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Be more Florence: why we need to get the voices of nurse and midwifery researchers heard

In the International Year of the Nurse and Midwife, two nurse academics urge nurses and midwives to unite and progress nursing and midwifery research agendas
Florence Nightingale RCNi challenge page

In the International Year of the Nurse and Midwife, two nurse academics urge nurses and midwives to unite and progress nursing and midwifery research agendas

Making up half the global health workforce, 22 million nurses and 2 million midwives provide essential healthcare across diverse settings ( World Health Organization (WHO) 2020 ). In recognition of the valuable work nurses and midwives do, and in line with the bicentenary of Florence Nightingale's birth, the WHO has designated 2020 the International Year of the Nurse and the Midwife. This year celebrates the work of nurses and midwives, highlighting the challenges and conditions they often face, and

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In the International Year of the Nurse and Midwife, two nurse academics urge nurses and midwives to unite and progress nursing and midwifery research agendas

Florence Nightingale RCNi challenge page
The RCNi has an interactive story on nursing pioneer Florence Nightingale at rcni.com/Florence-Nightingale

Making up half the global health workforce, 22 million nurses and 2 million midwives provide essential healthcare across diverse settings (World Health Organization (WHO) 2020). In recognition of the valuable work nurses and midwives do, and in line with the bicentenary of Florence Nightingale's birth, the WHO has designated 2020 the International Year of the Nurse and the Midwife. This year celebrates the work of nurses and midwives, highlighting the challenges and conditions they often face, and advocating for increased investments in the nursing and midwifery workforce. 

This 2020 celebration offers Nurse Researcher an opportunity to recognise and reflect on the history of nursing research that is fundamental to the provision of evidence based universal healthcare today. Florence Nightingale – who is broadly acknowleged as the founder of nursing – was also an active nurse researcher (Halcomb and Newton 2017). Her early work on environmental factors that promote physical and emotional well-being, mortality and morbidity during the Crimean war and the impact of nurse training on mortality were groundbreaking (McDonald 2015, Shetty 2016). Florence Nightingale was a passionate statistician, pioneer of survey tools and graphical data presentation, as well as an advocate for using evidence to guide policy and practice (Halcomb and Newton 2017).

How nursing research developed

After Florence Nightingale’s landmark publication Notes on Nursing in 1859, which focused on the health status of soldiers and their environment, the emphasis of nursing research in the early 20th century shifted to nurses and nursing education. The 1950s saw an increase in nurses with advanced degrees, the establishment of a nursing research centre at the Walter Reed Institute of Research in the US, and the availability of funding for nursing research. This further progressed in the 1960s to patient-care related research (Stolley et al 2000).

Although PhD education for nurses increased in the 1970s, nurses in most countries were required to enrol in non-nursing schools which negatively affected the research capacity of the profession overall. In the 1980s and 1990s nursing education progressively moved to the tertiary education sector which meant nurses and midwives were able to pursue higher degree research (HDR) programmes in their own disciplines (National Nursing and Nursing Education Taskforce 2006). This correlated with an incorporation of qualitative methodologies and a focus on holistic care and, since the 1990s, nursing and midwifery research has focused on improving clinical practice underpinned by a sound evidence base. While the number of doctorally qualified nurses and midwives is increasing, negative attitudes that have long discouraged the development of nursing and midwifery research remain. 

Negative attitudes and overcoming barriers

Negative and devaluing attitudes against nurses and midwives are founded on gender discrimination and the hierarchical structure that favours medicine over the nursing and midwifery professions. This situation is compounded by the belief that nursing is ‘women’s work' (Schneider 2016). Despite this, nursing and midwifery research continues to have an extensive influence on professional nursing and midwifery practice. However, nurses and midwives encounter substantial barriers in the conduct and utilisation of research. 

Call for papers

Nurse researcher
Picture: iStock

Nurse Researcher provides a platform for novice, emerging and experienced nurse researchers to discuss methodological and research methods issues, the challenges they have faced in undertaking research and research education and career development.

In this issue alone read about the psychometric properties of a survey instrument (Colgrave et al 2020), the complexity of linguistic issues in focus group data (Alzyood et al 2020), ethical considerations (Dahlke and Stahlke 2020, McNeilly et al 2020), using concept mapping to collect data (Dunlop et al 2020) and the experiences of undertaking research in low and middle income countries (Koirala et al 2020). This diversity highlights the range of nursing research being undertaken and the breadth of issues that nurse reseachers encounter. The scholarly debate and sharing of practical strategies, which Nurse Researcher promotes, is vital for nursing research capacity and impact.

Why not add your experiences or strategies? Read our article guidlelines
To discuss a paper idea email the editor Liz Halcomb, ehalcomb@uow.edu.au

Barriers to nursing and midwifery research have been consistently identified in the literature as inadequate dedicated time, lack of education and a lack of funding (Lewis et al 2014). There is a lack of systemic commitment to adequately address these barriers. Therefore, despite comprising the majority of the health workforce, there are relatively small numbers of nurses and midwives actually conducting research. Those that are active researchers receive minimal research funding compared to other health disciplines, which serves to further devalue nursing and midwifery professions.

The inequity in research funding often leads nurses and midwives to seek interdisciplinary partners. While interdisciplinary research is inarguably valuable in promoting better outcomes for our patients, it can have a negative effect on the growth and maintenance of nurses’ and midwives’ professional identities, research capacity building and the opportunity to be recognised as a profession leading research in our own right. Although the WHO acknowledges the value of nurses and midwives, the hegemonic status of doctors over nurses continues (Carryer 2020). For nurses and midwives to be truly valued in 2021, the International Year of the Nurse and the Midwife, health organisations and funding bodies need to make a commitment to diminish known barriers to encourage the conduct of further nursing and midwifery research. Providing dedicated time and space, education and greater funding for nursing and midwifery research has the real potential to improve nursing and midwifery practice and improve health outcomes for all.

Contribute to improving health and well-being

We can only change the things that we can control. Some barriers to developing nursing and midwifery research come from within the nursing and midwifery professions themselves. Such barriers may be due to conditioning, education, apathy, resistance to change, and failure to value research. In the International Year of the Nurse and the Midwife we urge nurses and midwives to unite and progress nursing and midwifery research agendas to ensure that the voices of nurse and midwifery researchers are heard within and outside the professions to contribute to improving the health and well-being of the community.

RCNi’s interactive story on Florence Nightingale

References


About the authors

Kath PetersKath Peters is associate professor and associate dean (international and engagement) at the School of Nursing and Midwifery, Western Sydney University, Penrith, New South Wales, Australia

 

 

Fiona McDermidFiona McDermid is lecturer at the School of Nursing and Midwifery, Western Sydney University, Penrith, New South Wales, Australia

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