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Guest Editorial: Intercontinental nursing
AAN News &
The Official Journal of the American Academy of Nursing
Opinion
Guest Editorial: Intercontinental nursing Author: Roger Watson, PhD, RN, FAAN
I
regularly visit colleagues in Europe, North America, Australia, and South East Asia, and in my capacity as Editor-in-Chief of the Journal of Clinical Nursing, I process manuscripts from all of these parts of the world and more. Clearly, there would be little point in visiting other countries and continents if everything were the same as it was at home; it is the differences that draw us to travel and work in other countries and cultures, and the differences are apparent. For example, there could hardly be a greater contrast in cultures between Europe and South East Asia. Likewise, there are differences in nursing practice that are unexpected, and I well recall the horror with which a Mainland Chinese colleague recoiled when I asked her about the influence of culture on the issue of gender differences when intimate procedures, such as washing patients, were involved. Her horror was not at the concept of intimate procedures, but rather at the thought of a nurse having to wash a patient—in China, this is a job for relatives or low-status attendants. Other differences are apparent at the level of workforce planning; in the United Kingdom, we are used to nurses not finding employment at times of economic downturn. But on a recent visit to Australia, it was—literally—headline news that, for the first time in memory, nursing students were not finding jobs. Therefore, differences are apparent at the level of practice and policy whereby we can, and often do, compare ourselves with others either to bemoan our own deficiencies or feel better that we are luckier than some. However, with the existence of international nursing organizations such as the International Council of Nurses (ICN) and the American Academy of Nursing (AAN), which is beginning to introduce international
Roger Watson, PhD, RN, FAAN, is a Professor of Nursing, The University of Sheffield, Sheffield, UK. Corresponding author: Mr. Roger Watson, The University of Sheffield, Sheffield, UK. E-mail: [email protected] Nurs Outlook 2010;58:167-168. 0029-6554/$–see front matter Copyright ª 2010 Mosby, Inc. All rights reserved. doi:10.1016/j.outlook.2010.03.004
fellows, and academic nursing journals publishing articles from across the world, there is clearly a great deal that nurses in different parts of the world have in common.
SO WHAT IS COMMON? Definitions of nursing are unhelpful in this regard; those such as the one proposed by the ICN tend to address the lowest common denominator. This does not make them wrong, but they only provide a starting point. ‘‘Nursing is what nurses do’’ is an adage often used to describe our work—but, again, is not helpful unless we know what nurses do, and often we do not. The manifest aspects of nursing are easy to observe and evaluate; they are the technical aspects, the essential aspects of patient care, and the tasks devolved by the medical profession, and so on. However, the scope of these aspects of nursing vary greatly between countries in tandem with the varying educational preparation of nurses and the relative power of the medical and nursing professions in different countries. Caring is often cited as the unique aspect of nursing but, again, this hardly clarifies matters because the definition of caring remains elusive, and nursing can certainly claim no monopoly on this most basic of human virtues.
THE LEGACY OF FLORENCE NIGHTINGALE In a search for something that binds us, I am repeatedly returned to the person commonly credited with the development of modern nursing. This is not just because I am British; it is because I have traveled so widely. For example, within the past two years I have sat at the desk (now in the office of a colleague) she once used in her apartment at St. Thomas’s Hospital in London and walked the corridors at Scutari where she earned her reputation as ‘‘the lady with the lamp.’’ However, these significant historical artifacts and places only partly contribute to my growing realization of the legacy of Florence Nightingale. The other thing that has cemented this realization is the frequency with which I encounter busts and images of Florence Nightingale across the world: we have one in my school. I have encountered them in Hong Kong and Taiwan, Turkey, elsewhere in the United Kingdom, and also in Australia and the United States. I find this remarkable, but more so given that Florence Nightingale’s legacy has become tarnished over the years with stories of her hypochondria M
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AAN News & Opinion continued Nightingale began, I was privileged to have a private visit to her rooms in the Turkish First Army base in Istanbul, which is on the Scutari Peninsula and the site of her first work with the wounded of the Crimean War. The museum is interesting; the preserved rooms where she worked and slept are emotionally moving. However, it was the walk from the main entrance to the rooms along the highly polished and military portrait–festooned corridors of the First Army base that brought Florence’s legacy home to me and gave me some insight into what unites us as nurses across the world. These are the corridors that feature the paintings of Florence among the wounded; they are instantly recognizable. It struck me, and strikes me still, that Florence was a pioneer: she was working under difficult circumstances, doing what nobody had done before with people unable to present their own case, and she was also doing what nobody else actually wanted to do. Does this sound familiar?
