ESNO Position Paper: 'Specialist Nurses and Professional Mobility in Europe'
Proceeding of the ESNO congress 2020
'Specialist
Nurses and Professional Mobility in Europe'
Ten or twenty years ago, most of us could not
have imagined the changes in healthcare we see today. Similarly, it is hard for
most of us to imagine how healthcare will be in 2030. However, one thing has not
really changed much over the last few decades: the role and status of the
health professional. This has been particularly noticeable for the role of the
specialist nurse.
Health care today and its main challenges
A decade ago, when the partner or
spouse of a graduate nurse in a senior role and with decades of experience in a
specific area got a job in another EU country, the nurse would struggle to move
into a role in the new country. This often resulted in the nurse moving out of
healthcare. In 2020, this has not improved. In some European countries, the
barriers for nurses moving across borders have become greater, whereas some
barriers have become embedded in European institutional rules.
The European professional qualifications directive,
put in place in 2013, was designed to allow professionals free movement to live
and work within the EU and to move more freely across EU borders. However, there
are still remaining various gaps in policy making, such as addressing the
future direction of nursing and nurses' professional mobility, and guaranteeing
free movement in perspective of a shortage of nurses.
There has been a shortage of nurses since
midway through the 1990s. This is jeopardising the provision of high-quality
and sustainable healthcare. We need to accept that today's system, which is
stable, certain, simple and clear from a national perspective, needs to shift
as the world shifts towards volatility, uncertainty, complexity and ambiguity (VUCA)
on a European level.
Future health care
If only national regulatory systems and
national nursing associations are entitled to fill in those gaps, the credibility
of the Professional Qualifications Directive[1]remains
questionable. To meet the requirements of healthcare in 2030, national and
pan-European institutions have to take brave measures to address the impact of
these issues. Measures should include new competencies and roles for nurses in
the future, as well as a common training framework (CTF) for specialist nurses.
- The changes seen in healthcare over the past few decades affect a number of domains[2]. These include a shift from:
- a focus on mono disciplinary medical teams to an interdisciplinary multi-professional approach;
- passive patient roles to active, engaged and literate roles;
- a disease-oriented approach to a person-oriented approach;
- predominantly acute care to predominantly chronic care, related to the increased elderly population and having an impact on comorbidities;
- a reactive-based healthcare system to a proactive and evidence-based healthcare system, a focus on prevention;
- a fragmented health system with specialists working in siloes to an integrated care system;
- volume-driven and quantitative data to value-driven and mixed data, with a focus on quality of care.
Healthcare 2030 needs to bring in new roles and
competencies. To do more and better with less will need integration and creation
of new networks, partnerships, and health eco-systems. Our organisations and
professionals need to be ready for transformation and innovation.
We strongly believe that investing in the recruitment
and training of specialist nurses, while recognising their advanced role as
nurse professional now and in the future is part of the solution to cope with this
new reality. Hence, we urgently need a European-wide acceptance of the role and
position of nurses with post-graduate qualifications in specialist roles,
through the adoption of a common training framework and a common set of
competences. This will allow all European countries to open their doors to qualified
nurses from across the EU and to ensure their populations receives accessible,
affordable, person centred and integrated care.
Call for action towards specialist nurses'
recognition and mobility in Europe
As ESNO, we call on the European Commission,
national regulatory bodies, and European and national nursing organisations to contribute
to an improvement of cross border healthcare and professional mobility for
nurses with post-graduate training and qualifications. This is required to
break through the siloes and be ready for the expectations of Healthcare 2030.
By formalising these processes, we will protect the future and enhance
progress.
We urgently call health institutions; both
regulatory and those representing national nurses, to open their doors and move
beyond the status quo.
“A manager accepts Status Quo, a Leader
challenges it” Warren
Bennis
Brussels.
25 – March 2020
[2]Christensen, C. Harvard Business
Review, 2000, Sep Oct , http://achc.org.co/hospital360/propuesta/Sincronizacion/Tecnologia_Disruptiva/Innovaciones_disruptivas.pdf
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