With Humanity in Mind

Towards this common aim, every nursing program will set its own priorities and apply its particular strengths and capabilities to meeting them. 

For the UCI Sue & Bill Gross School of Nursing, delivering the highest standards of care to meet the needs specifically of minoritized people has been a core commitment throughout our history – a history whose beginnings stretch back further into our community than the relative youth of our school would suggest. We are a small school, and thus well versed in the necessity of using our strengths strategically to maximize the impact of our research and of our teaching. But reducing vulnerability for those in most need – and indeed, understanding, anticipating, and alleviating their needs at source – remains the overarching theme of our work. 

There are, of course, enormous challenges to be faced. Many of these challenges are shared by schools of nursing across the country – and the world. At the time of my writing this, the vulnerability that nurses seek to lessen is deepening for many people – particularly in the wake of the Covid pandemic and its downstream economic challenges. This deepening vulnerability unequally affects the most vulnerable – the very young and very old, people with fewer or no resources, the unhoused, the chronically ill, and minoritized people, among others. As a result, such people – and there are millions of them in the U.S. alone – suffer increasingly poor health and die increasingly young.

Additionally, global issues such as extreme weather events and the rapid spread of new diseases threaten human health, particularly for those who are most vulnerable. The nursing profession does not always see the earth’s health as a central concern, but as the disproportionate impact of climate change on people who are already vulnerable becomes increasingly impossible to ignore, this position must rapidly change. Sustainability is nursing’s concern. 

In tackling the healthcare challenges that we face, there are new technologies and techniques that hold great promise for advancing nursing research, and for personalizing healthcare at sustainable cost with improved outcomes that address health equity. Yet investment, education, skills development, research and collaboration are all required to maximize the usefulness of such innovations for the benefit of all people. This, too, is nursing’s concern.

During the Covid pandemic, it was made more evident than ever that nurses are the backbone of the world’s healthcare system. Despite this, the profession is threatened. Burnout imperils nursing careers, creating an intractable gap between demand and supply. Shockingly, investment in nursing is in decline. Universities’ investment in educating future nurses does not match the importance of the profession to the public’s health and, in turn, to the health of society, which is essential for a good society. Often those who hold the levers of power, in healthcare systems and in universities, do not see the simple truth: without nurses there cannot be a good society. 

Over the next five years, we are committed to shining a light on the importance of investing in nursing. We leverage our contact with healthcare systems, government officials, and policy makers, and we will advocate for policy change by providing evidence of nursing’s positive effects on the system and on society. We will advocate for increased investment.

At our school, we will develop awareness of the direct relationship between climate change and the vulnerability of the populations we serve. We will collaborate with our campus and health center partners to reduce our own impact on the health of our world.

We will research and educate our students in these technologies and collaborate with our clinical and campus partners to translate them into practice. We will ensure that the most vulnerable remain at all times central to the technological development of nursing care. These are our goals as we commit to living them. 

We know that across our nation and throughout the profession worldwide, our fellow nurses and nurse educators will recognize many of these goals as their own. While the precise emphasis of each institution’s contributions may differ – whether we prioritise expanding the workforce, generating knowledge, producing nurse leaders, or advocating for change – we believe that speaking together – as the one voice of nursing – we speak on behalf of a good society, a society in which we all would wish to live. This is the power of a manifesto: it envisions a better world and provides a guide for us individually about how to work toward that end.

In five years we may look back and find that the Sue & Bill Gross School of Nursing has not accomplished all that we dream of accomplishing now. We can, however, be confident that through nursing leadership, advocacy, education, collaboration, innovation, and research, our school has the power and determination to amplify the impact of nursing on health. The ultimate measure of whether we were true to our intentions and beliefs, as laid out in this manifesto, is whether, in five years, we can say that we did what we did with humanity in mind.

Lessening human vulnerability through the lens of social and racial justice and antiracism

TO LESSEN HUMAN VULNERABILITY IS AN AMBITIOUS AIM

We are not new to this aim: our work has long begun.

