Guest Editorial and Discourse - International Nursing: The Benefits of Working Together to Improve Nursing Globally

Abstract

Nursing around the world is experiencing many common problems and challenges in its growth as a profession. The predominant issues, internationally, in nursing are: generation, dissemination, and utilization of relevant nursing knowledge; nursing's limited influence on policy formulation and implementation and on planning; the need for enhancement of nursing education (basic and post-basic); imbalances between supply and demand and maldistribution in favour of urban-based and curative services; poor working conditions; and the substitution of unregulated health-care workers for professional nurses. These issues reflect the state of nursing human resource development (NHRD) around the world, the three major components of which are: planning and policy; production - that is, the preparation of nurses to meet the health needs of a population; and management, which addresses all aspects of nurses' work - practice, recruitment, retention, utilization, and the work environment. The state of nursing knowledge varies internationally. Countries in the North have developed highly specialized bodies of knowledge, including nursing concepts, models, and theories. In these countries research is integral to the profession and nurses are strongly urged to engage in reflective practice and to base that practice on scientific evidence generated through a rigorous research process. New knowledge is being generated on nursing interventions as well as on education, organization of nursing services, and all dimensions of nurses' work life. At the other end of the continuum are countries in which nursing relies almost exclusively on knowledge generated elsewhere. Often, that knowledge is accepted without critical appraisal of its local relevance or awareness that it is outdated. The result may be nurses who are inadequately prepared to deal with the health problems of the population they serve. I vividly recall visiting a rural health unit in the South in the early 1980s and being informed by the nursing personnel that they had finally overcome the traditional practice of women using