1. Alexander, G. Rumay

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A number of global challenges will be with us for the foreseeable future: the aging of the population and the prevalence of chronic disease; issues affecting women's health; climate change, migration, and shortages of food; technology and transportation deserts; fragmented and intentionally unequal educational systems; revolt by those who feel ignored - not to mention big little lies. Perhaps the most pervasive, stubborn, and harmful of the challenges we face, regardless of where we live, is poverty.

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Poverty is not just a component of individual or family circumstances but a complex byproduct of how societies are organized. It is the result of a process of subjugation. In a very real way, the lives of those in poverty are controlled and shaped by mental models, as well as forces that work against change. These elements push those who are poor financially and professionally to the margins of the systems they are forced to navigate. Simply put, subjugation requires many to live with disrespect and lack of access to basic resources; to suffer ill health due to stress; to struggle against work- and employment-related hardships; to live with stigma; and to have their voices silenced or ignored. These different aspects of poverty are intimately intertwined and conspire against change. To our collective detriment, we participate in the status quo for that is how our social structures and institutions (governmental, judicial, educational, corporate) function, affecting how we act as members of the public and as health care providers. According to the researchers of the ATD Fourth World (2019) in Pushed to the Bottom: The Experience of Poverty in the United States, this would not happen without subjugation.


Mental models are imperfect, but useful. There is no single mental model from physics or engineering, for example, that provides a flawless explanation of the entire universe, but the best mental models from those disciplines have allowed us to build bridges and roads, develop new technologies, and even travel to outer space. As historian Yuval Noah Harari puts it (Farnam Street, 2019), "Scientists generally agree that no theory is 100 percent correct. Thus, the real test of knowledge is not truth, but utility." The best mental models are the ideas with the most utility that are broadly useful in daily life.


But each mental model is just one view of reality. The challenges and situations we encounter cannot be entirely explained by one field or industry. The development of transferrable liquid knowledge, knowledge that flows easily from one domain to the next and one country to the next (Stark, 2017), just might provide the robust mental model most needed today. Globalization, whether local or abroad, needs the energy of new mental models for true change to happen.


Relying on a narrow set of thinking tools is like wearing a mental straitjacket. Your cognitive range of motion is limited. But today, nurses can lead the way forward through the Nursing Now Campaign.


Nursing Now, a campaign to improve health globally by raising the status and profile of nursing, is a program of the Burdett Trust for Nursing run in collaboration with the International Council of Nursing and the World Health Organization. It is a global social movement with an active network of groups working to influence global and local policy. As of the first of June, there were 258 groups in 88 countries.


Globally, two efforts of the campaign are: 1) the Nightingale Challenge, aimed in part at recruiting and developing 20,000 young nurse and midwifery leaders worldwide, and 2) the dedication of 2020 as the Year of the Nurse and Midwife with at least 1,000 organizations taking part. Nursing Now USA will also address workplace violence, pay equity, staffing shortages, and barriers to practice. The Nightingale Challenge runs from January to December 2020. What does that mean for nurse educators? How can we help make the world a better place? Here are some steps we need to take.


* Sign up for more information at


* Visit and enroll your institution.


* Attend upcoming events.


* Share information on social media via #NursingNowUSA.


* Make a donation to support this critical work at (use code 422644 for the Nursing Now USA Support Fund).



Health problems are increasingly the same throughout the world because violations to humanity and decency, whenever and wherever they appear, look the same. What better time to begin this new journey, given that global nursing presents in many forms, with colleagues across the world? Collectively, let's do this. Positive persistence pays!




ATD Fourth World. (2019). Pushed to the bottom: The experience of poverty in the United States. Retrieved from[Context Link]


Farnam Street. (2019). All models are wrong. Retrieved from[Context Link]


Stark B. (2017, November 19). Liquid knowledge. Retrieved from[Context Link]