Leading with knowledge offers Nursing the opportunity to become visible

Within the Nursing Now campaign, Nursing in Colombia has a major opportunity to gather knowledge, initiatives and trends. In this context, and like a premonition about the challenges of keeping our discipline amidst the Colombian Health System, I would like to remember our teacher Nelly Garzón Alarcón (former president of the CIE in 1985-1989, and deceased in 2019), because her legacy continues inspiring one of the objectives of this campaign: to elevate the Nursing profile from local policies in order to build an international movement.

From our teacher Nelly Garzón I highlight the search for the recognition of the discipline through the application of own knowledge in a coherent and ethical way in the practice of care. Thanks to her training, Nelly, who was kind and convinced of the potential of her students, became a permanent advisor and driver for critical thought in Nursing care, promoting permanent reflection that would allow to qualify healthcare for persons, families and communities.

One of her final legacies was the Upsilon Nu Chapter of the Nursing Honor Society, an international organization that promotes leadership towards qualified nurses in order to achieve an international transformation in healthcare. This chapter was one of the first to support the Nursing Now campaign in Colombia; therefore, I would like to highlight its work regarding training new leaders through mentorship strategies based on formal interaction, sharing the personal stories of nurses with higher experience in the national and international setting.

Regarding the Nursing landscape in Colombia, the estimation for 2018 was of 66,095 professionals (14.6 per 10,000 inhabitants), located mostly in Bogotá (29%), and followed by major cities and provinces with mainly urban population. In terms of their profile, there was a large proportion of 25-to-34-year-old nurses, followed by the 35-to-44-year-old range. Overall, there was prevalence of women (80.3%) and with 791 dollars as estimated monthly salary (with a trend towards a lower sum).

Regarding the professional practice of Nursing, there are two laws in the country regulating its activity: Act 266 of 1966 (professional practice) (1) and Act 911 of 2004 (deontological and disciplinary liability for the act of care) (2). These regulations also established the Consejo Técnico Nacional de Enfermería (National Nursing Technical Council), which is the managing, consulting and advisory organ for the national government in Nursing matters. Additionally, there are organizations derived from the laws mentioned, and other non-profit organizations at academic, professional and scientific level, which contribute to generating initiatives and policies for the profession and healthcare in Colombia.

Currently, Colombia is facing challenges which have motivated the preparation of the National Nursing Plan 2020-2030 (3), an initiative that seeks a professional strengthening in the country through three strategic lines: work conditions and professional growth, professional education and quality in training, and leadership in Nursing. This plan intends to make a social, political and ministerial appeal in order to give recognition and visibility to the Nursing profession, and dignify the activity of male and female Colombian nurses. This plan is an intersectoral commitment for the future of the discipline, because it resumes the strategic lines of the Pan American Health Organization (PAHO) (4,5) towards an improvement in conditions for professional training and practice in interprofessional teams, and having impact on the health of persons both in the urban and the rural setting.

As a complement to the previously mentioned data, the role of Nursing in Colombia has been undervalued due to limitations in practice; because even though undergraduate training presents good quality indicators, its performance is limited to administrative matters, leaving out care, which is the essence of the discipline. That is why, through the National Plan previously mentioned, it is intended to implement mechanisms to acknowledge the professional experience derived of practice and advanced education, by training specialists, masters and doctors in the discipline. Likewise, the plan takes into account the National Policy on Integral Health Care (PAIS) (6), which offers opportunities for professionals to lead patient care in nuclear and transversal teams in healthcare approaches. On the other hand, it is important to state that this plan is targeted to all stakeholders in the General Health and Social Security System (SGSSS), which includes professional associations and organizations, ministries, Nursing professionals, insurance companies, health service providers, universities, users, and international cooperation organizations, among others; therefore, we are facing a major opportunity to strengthen the work of nurses in this country.

For this reason, within the framework of the Nursing Now campaign, the challenges for Colombia are to warn about the barriers for professional practice, such as the profitability model in the health system, the disease approach, the lack of opportunities in decision making, the low nurse-patient ratio, the underutilization of human resources regarding Nursing professionals in Colombia, the precarity of work conditions, lack of acknowledgment for postgraduate education, certification of skills by institutions without quality, the elimination of Nursing Departments, and the lack of a salary scale.

Summing up, we are facing many challenges, but the capacity of those of us in active practice through patient care, education, research and politics can be the strategy that allows to build over what has already been built, with own knowledge, acknowledgement among peers, and respect for the difference, just like Nelly Garzón Alarcón taught us and many Colombian and Latin American nurses.