Imagine waking up after the 2022 federal election to headlines of an “historic upset”, where a #WeCare movement powered by Australian nurses and midwives stormed Parliament to create a new power base that put “people before politics, policy before power”.
That was the rallying call put to more than 600 leading nurses and midwives on the opening day of the Australian College of Nursing’s (ACN) National Nursing Forum in nipaluna/Hobart, from former South Australian Labor MP and nurse and midwife Annabel Digance.
Many of the delegates battled wild winter weather to get to the three day leadership event, which opened on Wednesday with a welcome ceremony from the Pakana Kanaplila performers on the traditional lands of the palawa people of lutruwita/Tasmania.
The theme of #NFF2019, which trended nationally on Twitter during its packed opening plenary session, is ‘Nursing Now – Power of Policy’.
The event is showcasing the international Nursing Now campaign to raise the profile and status of nursing worldwide and local strategies to give the profession greater influence and broader scope of practice in Australia.
A series of keynote addresses from leading practitioners and academics on Wednesday urged nurses and midwives to “step up into the political arena”, to “grasp the power of policy”, and to break nursing’s tradition as “the silent profession”.
Digance is known, particularly in the health sector, for steering what is known as Gayle’s Law – SA legislation passed to strengthen the safety of nurses in remote areas following the 2016 murder of Gayle Woodford in the Anangu Pitjantjatjara Yankunytjatjara (APY) Lands.
Power, policy, politics, people
Delivering a keynote address titled ‘Power, Policy, Politics, People’, Digance told delegates their voices were needed to weigh in on social inequity and a host of healthcare issues, including the looming foray into healthcare of tech juggernauts Facebook, Microsoft and Google.
Nursing has collective strength and “a huge body of voices”, but it needs the courage to step up and into the political arena, said the former MP, who won an “unwinnable” seat in 2010 but was ousted in the 2018 state poll.
Now Associate Professor at Flinders University’s College of Business, Government and Law, Digance said the profession must eschew “self defeating conversations”, such as ‘I’m just one person’ or ‘It’s always been that way’.
“We need to stop that self-silence because self-silence diminishes,” Digance said.
Ahead of the event, ACN’S CEO Adjunct Professor Kylie Ward warned that nursing is “wilfully ignored and even locked out” of health care discourse and policy making in Australia and that nurses are “under-represented, disproportionately represented or not represented at all”, particularly compared to medicine and pharmacy.
Digance also sounded the alarm on their lack of representation in Parliament.
Nurses number nearly 400,000 in Australia, making them the single largest group of health professionals in Australia.
Yet she said there are just two currently in Federal Parliament – Labor MP and former ACTU head Ged Kearney, and the newly-elected independent Member for Indi, Dr Helen Haines.
By comparison, Digance said, there are 24 lawyers and, perhaps more concerning, 19 political lobbyists among the 227 politicians comprising both houses of Parliament in Canberra.
“For me, this is a really big red flag because this could lead to risky policy,” she said of the discrepancy.
Too often, she said, we hear the “overused line” from politicians and big business that “people are our most important asset”, when the sheer numbers of people who were homeless, could not afford dental care or live on the paltry Newstart payment of just $40 a day told a different story.
Digance talked about her time in Parliament and her efforts to amplify the voices of nurses and midwives or to address their concerns in policy.
It revealed to her how undervalued nursing still is, where prominent politicians had no idea of the level of expertise shared by a room full of nurses, and where the profession was still often thought of in stereotypes, including as “pan maidens”.
It was also “cringeworthy” how many politicians would rush to declare their credentials on nursing issues by saying their “mothers/wives are nurses/midwives”, she added.
Digance highlighted the #NursesPlayCards hashtag which went viral earlier this year after a US politician argued against better conditions for nurses, saying that some “in small rural hospitals probably play cards for a considerable amount of the day”.
It prompted a series of fantastic tweets, Instagram posts and memes, such as:
“US nurses don’t play games. We also don’t eat, drink, or pee for 12 hours at a time, because we are too busy saving lives!”.
— Nursesplaycards (@nursesplaycards) April 20, 2019
Everyday? #nursesplaycards #ornurse #smh pic.twitter.com/O8QrdUX9AY
— Angela Wells (@cyclegirl16) April 27, 2019
But while a great show of solidarity, it wasn’t enough, she said.
“As we head towards the next federal election what collective steps will we have taken, how will we look as a group, what will be our story? Will we have developed strong political acumen, and political networks, will we have a network of political nurse educators to influence and champion legislation and policy so we are at the political table?”
And with a mock front page article from The Australian to inspire, she urged them to imagine the headlines after the 2022 election:
“Political upset. Australians put people first, people before politics, policy before power.”
Autonomy and the body
The forum’s opening session also heard from Associate Professor Georgina Willetts, Head of Discipline & Course Director in Nursing at Swinburne University.
A registered nurse and midwife, Willetts is also the great great granddaughter of Sir Henry Parkes, former Premier of New South Wales and a leading colonial politician who was instrumental in bringing the first Florence Nightingale-trained nurses to Australia.
Willetts was schooled in nursing “on the cusp of change”, when training moved from being hospital-based into tertiary settings. Despite this professionalisation, she said it still struggles for respect and influence.
“Nursing now meets all the accepted criteria for a profession: it has its own systematic body of theory, professional authority, the sanction of the community and a regulated code of ethics, “ she said.
“So why have we as a profession struggled so much in achieving recognition?”
She said it was due, in part, to the “intangible” nature of nursing practice, where the therapeutic relationship, patient advocacy and holistic approach “are often unseen”.
“This relative invisibility and continued affiliation with medicine has compounded our struggle to legitimise our autonomy,” she said.
But she said there was also a stigma around nursing linked to its so-called “body work”, where – as some have written – the relational boundaries between nurses and patients blur spaces that are ordinarily taboo.
“We do a lot of personal things to the body that probably no other profession does,” she later told Croakey. “This is, for me, where a patient gets their trust: we wash them (or) if a patient gets sick, we clean them up.”
It’s “not necessarily saving lives, doing all the fancy stuff”, but it’s also not menial, she said.
While a nurse is doing that, they are assessing the patient: “what their skin looks like, how they move, how they talk.”
But Willetts said many nurses do not talk about these parts of their work to outsiders, because of the risk it is seen as “disgusting or revolting”.
That continues to reinforce the dominance of the doctor/nurse relationships, and the idea of nursing as “a complementary vocation”.
“One of the challenges that the future of nursing faces is to not run from this so-called body work, but to embrace it, claim it and demand the respect needed for such practice.
I think we need to be louder.”
Watch our interview with Willetts:
From the Twittersphere
With the ACN running a contest for best conference tweet, as well as providing delegates with pedometers to compete for most steps at #NNF2019, it’s little wonder the forum trended nationally on Wednesday.
We’re also offering free Croakey subscriptions to best entries to our #BeanieSelfieChallenge, and you have to be(anie) in it to win it so get snapping!
See below for a selection of some of Wednesday’s Twitter highlights, including a neologism or two (#nurding ftw!).
The Australian College of Nursing’s National Nursing Forum continues today in nipaluna/Hobart. See the full program here.
Croakey journalist Marie McInerney is covering the event for the Croakey Conference News Service and you can follow her live dispatches at @CroakeyNews. Bookmark this link for all our coverage and join the @ACN_tweet conversation on the hashtag #NNF2019