The year 2020 made visible the profound and significant impact of the ethical and clinical work of nurses on the health and wellbeing of our communities. Rising to the challenge of the global pandemic of COVID-19, nurses risked their lives, health and that of their loved ones as they faced concerns about safety, the allocation of scarce resources and the changing nature of nurses¡¯ relationships with patients and families (Morley et al 2020).
As we face into 2021 that visibility continues as nurses are the key healthcare workers rolling out the global vaccination programme that will, hopefully, lead to the end of the current devastating crisis. However, it remains to be seen if attention to the work of nurses on the front lines of the battle with the pandemic will endure.
The pioneering work of Florence Nightingale was also highlighted in a year which marked the 200th anniversary of her birth. The World Health Organisation (WHO) nominated 2020 as ¡®International Year of the Nurse and Midwife¡¯ and, in partnership with the International Council of Nurses and the global Nursing Now campaign, produced a seminal report, State of the World¡¯s Nursing Report 2020 (WHO 2020). The Report points out that while the global nursing workforce is 27.9 million, nursing has been, and continues to be, a predominantly female profession ¨C over 90% of the global nursing workforce is female ¨C with evidence of associated biases such as pay inequities and unequal treatment in the work environment (WHO 2020).
The predominance of women in nursing and the association of nursing with caring is not a matter of chance or ¡®nature¡¯; it is because the work of caring has long been designated the work of women. As, supposedly, ¡®women¡¯s work¡¯, caring responsibilities and practices are diminished and denigrated. It seems that we can only learn the hard way what care ethicists like Joan Tronto have been pointing out for more than three decades: care is fundamental to all human life (animal and planetary). The global community is yet to accept the overwhelming evidence that this is the case. However, the current pandemic serves as a crucible that forces attention to care giving and receiving as well as associated obligations of solidarity, justice and reciprocity.
¡®Every human being is vulnerable. We will all eventually die and we are all susceptible to bad luck, disease, socially and politically induced harms, and other disasters than might befall us. We are all, every day, care receivers; we are in constant need of care to maintain our lives. Most of this care is either invisible because adults provide much care for themselves; and because much care is invisible because it is beneath our daily notice to see the extraordinary work that others are doing to smooth our ways through transit, stores, schools, cleaning up after us in our homes and offices, and so forth. If we are all care receivers, though, we are also all care givers. From the youngest children who will imitate feeding their care givers, to professionals like nurses, to home health workers, domestics, and others who clean up after us, to activities that meet our basic needs and those of our families, we all give care every day. We are all interdependent.¡¯ (Tronto 2020: 96)
As members of a profession whose central aim is that of caring, nurses are uniquely situated to contribute to deepening our understanding of the caring practices that underpin all human life. They are also in a key position to advocate for the recognition, proper remuneration and empowerment of all care workers ¨C especially those who work for little or nothing. This is inherently a feminist project that has the potential to literally change ¨C and save ¨C the world.
Helen Kohlen and Joan McCarthy are the editors of the first collection of papers which bring feminist perspectives to key issues in nursing ethics (Kohlen H, McCarthy J, Nursing Ethics: Feminist Perspectives, Switzerland: 50¶È»Ò)
Morley G, Grady C, McCarthy J, Ulrich CM (2020) Covid-19: Ethical Challenges for Nurses, Hastings Center Report 50 (2020): 1-5. DOI: 10.1002/hast.1110
Tronto J (2020) An Interview with Joan Tronto on Care Ethics and Nursing Ethics. In: Kohlen H, McCarthy J. Nursing Ethics: Feminist Perspectives. Switzerland: 50¶È»Ò p.93-96.
World Health Organisation (2020) State of the world's nursing 2020: investing in education, jobs and leadership. Geneva: World Health Organization.
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Dr. Joan McCarthy
Senior Lecturer, Healthcare Ethics
School of Nursing and Midwifery
Brookfield Health Sciences Complex
Prof. Dr. Helen Kohlen
Lehrstuhl Care Policy und Ethik
Philosophisch-Theologische Hochschule Vallendar
Vallendar, Germany