Nurses address injuries…thus, we address wrongs. Injustice and injury share the same stem. There are many ways to address wrongs, but at the Sue & Bill Gross School of Nursing we have chosen to address wrongs, and the injuries they result in, through the lens of social and racial justice.

We recognize the degree to which social and racial injustices, and individual and structural racism, create and compound vulnerability – over multiple generations – in our world today.

WE CREATE LEADERS

Nurse leaders with advanced qualifications raise standards and provide opportunities in the workplace, even for those who do not choose to go beyond an entry-level qualification.

We emphasize the opportunities and necessity for nurses to pursue leadership careers focused on creating a healthier and more just society.

We aim to educate and inspire nurses to lead on matters of justice.

Our graduates can be confident in leading within the profession, and of advocating for the conditions in which nurses do their vital work of care.

WE STRIVE FOR INCLUSIVE EXCELLENCE AND ANTIRACISM

We are a profession that cares for all members of society: Nursing should reflect the community.

Nursing programs’ curricula and the work of clinical and academic researchers must be regularly evaluated and adjusted to ensure that racial and social justice concerns are always made visible.

It is a significant priority to recruit and retain a diversity of staff, faculty, and students, and to ensure that people feel a sense of belonging in their place of work, study or in any other interaction with us.

The Sue & Bill Gross School of nursing has made it a priority to ensure that every aspect of our education, practice, and research is such that we are both inclusive and representative of the full range of communities we serve – and indeed, of the country we live in.

Our patients need to feel heard and understood; never more so than when those patients have experienced racism, quite probably throughout their entire lives.

Making the invisible visible.

WE SHINE A LIGHT

Every day, nurses work with society’s most ignored and invisible people: people who find themselves excluded from systems of housing, employment, healthcare, food security, or social services because of their physical location, race, ethnicity, religion, economic status, age, the language that they speak, or some other factor. We seek to shine a light on their lives and their experience. Nursing institutions must ensure that the results of their research are seen by administrators and policy makers at the highest level appropriate. We do not accept that things are as they should be.

• We see each other, human to human – we are there for each other
• We advocate for others, as individuals, to get the care and assistance that they need
• In our clinical practice and research, we identify, examine, and challenge the experiences that others face.

We amass evidence that supports health equity, and shows the work that nurses have long been doing in the shadows.

WE LEVERAGE TECHNOLOGY

Informatics gives access to massive datasets in which, for the first time, the effects of care (and lack of care) are made numerically visible without the need to rely on randomized control trials, which are rarely practical or ethical as a means of investigating health equity.

Much nursing research has historically relied on qualitative reporting and analysis to provide eloquent evidence on a case-by-case basis. The rise of informatics and data technology gives nurse researchers the opportunity to analyze and represent care and wellbeing in quantitative terms – a powerful tool.

Nurses must be involved in such research to ensure that the right questions are being asked of the data, the right models designed.

As the potential of these developments grows, the importance of inclusion is amplified as never before, and inclusion concerns nurses.

The associated fields of AI and wearable technology are opening new avenues for responsive, personalized treatment that does not require the daily presence of a health professional, holding out the promise of care that is both sophisticated and sustainable.

WE VALUE OURSELVES

Legislative and policy changes are needed to empower nurses to practice most effectively, and to the full extent of their license. In the U.S., California lags behind many other states in the restraints it places on the independent practice of nurse practitioners.

The devastation wreaked by Covid brought shortfalls in nurse recruitment and high rates of burnout to the national headlines. We seek to investigate the difference between a burnout situation and one in which, however difficult, nurses feel able to continue. Nurses will always need:

• role models and mentors to guide them in meeting their commitment to patients, often in extremely difficult circumstances
• conditions in which good patient care is possible
• educational opportunities and a professional development infrastructure to progress, and feel fulfilled by, their careers
• recognition from their colleagues in healthcare – especially medicine and administration – in academia, and in government, for the difference that they make.

