1. Pickler, Rita H.

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Welcome to 2020 and the "Year of the Nurse," so declared by the World Health Organization (WHO) to honor of the 200th birth anniversary of Florence Nightingale, the acknowledged founder of "modern nursing" (WHO, 2019). As the WHO noted in it's declaration, proclaiming the year for nursing (and midwifery) was important in co-occurrence with the first State of the World's Nursing Report, which the WHO will launch in 2020. The report will provide a description of the nursing workforce among the WHO member states, offering an assessment of nursing's capabilities to support achievement of global health goals. In synchrony with the efforts of the WHO, the Nursing Now Campaign, initiated in 2018 to improve global health by raising the status of nursing and supported by the International Council of Nurses, will disseminate the report and help facilitate discussions about it (Nursing Now, n.d.).


Indeed, 2020 could be a year during which nursing learns more about our profession leading to increased input into solving significant health problems. We already know that nurses and midwives comprise nearly 50% of the global health workforce even though there are widespread shortages within that workforce. The WHO estimates that the world will need an additional 9 million nurses and midwives by 2030. Certain parts of the world, notably Southeast Asia and Africa, have long-standing nursing shortages, making it difficult for those countries and regions to meet critical needs for health promotion, disease prevention, and provision of care across care settings.


We also know that nurses make many contributions to healthcare. They provide and manage personal care and treatment, staff healthcare institutions (which could not exist without them), work with families and communities in less traditional healthcare settings, and play a central part in public health, controlling and managing disease. In many areas of the world, nurses are often the first and sometimes the only health provider available. Thus, the quality of nursing assessment and care is critical. Moreover, the contributions of nurse scientists to knowledge ungirding practice are essential for improvements to quality care delivery.


The WHO has asked its member states to strengthen nursing and midwifery through a number of activities, including securing the expertise of nurses in the development of human resources and health policies. The WHO's global strategic directions for strengthening nursing and midwifery provide a framework for developing, implementing, and evaluating nursing and midwifery (WHO, 2016). Four broad themes are proposed to guide the contributions of nursing to improve global health: ensure an educated, competent, and motivated workforce; optimize policy development, effective leadership, management, and governance; maximize the capacities and potential of nurses and midwives; and mobilize investment in building effective evidence-based nursing and midwifery.


Here, like others, I link the WHO global strategic directions to Nursing Now's Nightingale Challenge, which formally requests every health employer to provide leadership and development training for nurses and midwives to facilitate their development as leaders, practitioners, and advocates in health. I am not an employer of nurses, of course. However, I am a long-time nurse, which for me encompasses my work as clinician, scientist, educator, author, and editor. Like many others, I am dedicated to improving the scientific basis and, thus, the practice of nursing. I believe in science and in the capability of nurses, properly educated, to conduct rigorous scientific studies and thus contribute to nursing care practice and, more broadly, healthcare delivery. I believe that it will be impossible to achieve the WHO and Nursing Now goals if we do not invest in and support the further development of nursing science and nurse scientists. I admittedly worry that, in our efforts to educate more nurses for care provision, we will give short-shrift to the efforts needed to educate nurses to continue the crucial scientific work that provides the evidence for care practice, leadership, and policy. For just as we have a growing shortage of nurses providing care, so too do we have a shortage of those who are prepared to conduct the scientific research our discipline needs (Harrison et al., 2019).


Much has been written about the growing shortage of nurse scientists, at least in the United States (Smeltzer et al., 2016). Worldwide, the shortage of nurse scientists is even more concerning. Many solutions to address the scientific shortage in nursing have been suggested (Smith et al., 2016). My point is that, without a scientific basis, nurses cannot provide safe and effective care; one would not know what was safe and effective without science. Moreover, nurses cannot be expected to lead in healthcare delivery or contribute to health policy without personally possessing a strong scientific background and without a robust body of science to support care decisions (Coyne, Kennedy, Self, & Bullock, 2018).


And so, what do we do, as individuals and collectively, to develop nurse scientists and nursing science? First, we must encourage and support those who choose nursing for a career. We need to then be sure that, as part of basic nursing education, we provide knowledge and skills necessary to understand and apply scientific knowledge to practice, including active scientists providing instruction about scientific processes and current scientific findings. We must also carefully cultivate the next generation of nurse scientists, introducing them early to the wonders and challenges of scientific work, including the potential to solve vexing, common clinical problems in an efficient manner rather than by trial and error. We need to be sure that programs designed to prepare nurse scientists do so with a firm vision of the potential nursing science holds to improve health and healthcare delivery through discovery of unexplored relationships among health determinants and health outcomes and by developing, for future testing, interventions aimed at improving health outcomes. We also need to be sure that there are sufficient and high-quality avenues for scientific dissemination. In particular, scientific knowledge designed to improve practice needs to disseminated in ways that facilitate access to those who need it.


I hope that in 2020 we will learn much about how our profession and discipline are viewed by other health professions, governments, and the public. I also hope that you will support the efforts of the WHO, the International Council of Nurses, and Nursing Now, as well as other groups sincerely interested in preparing nurses to meet the healthcare needs of the world's citizens. Finally, I hope that we recognize that, in order to achieve the lofty goals of the WHO and others to raise nursing's status, the vision for nursing's future must include science training and scientific inquiry. Efforts to raise nursing's status by increasing the numbers of nurses in practice as well as improving nursing education and enhancing nursing's involvement in healthcare leadership and policy will fall short without a strong commitment to rigorous science and scientific dissemination.




Coyne B. M., Kennedy C., Self A., & Bullock L. (2018). A comprehensive approach to undergraduate nursing students' research experiences. Journal of Nursing Education, 57, 58-62. doi:10.3928/01484834-20180102-12 [Context Link]


Harrison T., Steward D., Tucker S., Fortney C., Militello L., Smith L., [horizontal ellipsis] Pickler R. (2019). The future of pediatric nursing science. Nursing Outlook. Epub ahead of print. doi:10.1016/j.outlook.2019.06.020 [Context Link]


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Smeltzer S. C., Sharts-Hopkon N. C., Cantrell M. A., Heverly M. A., Nthenge S., & Jenkinson A. (2016). A profile of U.S. nursing faculty in research- and practice-focused doctoral education. Journal of Nursing Scholarship, 47, 178-185. doi:10.1111/jnu.12123 [Context Link]


Smith C. R., Martsolf D. S., Draucker C. B., Shambley-Ebron D. Z., Pritchard T. J., & Maler J. (2016). Stimulating research interest and ambitions in undergraduate nursing students: The research-doctorate pipeline initiative. Journal of Nursing Education, 55, 133-140. doi:10.3928/01484834-20160216-03 [Context Link]


World Health Organization. (2016). The global strategic directions for strengthening nursing and midwifery 2016-2020. Retrieved from[Context Link]


World Health Organization. (2019). Executive Board designated 2020 as the "Year of the Nurse and Midwife.", Retrieved from[Context Link]