How ironic that the Year of the Nurse and Midwife, named in honor of the 200th anniversary of the birth of Florence Nightingale (May 12, 1820), has turned out to be the year of the global COVID-19 pandemic. Flo is looking down from heaven with a wry smile. In designating 2020 as the International Year of the Nurse and the Midwife, Dr. Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization (WHO) stated, “Nurses and midwives are the backbone of every health system: in 2020, we’re calling on all countries to invest in nurses and midwives as part of their commitment to health for all.”1 Kudos to nurses and midwives across the globe for your commitment to patient safety and public health in the face of the coronavirus pandemic. You make Flo and all of us proud!
May 2020 is the first ever Nurses Month in the United States.2 Given the enormous role nurses have played in the care of wounded patients, wouldn’t it be great to also designate May 2020 the Month of the Wound Nurse? Certainly Florence Nightingale provided much wound care as she worked diligently with soldiers in the Crimean conflict. Most contemporary wound care is provided by the members of the profession that she helped found.
According to a recent Gallup poll,3 nurses are viewed as the most honest and ethical professionals. The American public recognizes the vital role nurses play as care providers, advocates, sources of expert guidance, and interpreters of complex health care data into understandable and meaningful information for patients, families, and their communities. In other words, nurses help make communities healthier because of the resource role they serve; they help translate health care speak into language patients can understand and engage in their care.
Nightingale used many of the skills wound nurses use today. She taught disease prevention by focusing on cleanliness and hygiene in the filthy hospital in which she worked in Scutari. She made sure sick soldiers had proper nutrition so their wounds could heal (think diabetes and wounds). She provided direct care doing rounds (“The Lady with the Lamp”) and assessed patient status (what today could be called “Living and Breathing” rounds). She used principles of epidemiology. She critically observed that bed location influenced soldier death rates; when she had this investigated, more fatalities were found to have occurred among soldiers whose beds were located near a vent that linked to the sewer beneath the hospital. Think of Root Cause Analysis and the role that wound nurses play in analyzing causation and risk for suboptimal outcomes.
Most people associate Nightingale with nursing, but her impact on public health and epidemiology as a social reformer and statistician is just as important. She developed her eye for public health early in her life: she was home-schooled in science, mathematics, and languages (with sister Parthenope) by her father; traveled to Europe, Greece, and Egypt as a young woman; and answered the call to care in the Crimean War. Upon returning from the Crimea, Nightingale founded the school of nursing at St. Thomas’ Hospital in Central London, England (currently embroiled in the fight against COVID-19) and developed the first theory of nursing practice.4 She then turned her attention to improving the conditions (hygiene and sanitation) of British military hospitals across the world. Her vision was global, a legacy of public health, population health, and evidence-based practice. For more on Florence Nightingale, visit the Nightingale Museum website: www.florence-nightingale.co.uk
WHO has stated that “the world needs 9 million more nurses and midwives if it is to achieve universal health coverage by 2030.”1 We also need more wound nurses and wound care teams. The global COVID-19 pandemic will be transformational for individual wound care practitioners and for the wound care community. We will learn new ways to transition our wound care practices to improve access and quality. Let us pray that the lessons learned in 2020—from supply readiness to prevention to telehealth to virtual meetings—have a long-term impact on the way wound care is practiced.
Stay safe! Be well!