Providers of professional development in nursing, medicine, pharmacy, public health, health systems, and management must join forces to help improve nurses’ workplace satisfaction and their ability to do the work they have been trained to do. It is as important for our colleagues in other disciplines to collaborate with us as it is for us to work with them.

Mutually collaborative relationships between nurses and universities, and nurses and other healthcare providers and researchers, benefit everyone.

The world’s health is human health

WE SEEK OUT KNOWLEDGE

We live at a time in which all human health is inextricably involved in another crisis: the crisis of planetary health that has already begun. Climate change affects minoritized populations first and most severely. This means that concern for the world’s health is doubly within the remit of nurses and nursing institutions.

We must accelerate our efforts to educate ourselves as to what form environmental threats to health may take, whether through disease or disaster,or through the long-term erosion of health caused by pollution and a degraded environment. To be a nurse is to help other humans. This promise draws people to the profession – between 60-80% of nursing students (depending on the source) state the desire to help others as their primary motivation for choosing nursing as a career. Let’s look squarely at nursing’s role in ameliorating the impact of environmental catastrophe on society’s most vulnerable people.

WE CARE FOR OUR WORLD

Nurses know that individual acts can make an important difference: washing hands really does save lives. Behavior change can be inconvenient, and small efforts can feel futile when problems are global and policies lag behind the necessary practice. Yet in matters of environmental health, we are determined to learn, and we must be prepared to lead. Nurses are individuals: the most populous profession in the world. At UCI, we are also teams; a school; a medical center; a campus; a university. Individually and together, we can make an impact, and show our students that we care about their future. Other schools, hospitals, clinics, and universities can and must do the same.

We are committed, through our actions, to sending a positive message that change is not only necessary, but achievable.

WE ARE A WORLD COMMUNITY

Health inequities caused and compounded by social and racial injustice are (unfortunately) by no means confined to our county, state, or country. At the Sue & Bill Gross School of Nursing, faculty are currently involved with projects in Botswana, Guyana, India, and Korea, to name a few.

We are a rigorous academic organization within a world-class university. Under the strategy implemented by our founding dean, Adey Nyamathi, our first five years have been characterized by impressive growth in the quantity and scope of our research. With this expansion comes greatly increased potential for global partnerships, collaboration, and exchange.

We will continue to increase our national and international participation, and welcome to our campus colleagues, researchers, and students from around the globe. In the same way that the planet’s health is human health, the health of all humans around the globe is the health of every single one of us.

Increasing capacity to support our ambitions

WE TARGET AND CONTROL OUR GROWTH

Throughout the U.S., schools of nursing strive to increase capacity to meet the challenges to the profession and to humanity. At the Sue & Bill Gross School of Nursing, we must increase capacity while retaining the rigor, intimacy, and the personalized experience that are currently hallmarks of our school. Collaboration is key to increasing capacity. Excellence and focus draw funds: by pinpointing our specialties and by increasing the numbers of nurse leaders we educate and train, we similarly increase the scope of sources from which we attract funding to our school. We are confident that our goals can be met through targeted and strategic expansion.

Our focus is on growth that makes a difference – growth in the next generation of leaders, growth in nursing knowledge.

WE ATTRACT INCREASED INVESTMENT

Nursing as a whole requires greater support to answer the needs of our society. In this, all nursing schools are our colleagues, and we speak with one voice. We tirelessly promote the profession of nursing and the importance of nursing research and education to human health in Orange County, in California, and in the country and society in which we all live.

Alumni and faculty alike are our advocates and proof of excellence. We continue to identify and consolidate relationships with supporters and champions locally and nationally, pursuing funds for the essential work of nurses everywhere.

We exist to lessen vulnerability, to promote social, racial, and environmental justice, and to deliver compassionate nursing care of the highest standard in the most equitable and accessible way possible – for the sake of humanity.