(suppressed in the early years), her alleged bullying of individuals, and the possibility that her work in the Crimean War increased deaths, rather than saved lives, because of cross-infection. Florence cannot defend herself against accusations about her personality and behavior, but she would, undoubtedly, have been able to defend herself against those who use statistics to diminish her legacy—she was one of the first people in history to use figures to convince British parliamentarians of the need for health care measures in Britain. I often question people, especially in South East Asia, about their use of Florence Nightingale as a reference point when their own culture, religion, and political situation are so different from mine in the United Kingdom. The answers vary and are not usually very informative, as I think the image has always been there for decades. If anyone should know the answer, I should! Returning to the place where the legacy of Florence
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The Official Journal of the American Academy of Nursing
Opinion
Guest Editorial: Intercontinental nursing Author: Roger Watson, PhD, RN, FAAN
I
regularly visit colleagues in Europe, North America, Australia, and South East Asia, and in my capacity as Editor-in-Chief of the Journal of Clinical Nursing, I process manuscripts from all of these parts of the world and more. Clearly, there would be little point in visiting other countries and continents if everything were the same as it was at home; it is the differences that draw us to travel and work in other countries and cultures, and the differences are apparent. For example, there could hardly be a greater contrast in cultures between Europe and South East Asia. Likewise, there are differences in nursing practice that are unexpected, and I well recall the horror with which a Mainland Chinese colleague recoiled when I asked her about the influence of culture on the issue of gender differences when intimate procedures, such as washing patients, were involved. Her horror was not at the concept of intimate procedures, but rather at the thought of a nurse having to wash a patient—in China, this is a job for relatives or low-status attendants. Other differences are apparent at the level of workforce planning; in the United Kingdom, we are used to nurses not finding employment at times of economic downturn. But on a recent visit to Australia, it was—literally—headline news that, for the first time in memory, nursing students were not finding jobs. Therefore, differences are apparent at the level of practice and policy whereby we can, and often do, compare ourselves with others either to bemoan our own deficiencies or feel better that we are luckier than some. However, with the existence of international nursing organizations such as the International Council of Nurses (ICN) and the American Academy of Nursing (AAN), which is beginning to introduce international
Roger Watson, PhD, RN, FAAN, is a Professor of Nursing, The University of Sheffield, Sheffield, UK. Corresponding author: Mr. Roger Watson, The University of Sheffield, Sheffield, UK. E-mail: [email protected] Nurs Outlook 2010;58:167-168. 0029-6554/$–see front matter Copyright ª 2010 Mosby, Inc. All rights reserved. doi:10.1016/j.outlook.2010.03.004
fellows, and academic nursing journals publishing articles from across the world, there is clearly a great deal that nurses in different parts of the world have in common.
SO WHAT IS COMMON? Definitions of nursing are unhelpful in this regard; those such as the one proposed by the ICN tend to address the lowest common denominator. This does not make them wrong, but they only provide a starting point. ‘‘Nursing is what nurses do’’ is an adage often used to describe our work—but, again, is not helpful unless we know what nurses do, and often we do not. The manifest aspects of nursing are easy to observe and evaluate; they are the technical aspects, the essential aspects of patient care, and the tasks devolved by the medical profession, and so on. However, the scope of these aspects of nursing vary greatly between countries in tandem with the varying educational preparation of nurses and the relative power of the medical and nursing professions in different countries. Caring is often cited as the unique aspect of nursing but, again, this hardly clarifies matters because the definition of caring remains elusive, and nursing can certainly claim no monopoly on this most basic of human virtues.
THE LEGACY OF FLORENCE NIGHTINGALE In a search for something that binds us, I am repeatedly returned to the person commonly credited with the development of modern nursing. This is not just because I am British; it is because I have traveled so widely. For example, within the past two years I have sat at the desk (now in the office of a colleague) she once used in her apartment at St. Thomas’s Hospital in London and walked the corridors at Scutari where she earned her reputation as ‘‘the lady with the lamp.’’ However, these significant historical artifacts and places only partly contribute to my growing realization of the legacy of Florence Nightingale. The other thing that has cemented this realization is the frequency with which I encounter busts and images of Florence Nightingale across the world: we have one in my school. I have encountered them in Hong Kong and Taiwan, Turkey, elsewhere in the United Kingdom, and also in Australia and the United States. I find this remarkable, but more so given that Florence Nightingale’s legacy has become tarnished over the years with stories of her hypochondria M
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AAN News & Opinion continued Nightingale began, I was privileged to have a private visit to her rooms in the Turkish First Army base in Istanbul, which is on the Scutari Peninsula and the site of her first work with the wounded of the Crimean War. The museum is interesting; the preserved rooms where she worked and slept are emotionally moving. However, it was the walk from the main entrance to the rooms along the highly polished and military portrait–festooned corridors of the First Army base that brought Florence’s legacy home to me and gave me some insight into what unites us as nurses across the world. These are the corridors that feature the paintings of Florence among the wounded; they are instantly recognizable. It struck me, and strikes me still, that Florence was a pioneer: she was working under difficult circumstances, doing what nobody had done before with people unable to present their own case, and she was also doing what nobody else actually wanted to do. Does this sound familiar?
(suppressed in the early years), her alleged bullying of individuals, and the possibility that her work in the Crimean War increased deaths, rather than saved lives, because of cross-infection. Florence cannot defend herself against accusations about her personality and behavior, but she would, undoubtedly, have been able to defend herself against those who use statistics to diminish her legacy—she was one of the first people in history to use figures to convince British parliamentarians of the need for health care measures in Britain. I often question people, especially in South East Asia, about their use of Florence Nightingale as a reference point when their own culture, religion, and political situation are so different from mine in the United Kingdom. The answers vary and are not usually very informative, as I think the image has always been there for decades. If anyone should know the answer, I should! Returning to the place where the legacy of Florence
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