Nancy McKelvey's last day as chief nurse of the American Red Cross (ARC) was Friday, May 16, the end of Nurses Week and a week before the ARC's 127th anniversary. Set to retire in six months, McKelvey was forced out early: the organization eliminated her position and roughly 1,000 others, about one-third of the national headquarters' staff.
The ARC faces a $200 million deficit in its nearly $3.5 billion budget. Despite the ARC's legitimate attempts to solve its financial woes, many nurses question the wisdom of eliminating the chief nurse. According to the ARC's Web site, the chief nurse "[supports and strengthens] paid and volunteer nurse involvement throughout the Red Cross [horizontal ellipsis] [and] represents Red Cross nursing with external professional organizations, educational institutions, and regulatory groups." It's now unclear who will represent the perspectives and concerns of the 40,000 paid and volunteer nurses who implement many ARC programs.
Laura Howe, senior director of public affairs for the ARC, told AJN, "The elimination of the chief nurse position is nothing more than a reflection of the budget. We regard nursing as important. The ARC is run by volunteers. By keeping a strong volunteer structure in place with leadership by the [volunteer] national chair for nursing, we are keeping our tradition of our strong commitment to nursing."
McKelvey told AJN that she's working with ARC management and with Vivian Littlefield, the Wisconsin-based volunteer national chairman of nursing, "to build on the formal, field-based volunteer structure that exists today to maintain a strong nursing presence in the ARC." McKelvey noted that "there was no chief nurse position during much of the 1980s."
For the past four years, Littlefield has worked with McKelvey to lead and support ARC nurses. Losing the chief nurse position will make her job more difficult, she said, although the ARC leadership has assured her of some staff support and budget resources. Littlefield says what's happening to the ARC is a "tragedy, and nursing is part of that tragedy. But what would be worse would be to lose the presence of nursing in the ARC." Her challenge is to keep nursing going in whatever final structure evolves; she's glad that McKelvey will volunteer to do that with her.
As news of McKelvey's layoff spread, many nurses expressed dismay. Karen Ballard, president- elect of the New York State Nurses Association, said she'd stop encouraging nurses to volunteer, asking, "Why should nurses work for an organization that clearly doesn't value nursing, but rather just sees us as warm bodies to work for free?" Cheryl Schmidt, a nurse from Little Rock, Arkansas, who has volunteered for the ARC since 1974 and has urged "hundreds of students and colleagues to become volunteers," called the decision shocking. "Many organizations will be drawing from the same limited pool of nurses," she said. "Without a chief nurse at the national level, it will be challenging to attract nurses to the ARC."
Several nurses attending May's Forum for Government Chief Nurses and Midwives at the World Health Organization (WHO) headquarters in Geneva also expressed disappointment. The layoff occurred just as the WHO intensified support for nursing and midwifery, urging member nations to include nurses and midwives at the highest levels of health care planning and policymaking. Judith Oulton, the chief executive officer of the International Council of Nurses, called the ARC's decision "distressing," as did Jean Yan, WHO chief scientist in the office of Nursing and Midwifery. Fatema Abdul Wahed Al Ahmed, a chief nurse officer and director of human resources for the Bahrain Ministry of Health and one of Bahrain's delegates to the World Health Assembly, told AJN, "Nurses should be involved in making decisions, not just in doing what others decide."
ARC history is full of nurses: Clara Barton, a teacher who became a Civil War nurse, founded the organization in 1881. Jane Delano was the inaugural chairwoman of the National Committee on Red Cross Nursing Services in 1909. She enlisted more than 20,000 nurses into the ARC from 1909 until World War I ended. She founded the Red Cross Town and Country Nursing Service in 1918, which later became the Bureau of Public Health Nursing Service, the foundation for the U.S. Public Health Service. The ARC Web site observes, "Nursing's importance was acknowledged in 1992 when the Red Cross reestablished the Office of Chief Nurse which had been vacant since the early 1980s[horizontal ellipsis]. In late 1999, Red Cross president Bernadine P. Healy, MD, called for a renewed emphasis on the nursing program when announcing a structural realignment of the national headquarters." Apparently times, and priorities, have changed.
Maureen Shawn Kennedy, MA, RN, editorial director