12 May is the anniversary of nursing pioneer Florence Nightingale’s birth, and has been suitably celebrated since 1974 as International Nurses Day. The remarkable individuals who make up this profession are critical in the care of patients across the entire healthcare spectrum. Nurses, we salute you!
Celebrating the lady who started it all
12 May 2022 marks 202 years since the birth of ‘The Lady with the Lamp’, Florence Nightingale. She is revered as the founder of modern nursing, having professionalised care and established the first secular nursing school in the world. Nightingale was first recognised for her achievements during the Crimean War (1853–56), when she and her nursing team are said to have reduced death rates in military hospitals from 40% to 2%.
Her resumé didn’t stop at nursing, however. Nightingale was a skilled statistician and is credited with creating one of the first versions of the pie chart, to help others more easily understand health data. She was also the first woman member of the Royal Statistical Society; wrote more than 150 books, pamphlets and reports on health-related issues; and helped set up the Army Medical College in Chatham, England.
Nurses: the cornerstone of healthcare
Nurses are critical healthcare providers and are key in the global effort to achieve the Sustainable Development Goals set out by the UN. Nurses are the first – and, sometimes, the only – port of call for the majority of patients, particularly in community-based and primary healthcare environments. They work tirelessly to offer comprehensive care for disease prevention and management, health promotion and rehabilitation.
The nursing landscape
Nursing is the largest healthcare profession in the world, accounting for 59% of all health professions. The global nursing workforce is 27.9 million, of which 19.3 million are professional nurses (the remainder being associate professionals or unclassified).
In South Africa, the number of nurses in the healthcare system is ‘frighteningly low’ according to Sibongiseni Delihlazo, spokesperson for the Democratic Nursing Organisation of South Africa.
The South African Nursing Council reports a total of 280 231 nurses currently working in South Africa. This translates to an average of one nurse (registered, enrolled or auxiliary) for every 213 patients in the country across the public and private sector. In the Northern Cape, this figure is stretched to one nurse for every 350 patients. For context, in Queensland, Australia, there is one nurse for every four patients per shift.
A looming nursing crisis
As well as the current cohort of nurses being overworked, there is also a national shortage in new trainees due to a change in nursing curriculum and the introduction of new nursing qualifications. This has resulted in a reduced number of new nurses qualifying in the past six years. Exacerbating the issue is the fact that almost half of the South African nursing workforce is set to retire in the next 15 years.
‘We have a crisis of an ageing workforce,’ says Professor Laetitia Rispel, the South African Research Chair on the Health Workforce at Wits University. ‘It’s not just the replacement of the actual individuals, but you also have to look at the cumulative experience and wisdom in the health system, and that’s not going to be replaced unless we take action now.’
These issues are not exclusive to South Africa. Heavy workloads, insufficient resourcing, burnout and pandemic-related stress are global issues that contribute to increased numbers of nurses leaving the profession, ushering in the looming global nursing crisis.
The need for increased nursing training
It is essential that significant steps are taken to dramatically boost nurse training.
The WHO, together with the International Council of Nurses, released the State of World Nursing report in 2020. The report recommends that every country needs to increase its total number of nursing graduates by 8% per year on average, alongside ‘an improved capacity to employ and retain these graduates’. If not, it is likely that there will be a global nursing shortage of 5.7 million nurses by 2030, particularly in African, South-East Asian and Eastern Mediterranean countries.