The reported phenomenon of the ‘Great Resignation’ is expected to have severe consequences for health services. Health workers – the majority of whom are women – have been forced to endure difficult working conditions and immense work loads through the COVID-19 pandemic. In Switzerland, a country with a relatively small population, the situation has led to a current shortage of 7,500 nurses, with more departing the profession daily.
It is no surprise to Swiss nurses Sophie Ley and Yvonne Ribi, who have worked with allies to trigger a constitu- tional initiative for nurses, putting this to a popular vote across the country. Their demands were widely reported in the press and included addressing nursing shortages, improving the safety and quality of care of patients, and improving the remuneration and wellbeing of nurses. The campaign drew extensive media and prompted de- bate in other countries as nurses reported similar experi- ences and weaknesses in their own health systems.
The referendum was one of a number of initiatives spearheaded by Ms. Ley and Ms. Ribi in the past two decades. Through their political work, they advocated for a change in billing practices to allow nurses the authority to invoice health insurance companies for certain interventions without the requirement for a doctor’s order. When the measure was defeated in parliament, the Swiss Nurses Association turned to the people and started a five-year long campaign for a national referendum. In November, 2021 Swiss history was made when 61 per cent of the electorate voted in favor of the Nursing Initiative and the parliament was forced to take action for better working conditions and increased staffing, with measures for further allocation of education places yet to come.
Ms. Ley believes recognition of the professional competencies of nurses is key to overcoming the challenges inherent in the health system. “It is only by valuing nurses and recognizing nursing qualifications that we will be able to maintain health security. Globally, I think what we need now is to work together. We need to position the nursing voice on the world stage and use it to drive leadership on this issue,” she says.
As leader of a 25,000 strong organization, Ms. Ribi, who shares the award with Ms. Ley, is clear about the role her members play in the maintenance of healthy societies, something she says became evident to the Swiss public and to the world during the pandemic.
“The behavior and competence of nurses is very important for society – it’s a force for good. Nurses can make a difference when a community is in need. During the pandemic, we saw how nurses played a crucial role in securing the health of entire populations. We have to invest in greater numbers of nurses and better working conditions, not just because the institution needs flexibility, but because nurses also need flexibility.”
Ms. Ribi is positive about the power of solidarity when women work together. “When we are together as a group, we can change the constitution of our country, change the federal laws, influence the politics, make things better for nurses and for patients.”
Both women welcome debate about the profession, but ultimately believe that nurses themselves should be entrusted to serve as agents of change in the
health system and make decisions about how health programmes should be delivered.
“Today, a lot of people talk about our profession and explain how things should work. But we have to have our own definition about our field of competence, so that we can contribute to policy-making and make decisions on health programmes in the country,” says Ms. Ley.
