Nursing in France and Great Britain; Celebrating the International Year of the Nurse

From The Floor

Nursing in France and Great Britain; Celebrating the International Year of the Nurse

Nursing beyond our borders

By Geneviève M. Clavreul, RN, Ph.D.
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The nursing profession gets a lot of press coverage when something goes terribly wrong, such as when medication errors occur, a nurse steals medication from a patient, a nurse attacks a patient or other health care worker, and so forth. We also get press when nurses do good works, such as disaster relief and when we perform acts as good Samaritans. Yet, all too often, articles about bad nurses and bad nursing acts overshadow all the good that nurses do every day as they go about their lives.

This decade, however, is shaping up to be a busy one for nurses — and in a good way. In 2013, thanks to the team at Bare Roots, Inc. (and hopefully nurses too numerous to count), the world will tune into the Parade of Roses on Jan. 1 and see a float dedicated to the nursing profession roll down Colorado Boulevard. (Go to and check out last month's column, “Nurses: A Cut Above the Rest,” if you're not sure what I’m writing about.)

However, before this event takes place, nurses have another celebration that’s going on as I write: 2010 has been named the International Year of the Nurse, coinciding with the centennial anniversary of the death of Florence Nightingale. The plan is to provide the world’s 15-plus million nurses with opportunities to broaden the scope of their health education and promotion practices, and to help establish significant and effective global platforms for their advocacy.

Over the course of this International Year of the Nurse, it is my plan to pepper my columns with stories from the frontline of some of these nurses who work in a country other than our own. All too often our nation’s nurses are blissfully unaware of the challenges — both good and bad — that our fellow international nurses face as they go about their daily work. Let me begin with sharing my own experience from France.
Nursing in France: Proving Ratios Are Relative

It had been many years since I visited the country of my birth. But when the HIV/AIDS crisis surfaced, I returned to France to spend untold hours and days roaming the halls of various hospitals and research institutions. I had the chance to speak with and observe many French nurses as they went about their daily work, as well as experience some of the medical care there when I fell ill during a trip.

In France, nurses have a greater focus on the clinical aspect of nursing care, with about two-thirds of their training spent on clinical and only one-third focused on didactic/theory. Thus, the French basic nursing program more closely resembles our associate-prepared nursing program. There is a class of French nurses that resembles our nurse practitioners, but they have been granted practice liberties that would cause our American nurse practitioners to suffer paroxysm of jealousy.

One day a local thoracic and transplant surgeon offered to give me a tour of her ward, tempting me with the offer of being able to interview the transplant nurses that staffed and ran her multiple-transplant ward — that’s right, a multiple-transplant ward. Of course I couldn’t say no. The ward was large, even by American standards, with patients filling every bed. The nurse-patient ratio would have caused an American nurse’s head to spin, with one nurse providing care to several patients at once. But the French nurses and patients seemed no worse for wear, and indeed the patients seemed to be thriving under what we’d consider very stressful working conditions.

Part of this I think was due to the numerous aide soignant/e (nurses' aides) there to provide basic care, which allowed the handful of RNs to provide the more specialized and higher acuity care.
Nursing in Great Britain: Underfunded & Understaffed

Recently, numerous articles have been published on low wages in Nursing Times, the 100-plus-year nursing publication that addresses issues in Great Britain. Last year, Scottish officials expressed concern that since Scottish nurses often had to work two to three additional jobs just to make ends meet, how might this impact patient care and safety? And in case you missed it, our fellow nurses in England have had an ongoing battle with MRSA and C. difficile that has caused hospitals to close whole wards and challenged the nurses to engage in more aggressive hand washing and other infectious control techniques then we have ever had to face in our hospitals "across the pond."

The above comments are not meant to cast aspersion or shed a negative light, but they do serve to illustrate that each nation’s nursing corps has challenges both unique to its home country and shared with the global nursing community, such as nurse-patient ratio, the definition of nursing practice, educational requirements and salary.

Currently, Great Britain’s National Health Service is undergoing a great deal of upheaval from persistent underfunding and understaffing. It's also debating about the adoption of a national uniform, what the entry level of nursing should be, low wages — does this sound familiar?

There is also an ongoing debate on what role nurses should have in redefining the current NHS system. Many nurses are advocating for their profession to speak in a more united voice if they are to make substantive changes to NHS and how their profession is viewed by those who are in power.

For example, there has been brouhaha recently over a leaked comment from a draft of the Prime Minister’s Commission on the Future of Nursing and Midwifery, which suggests asking all nurses to sign a “pledge” reiterating their commitment to high-quality care, health service improvement and professional accountability. The mention of this pledge has ignited a firestorm of protests and comments from nurses throughout the NHS. (As mentioned previously, a good source to keep up with the state of nursing in Great Britain is Nursing Times. Not only can you access various news articles and nursing-related blogs, they have an excellent nursing practice area that is informative and gives the reader a good feel for the NHS nursing practice.)
Until I have the opportunity to bring my readers additional insights, stories and experiences from beyond our borders, keep an ear to the ground about festivities surrounding the 2010 IYNurse.

Consider bookmarking the site so you can keep abreast of the events, and be sure to save the date of April 25, which has been reserved for the 2010 IYNurse celebration in our nation’s capital. Organized by Sigma Theta Tau International, the Nightingale Initiative for Global Health and the Nightingale Museum, the event is free and will be held at the National Cathedral in Washington, D.C., from 4pm to 5pm.

This celebration could serve as an opportunity for nurses from all walks of life and nations to mingle, meet and share experiences in a once-in-a-lifetime forum. Just imagine that venerable cathedral packed to the rafters with nurses — what a sight, what an opportunity, what a memory! Let’s make 2010 a memorable International Year of the Nurse. 

2010 IYNurse
Nightingale Initiative for Global Health
Nursing Times
Sigma Theta Tau International

Geneviève M. Clavreul RN, Ph.D., is a health care management consultant who has experience as a director of nursing and as a lecturer of hospital and nursing management. She can be reached at

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