护理教育中的全球不平等：行动呼吁

护理教育中的全球不平等：行动呼吁深圳福彩中心,我的随身无人星球,棚组词, 作者：NursingResearch护理研究前 分享智慧 共同成长

作者：NursingResearch护理研究前

分享智慧

共同成长

Full text

Health inequity is a global phenomenon requiring an array of responses complicated by the impact of COVID-19. Two recent publications (Olufadewa, Adesina, & Ayorinde, 2021; Rosa et al., 2021) address the complexity of health inequity from differing perspectives. In the first instance, Olufadewa et al. (2021) suggested an egalitarian framework focused on global health research to reduce inequities between the world’s scholars. One of their primary points was that “dismantling inequities in global health must involve bridging the huge capacity divide between professionals in [high-income countries] HICs and [low-Income and middle-income countries] LMICs” (Olufadewa et al., 2021, e899). A second, more comprehensive response to health inequity focuses on a humanistic approach, capacity building. The concept of capacity building was expanded in the Nurses for Global Health Equity report (Rosa et al., 2021) by developing action-oriented guidelines to address social determinants of health.

Capacity building begins with ensuring adequate numbers of health professionals and educating them to the highest level of competence possible in a pre-determined timeframe. In this context, equity suggests that similar resources are available to educate as many health professionals as needed. In the US and across the globe inequity in both numbers of health professionals and resources to educate them are evident. In North America, governmental and professional bodies continue to note an ongoing shortfall in the nursing workforce, a situation occurring well before the COVID-19 pandemic. In 2020, the World Health Organization (WHO 2020) published The State of the World’s Nursing report. This report documents a global shortfall of almost six million nurses, despite increases in the nursing workforce since 2013 (https://www.who.int/news/item/06-04-2020-world-health-worker-week-2020).

Efforts to maintain and enhance numbers of graduates continue even during the continuing pandemic. In HICs, several specific strategies were implemented to ensure nursing students are able to complete their educational programs and meet the program outcomes. Some nursing regulatory and certifying bodies made adjustments so that within the limitations imposed by COVID-19, nursing education continues to flourish. Schools of nursing pivoted to increase virtual simulation and other strategies that kept students safe while supporting their learning. Telehealth became an essential skill to manage health needs of non-emergent patients and take pressure off inpatient settings overwhelmed with COVID patients. For some schools with rural students, connectivity and electricity capabilities became new issues, as did study spaces and managing while sheltering in place with family members.

For many middle and low-income countries the scenario has become more difficult. Lack of or inconsistent electricity and connectivity are not just nuisances but everyday concerns of living. The virtual simulation that many of us used to augment our teaching may not even be possible, assuming a school could afford the cost of the programs. While the issues have been present over time, COVID-19 both exacerbated and highlighted these educational inequities. One would need to question if patient outcomes can even approach equity if the education programs are inequitable throughout. These considerations do not even begin to address the issues related to availability of the vaccine to both stem the disease and ensure resources work towards health rather than caring for dying.

If health equity is to be a reality and not just a phrase we espouse, nursing will need to intentionally partner across global income and resource levels to assure more equitable and available education for nurses. Specific ideas include:

• – Ensuring funds are available for global educators to gather frequently together to develop equivalent educational strategies that work in places of all income levels.
• – Persuading purveyors of educational technology programs and platforms to create pathways so that nursing programs across the globe have access to educational resources and teaching scenarios are reflective of all income level countries
• – Promoting basic and available access to electricity and Internet for education and patient care
• – Funding collaborative research that examines nursing education with competencies and patient outcomes in countries with all income levels

Healing inequity begins with a sense of global community where everyone’s experience is heard and valued and contributes to shared missions of education, practice and research. COVID-19 has been a wake-up call for every one of us. It has also presented us with boundless opportunities to reduce disparities and improve equity. It is our choice how we respond.

全文翻译（仅供参考）

健康不平等是一种全球性现象，需要一系列因新冠病毒-19的影响而复杂化的应对措施。最近的两份出版物（Olufadewa、Adesina和Ayorinde，2021年；Rosa等人，2021年）从不同的角度阐述了健康不平等的复杂性。首先，Olufadewa等人（2021年）提出了一个以全球卫生研究为重点的平等主义框架，以减少世界学者之间的不平等。他们的主要观点之一是，“消除全球卫生不平等必须涉及弥合[高收入国家]HIC和[低收入和中等收入国家]LMIC专业人员之间的巨大能力鸿沟”（Olufadewa等人，2021年，e899）。第二，对卫生不平等的更全面的对策侧重于人道主义方法，即能力建设。《护士促进全球健康公平报告》（Rosa等人，2021年）通过制定面向行动的指导方针来解决健康的社会决定因素，从而扩展了能力建设的概念。

能力建设从确保足够数量的卫生专业人员开始，并在预先确定的时间范围内尽可能对他们进行最高水平的教育。在这方面，公平性表明，可以根据需要为尽可能多的卫生专业人员提供类似的资源。在美国和全世界，卫生专业人员的数量和教育他们的资源的不平等是显而易见的。在北美，政府和专业机构继续注意到护理人员的持续短缺，这种情况早在新冠病毒-19大流行之前就出现了。2020年，世界卫生组织（WHO 2020）发布了《世界护理状况报告》。这份报告记录了全球近600万名护士的短缺，尽管自2013年以来护理劳动力有所增加(https://www.who.int/news/item/06-04-2020-world-health-worker-week-2020).

即使在疫情持续期间，仍在继续努力维持和提高毕业生人数。在HICs中，实施了若干具体策略，以确保护理学生能够完成其教育课程并达到课程成果。一些护理监管和认证机构进行了调整，以便在新冠病毒-19的限制范围内，护理教育继续蓬勃发展。护理学校致力于增加虚拟仿真和其他策略，以确保学生的安全，同时支持他们的学习。远程医疗已成为管理非紧急患者的健康需求和减轻因新冠病毒患者而不知所措的住院患者压力的基本技能。对于一些有农村学生的学校来说，连通性和供电能力成为新的问题，学习空间和管理也成为新的问题，同时与家庭成员一起在适当的地方避难。

对许多中低收入国家来说，情况变得更加困难。缺乏或不稳定的电力和连接不仅是滋扰，而且是日常生活中的问题。假设一所学校能够负担得起这些项目的费用，我们中的许多人用来增加教学的虚拟模拟甚至不可能实现。随着时间的推移，这些问题一直存在，但新冠病毒-19加剧并突出了这些教育不平等。如果教育项目在整个过程中都不公平，那么人们需要质疑患者的结果是否能够接近公平。这些考虑甚至还没有开始解决与疫苗的可用性有关的问题，这些疫苗既能遏制疾病，又能确保资源用于健康，而不是照顾垂死者。

如果健康公平要成为现实，而不仅仅是我们所信奉的一句话，护理将需要在全球收入和资源水平上有意识地结成伙伴关系，以确保为护士提供更公平和可用的教育。具体设想包括：

–确保全球教育工作者能够经常聚集在一起，制定适用于所有收入水平地区的同等教育战略。

–说服教育技术项目和平台的提供者创建途径，使全球护理项目能够获得教育资源，教学场景能够反映所有收入水平国家

–促进教育和患者护理基本和可用的电力和互联网接入

–资助合作研究，以检查所有收入水平国家的护理教育能力和患者结果

治愈不平等始于一种全球社会意识，在这种意识中，每个人的经验都被倾听和重视，并为教育、实践和研究的共同使命做出贡献。新冠病毒19已经给我们每个人敲响了警钟。它还为我们提供了减少差距和改善公平的无限机会。如何应对是我们的选择。

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