Message from the Editor

Dr. Nandaprakash P, MSc (Nursing), Ph. D (Nursing)Editor in Chief, IJONEFrom the Editor’s Desk: Value of Nursing PracticeI would first like to thank the authors, editorial board and the reviewers for the commendable July 2023 issue of International Journal of Nursing Education. As nursing has matured and the issue of value in health care has now become the lifeblood of Indian healthcare system, this contribution could not be more timely or vital.I am eager to reflect on the authors’ call for nurses to incorporate into their practice the responsibility to call out low value care and efficient, cumbersome administrative processes that inhibit nurse’s ability to provide coordinated, high-value patient care. I am reminded that value occupies two poles at each end of any continuum. At one pole, value is advanced through the efforts of those who have a strong commitment to making a difference, having an impact, improving conditions and circumstances, and raising the quality of the human experience. Each of these are fundamental and historical drivers for the practice of nursing. The authors have captured well both the elements and processes associated with an ethically grounded, outcomes-driven, cost-effective, and value-based nursing practice. They have also emphasized that after the past two years of the pandemic the innumerable gaps that have long existed in the health care system now make it clear that it is in both the nurses’ and health systems’ interest to not return to a pre-pandemic reality if we are to advance the interests of a more mutually-rewarding health future. This corresponds to my 32 years of experience as a nursing professional. Little seems to have changed. As I look back at the important publications of those times, late 1990s and early 2000s, related to the themes of both workforce and value, one would see recurring conversations yet precious little movement.Value advancement and sustainability are inextricably linked. Nurses have the potential, when supported by size, location, and their centrality to all manner of health care delivery, to play a key role in addressing and aligning the determinants for a healthy future. The capacity for nurses to contribute to this aim is undeniable.However, at the other end of the value pole are issues related to nurses themselves. The question is: what is the real value of nursing? A cursory review of nurses’ institutional history indicates that nursing has always been identified only as a cost center in nursing resource management over the several decades of Indian health care. This means that the mental model, management processes, structural framework, operational mechanics, and financial ledger, validate that nurses have always been managed “on the margin.” According to a 2022 WHO report, “Nurses have finally learned their worth,” a health system chief executive elucidated nurse’s reality in starker terms: “Nursing has always been a burnout profession.The work is hard. It is physical and emotional; hospitals build in shortages into their business model, keeping their staffs lean and their labor costs down”More recently, the Economics Times reported that honourable Prime minister of India Narendra Modi ji urged people to show their appreciation to all nursing staff for their exceptional work even in the most challenging of situations Their deep commitment to protecting lives and public health is commendable He appreciated them for their dedication and compassion, which he said were exemplary.