Future of Nursing

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18 AJN ▼ April 2016 ▼ Vol. 116, No. 4 ajnonline.com

In March 2014, the Honor Society of Nursing, Sigma Theta Tau International (STTI), convened the Global Advisory Panel on the Future of Nurs- ing, or GAPFON (www.gapfon.org). The panel of in- ternational nursing leaders is tasked with identifying and addressing the world’s most pressing health care issues and ensuring that nursing and midwifery are part of the global health conversation. Nearly a year into the 18-month formation phase, the 14-member panel, chaired by Martha N. Hill, PhD, RN, FAAN, Johns Hopkins University School of Nursing dean emerita and professor, is setting up regional meet- ings around the world to determine nursing’s priori- ties in the global discussion. Among STTI’s goals for GAPFON is to foster collaboration between nursing leaders and leaders from other disciplines, such as economics, government, education, and regulatory agencies.

“We are collaboratively creating a dialogue about nursing and global health that goes beyond any particular organization or group,” says Patricia E. Thompson, EdD, RN, FAAN, chief executive offi- cer of STTI.

GAPFON’s inaugural meeting was held in Basel, Switzerland, a location chosen to reflect the politi- cal neutrality of the organization. Meetings repre- senting three regions, Asia and the Pacific Rim, the Caribbean, and Central and South America, were held in June and July 2015, in partnership with re- gional associations, such as the Pan American Health Organization and the Korean Nurses Association. The regional groups discussed both global health concerns and issues specific to their locales, such as disaster preparedness after earthquakes. Four more regional meetings, covering North America, the Middle East, Europe, and Africa, are scheduled for the first half of this year.

COMPLEMENTARY, NOT COMPETING, MISSIONS The formation of GAPFON, Thompson says, was initially met with some skepticism. She and her fel- low panelists have emphasized that the purpose of the organization is not to compete with the efforts of groups like the International Council of Nurses (ICN), which holds conferences around the world on nursing leadership as well as specific health care issues such as infectious diseases and counterfeit medications, but to bring everyone to the same ta- ble. “We are all working very hard individually,” Thompson says, “and we will have a much larger voice if we work collaboratively.”

In fact, the GAPFON meeting in Asia was delib- erately scheduled on the heels of the ICN’s confer- ence in South Korea, so that members would be able to attend both. With somewhat different but overlapping populations (the ICN has a member- ship associated with national nursing associations, whereas STTI focuses largely on nursing scholars and leaders), the efforts of the two groups coexist well.

AJN REPORTS

The Global Advisory Panel on the Future of Nursing

A new international nursing organization thinks globally, works locally.

The Global Advisory Panel on the Future of Nursing (GAPFON) is made up of interna- tional nursing leaders. Photo courtesy of GAPFON.

[email protected] AJN ▼ April 2016 ▼ Vol. 116, No. 4 19

ICN president Judith Shamian, who also sits on the GAPFON panel, believes that GAPFON’s mis- sion complements what the ICN is doing. STTI is an affiliate member of the ICN, and “there is a har- monious flow of information back and forth,” she says. “[We have a] shared mission to strengthen and support the nursing community at large.” And al- though the ICN has a lot of regional and international training programs, Shamian believes that opportu- nities on that level have been missed. “My board members have countries assigned to them and they try to work with them, but it’s not in a structured way,” she says. “So STTI is really to be congratu- lated for doing this.” She emphasizes that STTI pro- vides a forum in which a cross-section of nursing leaders around the world can meet and talk about specific needs.

As an apolitical organization with strong resources, STTI was uniquely well positioned to launch the ef- fort. It comes down, Shamian notes, to who was will- ing and able to do it. That doesn’t mean, however, that GAPFON will remain under the purview of STTI indefinitely. “We have been very careful to say we are only convening this initiative,” says Thompson. “The idea is that this should live and move on within the broader nursing world over time.”

NURSING’S GLOBAL PRESENCE Nursing has seen its international voice and represen- tation fading around the world. The reasons are com- plex. For instance, financial interests push nurses out of leadership roles, and serious conflicts between health care disciplines remain. But those are just pieces of a larger puzzle. “Part of the ownership [of the problem] belongs to nursing,” says Thompson. “We haven’t always worked well together to be able to move initiatives forward.”

Shamian agrees. She isn’t convinced that GAPFON will solve the problem by itself, and she knows that efforts by STTI and other international organiza- tions that keep the profile of nursing high must be embraced.

Nursing organizations have wrestled with nurs- ing’s decreasing presence for several years. For exam- ple, the ICN’s Council of National Representatives

passed an emergency resolution on the issue in 2011 and at a meeting in 2013 identified an absence of senior nursing leadership at World Health Organiza- tion headquarters and in many of the regional offices.

Although these actions take nursing in a positive direction, the more than 16 million nurses world- wide continue to face a power vacuum. Policy, fund- ing, and program decisions are often made without nurses’ irreplaceable knowledge and experience, which Shamian calls a tragedy for global health. “We have never been as [well] educated, had as much research to contribute, and had so little power,” says Shamian. “It’s depressing, but we all need a wake-up call.”

NOT JUST ANOTHER THINK TANK Thompson is careful to emphasize that data gathering is not the end goal for GAPFON but merely the first

phase. After the regional meetings are completed this summer, an implementation phase will begin, in which the umbrella group will look at its partnering orga- nizations and try to find “mission matches.” Address- ing regulatory issues, for instance, is part of the ICN’s mission, so it might be well suited to taking that on.

The hope is that essential groups and expert pan- els will work with local governments and organiza- tions to come up with and implement action plans. “Each region is extremely different, so implementa- tion cannot be the same everywhere,” Thompson ex- plains. “That’s why it’s important to get to every one of these regions and get people to participate and buy in.”

Ultimately, in terms of health, the world is smaller than it has ever been; how quickly communicable dis- eases can now spread, for instance, has already had serious consequences. “You can’t think anymore that ‘because I live in the United States I’m not affected by diseases in Africa or Asia,’” says Thompson.

And the voice of the nurse has never been more crucial in this ongoing conversation. Nurses are vital players, Thompson says. “We are the largest number of health care providers by far. We are the ones with patients in acute care settings 24/7 and the ones out there in communities working regularly with patients and families. Our knowledge and insight need to be part of the discussion.”—Laura Wallis ▼

Among GAPFON’s goals is to foster collaboration between nursing

leaders and leaders from other disciplines, such as economics,

government, education, and regulatory agencies.