits you receive."
Pictured (left to right):
Rachel Donegan (New Zealand)
Jennifer Varty (Canada)
What Else Did Nurses Like? Helping Patients Get Well
Teaching patients about their health and how to manage their chronic diseases were important and satisfying to many nurses. For one nurse from Ireland, job satisfaction comes from "visible patient improvement." Pride in sharing their expertise with friends and family was mentioned by many, such as the nurse from Nigeria who spoke about "the joy of being my family's nurse and having others turn to me for their health needs." A nurse from Thailand is "proud and happy to see patients better from my caring."
Still, more than a few nurses are frustrated at the limitations placed on their abilities to help patients. "Being a nurse you have immense responsibility but limited authority; your scope of care for the patient is limited" (nurse midwife from Kenya).
Pictured: Maria Reynolds (Ajman, United Arab Emirates)
What Else Did Nurses Like? Teaching and Mentoring Young Nurses
A few respondents complained about the attitudes of young nurses and questioned the suitability of some for nursing, but most expressed satisfaction in:
• "Mentoring others in a profession I love" (nurse from Canada);
• "Passing my skills to a new generation" (nurse from Australia);
• "Teaching students what nursing really means, to instill a passion for the profession" (nurse from South Africa); and
• "Investing in the younger generation to shape the future of healthcare" (nurse from Hong Kong).
Pictured (clockwise from top left):
Lee Joyce and coworkers (Malaysia)
Marcini D.C. Ramilo and staff (Philippines)
Nurse and student (South Africa)
Haj Mohammed Abbad and students (Canada)
Most Distressing: Inadequate Staff
Asked what was most distressing about being a nurse in 2011, 44% of nurses identified inadequate staff and excessive patient loads. Comments often reflected staffing issues stemming from budgetary cutbacks, and the belief that the quality of patient care was suffering as a result. A senior charge nurse in long-term care in the United Kingdom is "frustrated at being unable to look after people the way I was trained due to inadequate staffing levels." Other nurses want:
• "Adequate staffing levels to enable excellent delivery of care to patients" (nurse from Guernsey);
• "To make our voices heard, because poor staffing means suffering for nurses and patients" (nurse from Israel); and
• "Continue assertive lobbying for safe nurse staffing ratios" (nurse from Guatemala).
Pictured: Wilma Fernandez (United Arab Emirates)
Most Distressing: Lack of Respect
The perception that nurses are not respected by their colleagues seems to be a universal one. Among nurses outside of the United States, 34% said that "lack of respect from other members of the healthcare team/nonnurses" was one of the most distressing factors that they faced in 2011.
An intensive care unit (ICU) nurse from Canada said, "I never am disrespected...to my face...but I hear that others, not fortunate enough to work in the ICU, are." Other nurses mentioned the general lack of respect from one's own colleagues, as well as from staff in other units or departments. A nurse from Guyana complained of a "lack of respect from superiors," and a nurse from the United Kingdom is tired of "constantly having to prove our worth and value."
Pictured: Hospital nurses in the Philippines
Most Distressing: US vs Non-US Nurses
We share the bad along with the good in nursing. Responses to the question, "What did you find most distressing about being a nurse in 2011?" were once again similar among US and non-US nurses. Lack of staff and excessive patient loads were cited by proportionally more US than non-US nurses, but otherwise, nurses around the world apparently agree on the major problems in nursing.
What Else Do Nurses Dislike? Paperwork!
Don't be fooled by the smiles. Whether it is done on paper, or computer, or both, nurses around the world complain about "endless documentation." Nurses agree that we need to spend "less time on paperwork, and more time on nursing." A nurse from the Philippines is tired of "spending the 8-hour shift on the station charting and doing paperwork," and a nurse from Canada asserts that we need to "drastically reduce the amount of superfluous paperwork" that nurses are required to complete.
Pictured: Mari Liza C. Gajesan (Saudi Arabia)
What Nurses Want: Professionalism
A nurse from Jamaica expressed this wish:
"The nursing profession would seek to transform its image and that its contributions would be sought after in shaping health and related policies."
Many nurses have similar hopes:
• "Shape a global nursing image and improve the position of nursing in all areas of healthcare" (nurse from Iran);
• "[Nursing should] become as high as other healthcare professions" (nursing student from Indonesia);
• "I would like patients, families, and colleagues to really understand what nurses do" (nurse from Spain);
• "Nurses should be the boss for nurses and strive for uplifting the standards of the nursing profession" (nurse from India).
Pictured (left to right):
Iola Fernandez (Philippines)
Sonata Sliuzaite and Diana Kostiuchiniene (United Kingdom)
What Nurses Want: R-E-S-P-E-C-T
Respekt. Respeto. Aanzien. احترام. Berkenaan. 尊重
Paggalang. सम्मान. No matter how you say it, nurses everywhere want it.
