Introduction by Veronica Feeg. The meeting was convened to discuss the formalization of an international nursing organization to be called the International Child Health Nursing Alliance (NOTE: organization's name determined by the responses of the atten dees) dedicated to improve the health and well-being of children. Its purpose would be to link nurses who care for children to information; people and material resources; and tools for development that assist them in their work.
Opening comments by Maureen McTeer. Ms. McTeer addressed the group with the point that despite many advances in health care and technologies, women and children of the world continue to be disadvantaged.
Women raise the world's children and support most of the world's families, yet, they have neither recognition nor thanks from the rest of the world. This truth underscores the link between affluence and influence, and those who are the most poor, the most needy, and the most at risk are the children and families for whom we all care. Most notably the women and girls of these countries, lack the afflue nce to make any substantive change in influencing public and health policy. Children's rights and opportunities are dependent on mother's education and ability. Education continues to be denied to women, wives and mothers due to their lack of status, and therefore no perceived need for education.
Ms. McTeer suggested that those of us with skills and knowledge should come together to form an international nursing affiliation in order to address many of these problems. Pediatric nurses in their daily work touch the lives of women and children and c an bring influence to bear. She suggested that these needs call for action, that those of us who nurse and more fortunate would be able to help out our sister countries less fortunate with information, knowledge and skills development.
Possible Actions
Ms. McTeer offered the following thoughts about moving forward with this initiative:
· We should create one such organization, joining considerable voices to influence laws and policies which value women and children. It would be important to make policy-makers focus on women and children and pediatric nurses to contribute to the process of decision making, for example calling for the provision of quality child care.
· Pediatric nursing enables us to work directly with women through children. By and large nursing is a profession made up of women who can act as role models for young girls to emulate. Nurses should not underestimate the impact of influence that they ca n have. In addition, since nursing is a predominently female profession, what is good for nurses is good for women in their efforts for equality worldwide. Our daughters should not be condemned to fight the battles for equality and health over and over.
· Nurses can play the role of being conscience and catalyst to improve our world.
Meeting Proceeding
Veronica Feeg structured the discussion around 4 triggering questions and invited comment from the participants verbally and subsequently in writing. These comments are integrated in the following summary, arranged by question.
Question 1: What are the 1-2 most compelling issues facing children and families today that pediatric nurses should be concerned with?
· An opening comment indicated that children's needs are not being met by today's health care system. There are tremendous, common international challenges facing children and families and we should set a global agenda. It is important to see an organiza tion like this take up this agenda and not get into professional nursing issues, rather taking a broader approach of advocacy - to serve as a voice for children.
· Our focus should be placed on children who are most at risk, particularly in this time of economic restraint in most countries. Medically fragile children, who consume expensive health care resources, are especially at risk and should the focus of our c oncern.
· This nursing group can serve as a professional network, using a global vehicle to help people understand and cope with change, but more importantly to drive change as well.
· Speaking from developing countries, participants were more concerned about health than diseases, and the role that we as pediatric nurses have in promoting health. We can not think of the child without thinking of parents and families. Helping them to cope with disease and socioeconomic determinants of health should be our purpose. For this, a network is essential.
· Several comments addressed the problem of access to health care for women and children. In particular, some countries provide limited education to fulfill that role. For example, there are only 3000 nurses in Nicaragua and there is a 3 to 1 ratio of doc tors to nurses. In some cases, countries do not educate pediatric nurses, just nurses. These nurses need assistance to supplement their knowledge base about caring for children.
· It is important to note that while there is a necessity for the network, there are other organizations with similar aims. Therefore, we need to collaborate, making our voices heard; we need to identify our unique perspectives; and we need to find out wh o is doing what, thus working within the larger networks of child health professionals and voluntary organizations.
· Pediatric nurses need to assist parents in parenting/child caregiving. Parents are so often the primary health providers to children in the world and nurses need to empower them to be competent in this role. Information supporting parents should be made available to pediatric nurses through this network in order to facilitate this development.
· One of the major goals for this organization is to spread information at the grassroots level.
· We need to view education to developing countries not as a handout but rather as a tool. Nurses in this network can assist in providing education to nurses in developing countries thereby empowering them to influence change in their own society.
