Most nurses have little time to think about, much less address, global health concerns. Yet nurses are positioned uniquely to contribute to worldwide health, according to a recent World Health Organization report.
Linda Sarna, RN, PhD, FAAN, AOCN, professor and Lulu Wolf-Hassenplug Endowed Chair at the UCLA School of Nursing, co-authored the WHO report, which addresses how nurses can affect the “global burden of noncommunicable diseases” and the support systems they will need to do this.
Sarna’s report, released in December 2012, is a response to a United Nations Resolution on the prevention and control of NCDs — mainly cardiovascular diseases, cancers, chronic respiratory diseases and diabetes — that are responsible for 60% of deaths worldwide, according to the WHO.
The U.N. Resolution had called for a September 2011 General Assembly meeting on combating NCDs — only the second summit ever to address health concerns (the first was on HIV/AIDS). The assembly charged the WHO with recommending actions for preventing and handling NCDs.
“This will be a massive effort,” said U.N. Secretary-General Ban Ki-moon at the summit. “NCDs are altering demographics. They are stunting development. And they are impacting economic growth.”
Sarna said she became involved in the U.N./WHO effort when she and her colleague, Stella Aguinaga Bialous, RN, DrPH, FAAN, WHO senior consultant and president of Tobacco Policy International in San Francisco, were on their way to an International Council of Nurses meeting in Malta shortly after the U.N. adopted the resolution. Sarna said she wanted to stop by WHO headquarters in Geneva, Switzerland, because she and Bialous had just finished editing nursing research on tobacco and wanted to make certain they could share their information worldwide.
In Geneva, they met with Annette Mwansa Nkowane, RN, RM, BSN, MA, technical officer for the WHO Department of Health Systems, Policies and Workforce. “She said WHO had few resources to respond to the U.N. resolution, and I said we could help,” Sarna recalled. “Our emphasis was on tobacco use, alcohol, unhealthy eating and physical inactivity,” the main causes of NCDs.
Sarna and Bialous pulled together what they had learned in their research in a report for WHO and presented their information at two major nursing conferences: the WHO Global Forum and the Triad meeting, which included WHO officers, the International Confederation of Midwives and the International Council of Nurses. What then evolved were specific strategies to enhance the evidence-based capacity to address NCDs, Sarna said.
Sarna’s and Bialous’s report for the WHO notes the world’s 19 million nurses and midwives account for more than 50% of all healthcare providers in most countries and represent the largest group positioned to significantly contribute to preventing and treating NCDs.
The report details evidence-based nursing practices and suggests actions to enhance nursing and midwife capacities to respond to NCDs in their practices. It calls for changes in standards of practice, competency statements, curricula and job descriptions as necessary for nurses and midwives to better prevent, treat and manage NCDs and their risk factors. It also says nurses working more closely with policymakers and increased efforts in nursing research and education are needed to support such changes.
Sarna, who has published widely on tobacco control and began the first national program to support nurses wanting to quit smoking, is actively engaged in efforts on all fronts to reduce NCDs in the U.S. and other nations. She recently concluded research in China and, with Bialous, has a project in Poland and the Czech Republic — countries with a high prevalence of smokers, she noted — to expand the role of nurses.
For the May issue of the American Academy of Nursing’s journal Nursing Outlook, Sarna authored a resolution calling for all colleges and nursing schools to be smoke-free, and said the academy is working on a resolution calling for nurses to exhibit the skills needed to help tobacco users quit.
Sarna hopes the issue of NCDs and their prevention is part of the nursing discussion for years to come. Research conferences should focus on risk factors — especially tobacco because it can lead to all four of the NCDs the U.N. is targeting — as the leading cause of preventable deaths around the world, she said. “I don’t mean a break-out group,” she said, “but a major thematic address, a nursing call-to-arms.”