Advocacy No. 2

Where was I..? Oh yes - if we have largely withdrawn from the role of advocate, than what is left politically (no pun intended)? The nursing pioneers set an agenda that in many respects we have still not addressed. They made a difference - have we?

So what was the agenda set by the nursing pioneers and why does this matter now? Amongst many other things their efforts highlighted:

* the elements of basic nursing care
* importance of data - information - knowledge
* the diverse scope of nursing (health care)

They helped to define nursing and what constitutes nursing's standing agenda items. This post is not a denial of progress, because of course giant strides have been made, but where are we now? And, more crucially where do we need to be in the next 10, 20, fifty years...?

I cannot speak first-hand, because I am no longer at the sharp-end of general nursing care. From what the media says though what frequently passes as 'nursing care' these days fails to meet basic care needs. Especially, it seems when older people are the focus care delivery. Lobbying and action to protect the tenets of high quality basic nursing care is ongoing. This, however, is were our language changes and we shift from advocacy at that nurse-patient level to activism. What can nursing do as the population pyramid changes? And this is just the start as the issues in-tray is overflowing:

* ecosystem health - global warming
* global health: Aids, diarrhoea, TB...
* migration - refugee status
* public mental health
* health promotion
* public literacy, engagement, expectations
* ...

In order to wave a banner (never a shroud) effectively, you need hard and soft data. A banner is insufficient. Yes, true - it might get you noticed, but attention span is all with this issue set. That data needs to be transformed into information, knowledge - in short intelligence. All too frequently the facts we need are incomplete, inaccurate, or too late. Two circumstances are guaranteed:

1. There are facts critical to furthering the cause and
2. they are totally absent
(and not expected to arrive within the interval of a pregnant pause)

So much of what NU S NG does remains invisible. This must change.

We noted previously what the students may ask, I wonder what the pioneers would say? One thing for sure - they would not balk at the challenge and neither should we. Nurses as advocates begins with patients and their care, but it should not and must not end there.