How the role of nurses has been redefined

The profession of nursing in the modern context has evolved beyond just clinical care and support to patients. Nurses around the world are an important bridge between families and patients on the one hand and the healthcare professionals and the hospital on the other.

Post- Covid, the International Council for Nurses (ICN) published a report on how the pandemic resulted in stress and a major burnout for the nursing force around the world, triggering widespread dissatisfaction and many leaving the profession.

As we commemorate this noble profession on the International Day of Nursing, it is important to reflect on some of the bleak realities. As per the World Health Organisation (WHO), there are an estimated 29 million nurses worldwide and 2.2 million midwives. WHO estimates a shortage of 4.5 million nurses and 0.31 million midwives by the year 2030.

If healthcare equity is to become a reality for all and access to quality care is something nations are striving for, the nursing force plays a crucial role in access to health care delivery and innovation.

Nurses, who account for a sizeable section of the population in healthcare globally, combine the unique art of compassion, care and dispensing of medication with the science, skills and knowledge required to understand the true nature of disease, the efficacy of treatment and the power of research in improving outcomes and patient care.

Some paradigm shifts

Today, with the rapid strides in machine learning, Artificial Intelligence applications in healthcare and advances in other areas including genomics, there are numerous opportunities to improve understanding, efficiency and ensure optimal care. The nursing workforce can develop and undertake research to increase understanding and contribute to literature for the benefit of all.

In this month, as we celebrate the significant contribution of nurses to the healthcare sector globally, we have got to acknowledge the contribution of nurses towards providing a more articulate and enhanced experience to every patient both in hospitals and in the community. Nurses have great potential in providing their unique perspective to healthcare that arises from their first-hand patient experience, their training, experience, and their empirical clinical knowledge.

A case in point

To cite an illustration, I had the opportunity of spearheading the translation of research findings in monogenic diabetes into clinical care through the instigation of a national network of genetic diabetes nurses in the UK.

People with rare genetic types of diabetes caused by a change in a single gene (monogenic diabetes) were typically misdiagnosed as having Type 1 or Type 2 diabetes, and therefore often treated unnecessarily with insulin injections.

With my efforts, genetic testing of those likely to have monogenic diabetes has increased the numbers of patients confirmed with different types of monogenic diabetes which has resulted in improvements in treatment and quality of life.

This has not only impacted the approach to diabetes care through increased awareness of monogenic diabetes but improved blood glucose control for many patients with dramatic improvements in quality of life. Since the start of the Genetic Diabetes Nurses network, referrals for genetic testing have continued to increase, with around 4,500 patients in the UK with a confirmed diagnosis of monogenic diabetes. In the past two years, this model of training was extended through work with NHS England to provide free virtual training to healthcare professionals across England, resulting in a further 1,054 staff trained since 2021, with 95 per cent of hospitals in England offering a diabetes service having a trained and named monogenic diabetes lead.

In the case of Neonatal Diabetes which is diagnosed within the first six months of life and is also caused by a change in a single gene the Royal Exeter University Healthcare NHS Foundation Trust is able to offer genetic testing free-of-charge for anyone diagnosed with diabetes within the neonatal period from anywhere across the world who would otherwise be unable to afford it. This will make a huge difference to the lives of many across the world in improving their treatment and care. I was absolutely delighted to be able to divert some of my winnings from the Aster Guardians Global Nursing Award, which I won last year, $250,000, to fund these tests, in the support of genetic testing for those with neonatal diabetes across the world. I take pride in being the lead nurse in monogenic diabetes and taking this role in reducing the burden of disease in the world.

The dawn of new treatment approach

Studies point out that registered nurses (RN) can take on so many more responsibilities and bring major relief to primary caregivers by assuming at least four responsibilities:

1. Engaging patients with chronic conditions in behaviour change and adjusting medications according to practitioner-written protocols;
2. Leading teams to improve the care and reduce the costs of high-need, high-cost patients;
3. Coordinating the care of chronically ill patients between the primary care home and the surrounding healthcare neighbourhood
4. Promoting population health, including working with communities to create healthier spaces for people to live, work, learn, and play

The potential of RNs is profound and adopting the right approach could unleash many more dimensions they can demonstrate in the healthcare sector.

Nurse Margaret Helen Shepherd is associate director for Nursing Research/Consultant Nurse at the Royal Devon University Healthcare NHS Foundation Trust and Honorary Clinical Professor of Monogenic Diabetes at the University of Exeter and a distinguished winner of the 2nd edition of the Aster Guardians Global Nursing Award.

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