• "More respect for the multidisciplinary role of the nurse" (nurse from Belgium);
• "Better conditions and respect for nurses" (nurse from Botswana);
• "Respect for nursing as a profession" (nurse from Kenya);
• "Respect from patients, their families, and the health team" (nurse from Mexico);
• "Respect the contributions that each and every one of us makes to caring for patients" ( a nurse from New Zealand);
• "Stand up against people who put down nursing" (a nurse from India);
• "Acknowledgement of the nursing skills from our employers" (a nurse from Sweden); and
• "Civility and respect for each other" (a nurse from Bermuda).
Pictured: Mariclare and Hanaa Ayesh (Jordan)
What Nurses Want: Strong Leadership
Nurses want to be governed by nurses, and they want those nurses to have the necessary qualities to be effective leaders.
• "We will no longer shy away from leadership. We will set the direction for holistic, humane healthcare" (nurse from Canada);
• "Nursing decisions must be made by nursing leaders and not by other professionals" (nurse from Malaysia);
• "More respect from our managers" (nurse from Switzerland);
• "For nurse managers to manage rather than to delegate and be forever in meetings" (nurse from South Africa);
• "To be able to nurse patients once again, instead of nursing managers and their targets" (nurse from the United Kingdom).
Pictured: Red Cross Voluntary Nurses (Italy)
What Nurses Want: Autonomy
Autonomy for nurses is the ability to practice to the full extent of their training and abilities. They want to be trusted, and to be able to use their hard-earned knowledge and expertise to help patients.
• "Increase autonomy to ensure that nurses can think for themselves rather than be care pathway robots" (nurse from the United Kingdom);
• "Give over and allow more autonomy -- nurse are very smart, capable people and don't need to be organized by everyone else" (nurse from Canada); and
• "Nurses should get autonomy in their work, no matter where they work" (nurse from United Arab Emirates).
Pictured (clockwise from top left):
Heather Vaartstra and Jackie Dekens (from Canada, working in Namibia)
Al Fewster (Canada)
Chris Carr (from Australia, working in Ayacucho, Peru)
Sheetal Saxena (India)
What Nurses Want: Teamwork
It is impossible to count the number of times nurses mentioned "teamwork." Communicating and working together is universally desired by nurses, but for many, it isn't as effective as it could be. A few teamwork-inspired resolutions included:
• "Have nurses' roles in patient care better recognized and accepted by other healthcare professionals, allowing us to become a stronger healthcare team" (nurse from Ireland);
• "Good communication and teamwork; never lose sight of the fact that the patient comes first" (a nurse from the United Arab Emirates); and
• "See patient care as teamwork -- doctors and nurses have different skills but are equally important!" (a nurse from The Netherlands).
Pictured (left to right): Lovely Melody, Amabelle, Rona, Aleli, and Thamir (Saudi Arabia)
What Nurses Want: Better Compensation
Fewer than one third of nurses reported that their salaries and benefits were adequate in 2011. The number of resolutions about raising the salaries of nurses supports a widespread belief that nurses are underpaid. Nurses want:
• "Adequate salaries!" (nurse from Germany);
• "Better remuneration to make the stress of the profession worthwhile" (nurse from Nigeria);
• "To be seriously recognized as a profession, especially in the salary area" (nurse from Australia); and
• "Better pay and work-hour options for nurses!" (nurse from Norway)
• "Adequate salary and benefits, just like any other profession. We are saving human lives and improving people's quality of life" (nurse from Canada).
Pictured: Nurse and porter (South Africa)
What Nurses Want: More Time for Patients
Having more time to care for patients means many different things. Nurses want:
• "More time for patient care" (nurse from France);
• "Return the focus to being with the patient -- allowing qualified nurses to do what they think is needed" (nurse from the United Kingdom);
• "To stop filling in the gaps for other staff and stick to nursing patients" (nurse from Finland);
• "The art of caring" (nurse from Antigua and Barbuda);
• "More time to assess the patients" (nurse from Austria);
• "More time to talk with the patients" (nurse from Malta); and
• "More satisfactory relationships with my patients and their families" (nurse from China)
Pictured: Niki Parle and patient (Australia)
Nurses Participating in the Survey
The most responses were received from:
• Canada: 1247
• Australia: 973
• United Kingdom: 596
• New Zealand: 273
• Philippines: 148
• Malaysia: 101
• United Arab Emirates: 99
• Singapore: 94
• India: 86
• Saudi Arabia: 83
• Ireland: 77
• Italy: 55
• South Africa: 53
• Israel: 49
Other countries with more than 10 respondents included Belgium, Botswana, Brazil, China, Germany, Hong Kong, Indonesia, Iran, Jamaica, Jordan, Kenya, Malta, The Netherlands, Nigeria, Norway, Portugal, Puerto Rico, Qatar, Spain, Sweden, Switzerland, and Thailand. In the United States, 14,850 nurses participated.
Laura A. Stokowski, RN, MS, Staff Nurse, Inova Fairfax Hospital for Children, Falls Church, Virginia; Editor, Medscape Ask the Experts - Advanced Practice Nurses
Disclosure: Laura A. Stokowski, RN, MS, has disclosed no relevant financial relationships
