On the International Nurses Day, the EFN urges national governments to STOP downgrading nurses and risking citizens’ lives to save money!

On the International Nurses Day, the EFN urges national governments to STOP downgrading nurses and risking citizens’ lives to save money!

Posted on May 10, 2017

Celebrated on 12 May, the date of Florence Nightingale’s birth, the International Nurses’ Day is a global event initiated by the International Council of Nurses (ICN) in 1965 and held each year in recognition of nurses’ invaluable work.

But looking at nursing in the EU, is there something to celebrate today?

Nurses are the single largest occupational group in the health sector, providing frontline care, 24 hours/7 days in a roll, 365 days a year, being the first contact point for patients in the health and social service, and thus playing a central role in the delivery and quality of healthcare services. But, the economic austerity has broadly increased challenges for health professionals, and nurses in particular.

Although the Council conclusions on Innovation for the benefit of patients (2014) recognised that “Innovations in healthcare can contribute to health and well-being of citizens and patients, (…) and can lead to more effective ways to organise, manage and monitor work within the health sector as well as to improve the working conditions for healthcare staff”, national governments within the EU Member States keep on cutting health budgets on the back of nurses’ salary, on nurses’ posts, compromising the quality of care and patient safety.

Furthermore, in many EU Member States (Malta, Cyprus, Czech Republic, Slovakia, Slovenia, Poland, … and UK) governments are today replacing general care nurses – Professional Qualifications’ Directive (PQD) nurses – with cheaper, lower qualified nurses, with a lower salary, doing tasks outsourced from Registered Nurses (RN), but not complying with the Directive 2013/55/EU, which is preventing them to move freely in the EU based on mutual recognition of professional qualifications. The EFN is, therefore, not surprised at all that infringement procedures for non-transposition of DIR55 (that should have been implemented in all the EU Member States since 18 January 2016, which is not the case) are to be launched.

Fortunately, nurses can rely on EU legislation, holding governments back from downgrading nurses, and ensure appropriate education and qualifications of general care nurses, and allow opportunities to advance the nursing profession, key to guaranteeing the sustainability of the health workforce and ensuring the willingness of young people to choose nursing as a career path (see EFN EU Nursing Workforce Matrix 3+1).

The EU developments related to the free movement of health professionals, including the European Professional Card, all having quality and safety as key drivers for better health outcomes, have been very beneficial for the nursing profession in the last 60 years (De Raeve, 2017, The EU, What is in it for me?). This includes the upscaling of the Professional Qualifications’ Directive, incorporating article 31 (with a set of 8 competences that set the minimum educational requirements for nurses responsible for general care – see EFN Competency Framework) providing the nursing profession a legal basis to develop further nursing as a profession, throughout the EU and Europe. As such, whatever educational pathway a person chooses to follow, in order to become an ‘EU nurse’ – a ‘PQD nurse’ – they have to fulfil the same minimum requirements and be able to meet the stipulated competences. This will deliver highly competent, motivated nurses supported by high quality EU workforce policies that stimulate free movement and is key to modernising current healthcare systems.

Moreover, nurses are frontline to coordinate care and empower patients and citizens. We, therefore, need highly qualified healthcare professionals with advanced roles (ref. EU Guideline on Advanced Roles) and the necessary skills and knowledge to support their roles and responsibilities (ref. EU Guideline on Nurse ePrescribing & EU Guideline on Integrated Care). This will all lead to sustainable ecosystem, in which nurses, take the lead.

Nurses are very close to EU citizens and that is clear from the Eurobarometer trust numbers! No other profession scores so high!! Now trust you earn, you do not buy! As such, the nursing profession has, within this economic, political and social endeavour, an essential role to play, not only in defending the future of health and social care ecosystem, but in helping to define what kind of European Union we want to live in. It is, therefore, crucial that the EU Institutions value and recognise the contribution of frontline healthcare workforce who are working daily to give of their best to patients in very challenging environments.

Though, research evidence is needed to guide the policy-makers and politicians to make informed decisions. The united nursing research voice consequently plays a crucial role by joining the professional nurses’ voice towards the EU Institutions: Council, Parliament and Commission. Nursing research and nursing political lobbying can turn around rising populism and social unrest. Altruism, integrity, compassion, and respect for human dignity – by definition characteristics of a nurse – are ingredients needed to refocus the European project toward its citizens. EU citizens have always supported and trusted nurses; it is a privilege being in such a position in society.

Therefore, on the International Nurses’ Day, the EFN calls on the European Commission, the European Parliament and Council to support nursing as a profession, and value the work of 3 million nurses in the EU, highly valued by its citizens, but not by its politicians.

Nurses, are proud of being nurses, supporting the weakest in our society. Self-interest is not driving the nursing profession, instead, altruism keeps us going, keeps us smiling, keeps us advocating for those needing support and making sure health services are safe and of high quality. Thus, resilient health and social ecosystems need to support nurses, empower nurses, value nurses.

Nurses are the cornerstone of our health system, …. It is time to act!