May 07, 2020
By Barb Shellian

Voice for the Vulnerable

iStock.com/JayBoivin

It is part of the fabric of nursing: speaking up, advocating for health as a human right, and being a voice for the marginalized, the disadvantaged, and the unseen. It is a responsibility that is not taken lightly.

Look around—you will see it in clinical settings in acute care, in home care, in emergency rooms, in schools, and on street corners. Nurses being the voice for the vulnerable.

One of the most meaningful experiences of my nursing career was time that I spent with a home care nurse in the Downtown Eastside in Vancouver. Her clients were not dressed in three-piece suits or driving a nice car to a well-paying job, but they were human beings and she treated them with respect. She connected them with resources, listened to their stories, and understood the challenges that they faced just getting through the day. She was their voice in many ways. Her advocacy continued to the point of amplifying that voice within the professional organization at levels that would not otherwise be possible.

This virus has made us sit up and pay attention.

I have observed nurses in an emergency room follow women into the bathroom to ask privately—really ask—if they feel safe at home. Many such women feel that their voice is silent and that they are trapped in a situation with no options or hope of escape. Nurses help them find their voice, realize their opportunities, and assist them to rebuild their lives before it is too late.

Nurses: a global voice

Nurses have been a global voice for the World Health Organization’s Health For All priorities (WHO 2020), speaking on behalf of the vulnerable and highlighting the connection between the social determinants of health and food security, literacy, housing, access to health services, and the health status of a population. Nurses work in remarkable situations across the globe where others would not go—starting clinics in remote areas, immunizing children after their mothers have walked with them for days, helping communities to access a safe water supply. They turn words into action.

In Canada and elsewhere in the world right now, COVID-19 is all-consuming in terms of planning, intervention, surveillance, prevention, and treatment. This virus has made us sit up and pay attention to something that nurses have known for many years—the importance of the nursing presence in long-term care settings. Care of frail older adults requires specialized nursing knowledge and expertise. The presence of regulated nursing professionals in sufficient numbers can support and direct the personal care that is required. It also helps integrate the care of the family and promote holistic aging with dignity and resilience.

Nursing in long-term care

Nurses working in long-term care deserve our praise and compassion for what they have gone through as COVID-19 ravages those settings.

The sheer number of COVID-related deaths in long-term care has caused me to weep. We need to ask ourselves: did this have to happen? My heart breaks for the residents, the families, and the staff that have been affected by this situation. Will we learn from it and do better?

Nurses working in long-term care deserve our praise and compassion for what they have gone through as COVID-19 ravages those settings. We need to listen to their voices across our country—as they speak for the vulnerable—wanting more for our elders in terms of safe, competent nursing care.

Individual nurses, nursing groups, and the public need to commit to making changes where change is needed. When I make rounds in the long-term care settings in my area of responsibility, I reflect on the lives of all the folks there—the world they grew up in, the careers they had, the families they raised, and the opportunities that I have had because they went before me.

We will know that real change has happened when long-term care receives the same support and profile in our health system as the intensive care units. Perhaps it will take COVID-19 to get us there.

Being a voice for the vulnerable does not mean that nurses speak because we “know better”; we speak because we care, because we want to make a difference for others, and because we want to create a worthy future for everyone, regardless of the strength of their voice.

Reference

World Health Organization (WHO). (2020). Health for All. Priorities.

Editor-in-chief Barb Shellian is a registered nurse committed to nursing practice, health care reform, and people. She is the immediate past president of the Canadian Nurses Association and also Director of Rural Health, Alberta Health Services Calgary Zone, and is located in Canmore, Alberta.

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