Global – “of or relating to the whole world, embracing the whole of something.”

Nursing: “…autonomous and collaborative care of individuals of all ages, families, groups and communities, sick or well and in all settings.” (ICN)

My name is Barbara Waldorf. I have worked in nursing for 30 years, in education, pediatrics, public health and mental health. I currently teach public and global health and mental health nursing at Regis College (Weston MA) as well as working at Mclean Hospital at the Pavilion and 3East. I am also the co-founder and executive director of the Global Nursing Caucus. This is my experience starting this non-profit organization.

The journey has been long with many turns. My first step into global health was running a small clinic in a Tibetan refugee camp. Despite being a new graduate and feeling completely inadequate, I did it – there was no other choice. Over the next 20 years, I worked in Kathmandu training health workers; in London at a private pediatric hospital frequented by Arabs from the Gulf States and in a pediatric emergency room of a large inner city hospital. At the time, I thought this was a unique and personal path, but actually it is an example of the impact on one life of the larger forces at work in the globalization of health care.

Viruses and tsunamis, wars and mass migrations all ignore political borders and makes health care a worldwide concern. The process of globalization – the “vanishing boundaries between individuals, organizations, societies, and nations” impacts everything nurses do, whether we realize it or not. Nurses and midwives are the majority of the global health workforce. We deliver the bulk of all health care services worldwide. Nurses are the experts in patient care.

Global health and nursing practice are combining to form a new paradigm – global health nursing. An ever-growing number of nurses working internationally, in resource poor settings, and with multi ethnic populations domestically are forming this field. Global health nursing combines elements of cross-cultural awareness, public health, and expanded roles in management, clinical areas, policy development and education. It incorporates the ethical principles of social justice, equity and concern for human rights; and acts as the “next step” in bringing together public health and nursing.

All of these elements were at play, when we started the Global Nursing Caucus at Boston University School of Public Health, where I had returned in 2010 for a Masters in Public Heath. One professor was a nurse, and any student who was also a nurse, eventually found their way to her office. Alone and increasingly together, we found a place to ask the questions that had been roiling around in our heads – What was the role of nursing in global health? What impact does globalization have on nursing? How can we respond to these forces? Who and where were the nurses in global health and how could we find them?

Fortuitously, at the same time we were asking these questions, the Center for Global Health at Massachusetts General Hospital (Boston) was planning a seminar on Global Nursing. A group of us attended this seminar. We heard nurses contextualizing their experience of working globally, combining both nursing and population health perspectives, and looking at it through a global lens. Nurses central to the field brought ideas and concepts we had been reading about to life.

After this seminar, fired up and ready to respond, some of us went to a small coffee shop on Charles St. and made the commitment to start a group that would focus on bringing together those interested in global health and nursing. We called it a caucus because we felt that the most important aspect of the group would be to bring together all of those working in the field, from all countries, to share their experience, collaborate and support each other. This was the initial impetus for starting the GNC.

Since that day, we created a website and a monthly newsletter, forged connections with nurses working worldwide, and held conferences and gatherings exploring various issues in global nursing. We are currently working on incorporating as a 501c3, planning our next conference focused on policy, exploring fellowships, development, and governance issues, and continuing to network with our colleagues near and far.

Our most recent conference (November 2014) brought together colleagues from around the globe to focus on promoting nursing advocacy in global health.  The conference used live webcast, virtual oral and poster presentations, blogs on Global Health Delivery Online (GHD Online), and Twitter to bring together nurses from almost every continent. Nurses presented virtually from Oman, Mexico, Haiti, and Kenya and joined over 110 colleagues at UMass Boston. The keynote addresses highlighted the role of nurses in promoting global health and advocated for the importance of the nursing profession in creating initiatives to improve global health.

Global nurses know what happens in one part of the world is intimately and rapidly connected to everywhere else. Ebola is our most recent reminder of this fact. Global nursing incorporates social justice and health equity, ideas integral to nursing since Florence Nightingale. The mission of the GNC is to advance the role of nursing in global health practice, education and policy through advocacy, collaboration, engagement and research. We are expanding and welcome everyone to join us in creating this new field.