I’m very proud to be Irish. When approx. 80 million people across the globe claim Irish ancestry in some form, it’s programmed into my DNA to be globally focused. For a current population of 4.5 million, we’ve had unrivalled and somewhat disproportionate influence on the world; We’ve given it Heaney, Joyce, Friel and Yeats. That’s not to mention Guinness and Riverdance. We have sat in the top offices across the world- from JFK in the White House to Annette Kennedy (I don’t think they’re related!) at the International Council of Nurses.
Like many of my ancestors before me, I choose to leave Ireland and have come to call the United Kingdom my second home. Growing up, the UK was always viewed as more advanced, more liberal and forward thinking compared to Ireland. The health service may be a case in point, and as proud as I am to be Irish, I’m beaming when I say I work for the Scottish NHS and see the principle of ‘free at the point of access’ in action every day. Yet I’m embarrassed at how the UK family of nurses have chosen to no longer take their place at the table with their brothers and sisters in global nursing family at ICN.
I think I find it more inconceivable when one considers my fortune to be connected to the University of Edinburgh. It’s an institution that prides itself not only its global impact (it’s motto is ‘Influencing the world since 1583’), but at its core, outwardly looking and seeks to make partnerships in the creation and exchange of new ideas in order to be a truly global university. Therefore the benefits of global travel and exchange are promoted constantly.
This led to me applying and securing funding from the university’s GoAbroad scheme to attend this year’s Congress in Singapore*. I was selected to present a concurrent session at the Congress which was a policy review of 8 English-speaking regions’ mental health strategies and what they are saying about the physical health of people with serious mental illness (SMI). I couldn’t think of a more apt arena than ICN congress for such a paper!
See the thing is, people with SMI (such as schizophrenia and bipolar disorder) die between 10-20 years younger compared to the rest of the population. They have 2-3 times higher rate of cardiovascular disease and one in five will develop diabetes. It is estimated that rates of HIV are anywhere between 3-8 times higher. This is not a UK phenomenon but so global in its grasp that the World Health Organisation has formed an expert working group who have produced guidelines and recommendation on how these major health inequalities should be tackled. Nurses are key to addressing many of the causes.
On top of presenting, I got to meet the Chief Nursing Officer for WHO, Elizabeth Iro during the many coffee breaks (euphemism for networking sessions) and ask her why of the 22 experts on the working group, only 1 was a nurse. I got to meet the Deputy CNO of my own health service and pose questions to her about Scotland’s approach to safe staffing legislation during the formal session but afterwards privately. Indeed, I had unrivalled access to the CNOs of several countries along with heads of regulation and senior policy makers, who didn’t just want to share their experiences (though they did with great generosity) but also wanted to hear about my research and what they could learn from it. It was one of the best events I have attended and possibly the highlight in my short career to date.
I’m one person and managed this level of access. Imagine if we were represented as a full member of ICN with a large body of members?
The UK’s official absence from the congress was palpable. Indeed, it some ways you felt slightly lost and on the outside because your country was not ‘officially’ there. This is despite several UK officials in attendance. However, were they invited into the various meetings which were taking place on the fringes of the main event?
I must admit that I’m an RCN member and have been since my first day as a student nurse. It would seem sensible to be a member of the largest professional body of nurses in the world. Yet this is not the RCN’s attitude to sitting at the international table.
Despite being nearly 11,000KM away from home, I soon learned that the pressing issues which we content with in practice in the UK are experienced by health systems across the globe. Issues such as the management of smoking in psychiatric settings, how to balance recovery-focused practice against the issues of compulsory treatment. Not to mention the ever-present ‘delayed discharges’.
We are not immune to the issues faced by other countries. We may be a wealthy nation but we are a much more unequal one than we were 30 years ago. We know inequality kills. We don’t have all the solutions. Take my own research for example and the statistics mentioned earlier. I believe that nursing is part of that solution, but we will only achieve if we are willing to reach across the boundaries to not only share good practice and but learn from others. It is no exaggeration that lives depend on us to do so!
Gearóid Brennan is a PhD Scholar within the Department of Nursing Studies at the University of Edinburgh. He works as a staff nurse within NHS Lothian, Edinburgh.
*Approx. 36% of the trip to Singapore was funded by the University of Edinburgh GoAbroad fund. The remainder was self-funded by the author.