Years ago, at a workshop on shaping health policy for nurse leaders, I heard a speaker say, “Nurses are this country’s best kept secret, and we need to wake up.” 

It was a statement that stuck with me.

The other piece of advice I remember from this workshop was how policy-makers respond well to key phrases such as: “cost of care,” “quality of care,” “access to care.” During my work as a legislative aide for the chair of the Wisconsin Assembly Public Health Committee, I saw this at work. I also saw how experienced state legislators will really engage in the health care debate when they hear firsthand from a nurse about how their constituents are affected by low-quality health services.

The longer I am in this health business, the more convinced I become that the health of a country depends on the quality of its nursing care. In many developing countries, it is nurses who staff the small health centers and dispensaries. Entire communities depend on these nurses to competently offer health education, to prevent illnesses and promote healthy behaviors, to diagnose and treat common illnesses, and to refer clients to hospitals when their condition requires it. 

In hospitals, it is the nurses who are there 24 hours a day, 365 days a year. When a client’s condition is deteriorating and needs immediate medical attention, it is often the nurse who alerts the doctor of this emergency. Nurses’ experiences matter, and their words carry power.  Yet too often we fail to command the well-deserved seat at the policy- and decision-making tables. In this regard, we can continue to learn to be more strategic from our mentor, Florence Nightingale. 

During the Crimean War, Florence Nightingale fought tirelessly for excellence in nursing practice, campaigned to improve health standards, and employed evidence in understanding if health outcomes were being achieved. She fought to improve sanitation and working conditions at health facilities and cared for the poor and indigent despite continual opposition. 

Many of these needs still exist today.  

Today, many nurses are caring for people with HIV/AIDS or malaria, people who need family planning information and contraceptives, and people who have very limited income to spend on health care. Many nurses struggle with overwhelming workloads and in environments with low morale and intolerable living conditions. All nurses need to wake up and fight for themselves, their communities, and their countries to invest in the health of all citizens. Without good health, individuals have difficulty learning and cannot achieve their potential in school and work; therefore, economic growth is stunted, and the cycle of poverty and disease continues.

This is where I think Florence Nightingale’s strategies are equally efficacious today. Nightingale demonstrated excellent leadership and management skills and raised the image of nursing from a second-class job for poor women to a highly respected profession that required a high level of education. She worked with policy-makers to change laws to improve access to care for the poor; she started a professional nursing curriculum; and many nurses trained by Florence Nightingale became international pioneers in nursing. In fact, she trained the first professional nurse in the United States, who then opened many training schools. This is the kind of impact individual nurses can have when they take on a leadership role and build on their own vision for nursing and compassion for people.

Today, on International Nurses Day, I want to propose we consider the importance of nurse leaders and how these leaders can influence the entire profession and improve health outcomes.  In the book The Extraordinary Leader: Turning Good Managers into Great Leaders, John Zenger and Joseph Folkman outline the five broad characteristics of great leaders after examining data from 250,000 leaders and identifying their most important qualities. The central and core characteristic of excellent leaders is personal integrity and honesty, followed by:

• Technical competence
• A focus on results that stretch you
• Being a champion for change
• Excellent communication skills.

I also wanted to share a few examples of how I think we could apply these leadership characteristics to nursing:

• Honesty and integrity: Ensure that all nurses are registered and have an active practice license by the regulatory body.
• Technical competence: Identify skills or knowledge gaps needed to improve our practice and participate in continuing professional development training.
• Focus on results that stretch you: Commit to using current and reliable data to estimate training requirements for pre-service education for the next five years.
• Be a champion for change: Lead members of your nursing organization to share ideas about improving access and quality of health services with policy-makers. Recognize nurses who make a difference in the quality of care.
• Excellent communication skills: Encourage and empower newly qualified nurses to achieve their highest potential in nursing.

I am proud to be a nurse. Let’s recognize the contribution of the fraternity of nurses globally who work tirelessly to care for those we love.