One comment was related to specific problems and disturbances during the first 1 or 2 years of babies' lives, including separation, postpartum depression and colic. These and other symptoms of problems in the early development years are of concern to nu rses. Another nursing problem identified by the group was pain and symptom management. This network could offer access to tools and expert practice that will assist others with their nursing care.
Question 2 - What resources are available worldwide to pediatric nurses that assist them to care for children and their families? what should be available through this network?
·Several general comments included that there are "people" resources available currently that need to be identified - who they are? where they are? and what they have to offer? This network could facilitate the collection and establishment of such a data base that links people to expertise.
· Specific comments were made related to use of the internet and fax machines. The potential for electronic communication enhances the opportunities for this international network to make the dream become a reality.
· GlobalChild Net - available through the internet - offers a communication infrastructure system world wide. However, we should not assume that technology is the only answer, but rather, it should be used as a vehicle to effect change. This communicatio n needs structure and we need to go to the grassroots; we need to have access; we need to play leadership roles; and we need organization in the system. This tool can be used to benefit the children by providing education indirectly and directly to their caregivers.
· We need to make available to pediatric nurses in their work places a mechanism to access resource material. Some nurses in remote places should be able to get teaching material already translated and ready to be used.
· It is essential that we do not assume that we know what families need, but forge partnerships with them, not imposing our ideals on them. We need to start from their perspective.
There are a range of NGOs and voluntary groups that pediatric nurses are already aligned to and should be encouraged to continue in their collaboration.
·It was suggested that corporate sponsorship and/or support could help to facilitate the mechanisms to enable this group to become a reality. Events such as the those sponsored by the U.N., the W.H.O., and UNICEF are possible catalysts for pediatric nurs es to influence policy. This group can provide the collective wisdom and become the organized voice in these forums. The continuing message must be to "put children first" in policy decisions.
Question 3 - What kind of organization should be in place for us to contribute to the greatest extent that we can?
· This type of multinational organization formed as an alliance of like-minded child health nurses and friends should be considered. It should not be exclusive to nurses in general or pediatric nurses specifically. It should not have a country-based struc ture, but rather, an interest-based structure. The organization could be very fluid, where those who are interested, i.e., sub-groups, could join together by areas of interest, expertise and advocacy. We should not be caught up in static forms, not be an end in itself, but a means to achieve ends. Otherwise, power and information remain at the "board" level and not with the children.
· The purpose of the formation should be centered around child health advocacy and empowering nurses through information transfer to achieve these goals in their own societies. The child is the center of this group's focus but should always be considered in the context of the family.
· This group should be called the International Child Health Nursing Alliance.
· We want to be in a position to influence, and shape the future for global child health. When policy makers are introducing legislation or making decisions affecting child health policy they should consult with the International Child Health Nursing Alli ance. Policy change is a two way process and we need to develop communication systems to ensure ideas from the grassroots can inform the decision making process.
Question 4: How can we share our nursing expertise, information and/or resources with one another to contribute to a "child-friendly" world?
Action Plan
Veronica Feeg invited participants to indicate a willingness to become involved with the International Child Health Nursing Alliance. This involvement would begin with (a) a minimum willingness to follow-up from this conference with papers/presentations that can be available in print and electronic media; (b) agreement to continue to inform others about the alliance and contribute ongoing articles or information to the newspaper page and on the internet; (c) identifying additional child health-related or ganizational contacts, resources and linkages; (d) a commitment to the promotion of the goals of the alliance; (e) participate in the Nursing Conference for Child Health 2000 in the future with a goal to improve the profile of nurses and nursing in the pl enary sessions and program; and (f) taking responsibility for particular activities that will be developed within the alliance.
Commitment was given by many participants for specific action to take the work forward and by all in seeing such a development for child health nursing. Veronica Feeg will contact all those interested in the near future.
Closing
In closing Veronica Feeg informed the participants that Ms McTeer has very kindly offered to present a report from the proceedings. It is anticipated that this report will recommend the launch of the International Child Health Nursing Alliance. This repor t will be provided in the final session of the nursing conference at 5:00 p.m. on Saturday, June 3rd 1995. Return to Home Page