On International Nurses Day: See Care Everywhere

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On International Nurses Day:  See Care Everywhere
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This article is part of a series in which OECD experts and thought leaders – from around the world and all parts of society – address the COVID-19 crisis, discussing and developing solutions now and for the future. It aims to foster the fruitful exchange of expertise and perspectives across fields to help us rise to this critical challenge. Opinions expressed do not necessarily represent the views of the OECD.

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As the coronavirus pandemic ravages people around the globe, many places have adopted the kind of thanks seen in Italy and here in New York City each night, as people lean out of their windows to applaud, ring cow bells, sing, and shout “thank you” to doctors and nurses. Many nurses are raising a different ruckus. They are protesting the shortages of masks in New York City, they are objecting to reusing masks in California. Nurses look out for themselves, but they also look out for everyone. 

Nurses understand, better than most other people, the centrality of care in people’s lives, the way that care often demands sacrifice, and the complexity of providing good care. What we can do to honour nurses, then, is not only to make certain that they actually have the supplies and staffing that they need to do their work well. To honour nurses, we can also take more seriously the place of care in our world and act accordingly.

Following in the Footsteps of Florence: We need better policies to protect nurses at the frontline of crises by Paul de Raeve, Secretary-General, European Federation of Nurses Association

Following in the Footsteps of Florence: We need better policies to protect nurses at the frontline of crises by Paul de Raeve, Secretary-General, European Federation of Nurses Association

Even though you would not necessarily know so by reading our leading political and social theories, care is central to all human life. Every human being is vulnerable. We will all eventually die and we are all susceptible to bad luck, disease, socially and politically induced harms and other disasters than might befall us. We are all, every day, care receivers; we are in constant need of care to maintain our lives. Most of this care is either invisible because adults provide much care for themselves; and because a lot of care is invisible because it is beneath our daily notice to see the extraordinary work that others are doing to smooth our ways through transit, stores, schools, cleaning up after us in our homes and offices, and so forth. If we are all care receivers, though, we are also all care givers. From the youngest children who will imitate feeding their care givers, to professionals like nurses, to home health workers, domestics, and others who clean up after us, to activities that meet our basic needs and those of our families, we all give care every day. We are all interdependent.

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What the coronavirus pandemic has made clear is that while some of the essential workers, such as nurses, are highly skilled, others provide care and yet receive little social or economic recognition for the care work they do. Once we start to look more closely, care work is vastly undervalued. Those deemed “essential workers” – sanitation workers, transit workers, grocery store workers – are not the most vaunted members of society.  Nevertheless, such care work is devalued. It is also the case that gendered roles for men and women perpetuate the idea that care is “women’s work,” though men’s organisations around the world are beginning to take up the challenge of seeing that men, too, do care and need to take caring more seriously.

But there is another thing about care that is worth noting; care is also an ethical posture toward the world: call it the ethics of care.

Read COVID-19 pandemic: A Crisis of Care from the Care Ethics Research Consortium

While nursing aims at producing a particular caring outcome, such as saving this patient’s life, good care also produces another benefit: it produces a sense of safety, of being cared for, of being in a position to go forward and to return care to others. If greed creates a vicious circle, as those who now have more want ever more, caring produces an opposite effect: a virtuous circle. Nancy Folbre, an economist, wisely called this “the invisible heart” that complements the economic self-interest of Adam Smith’s “invisible hand".

If people throughout a society feel solidarity because they have managed to be well cared for, if they are willing to support care for others, the end result is more care for those who are more vulnerable. Through a concern for care, the focus on social inequalities, deep injustices in how social benefits are allocated become more visible.  And once problems are more visible, it is more possible to correct them. To choose a simple example from the United States: Why don’t hospitals and nursing homes set minimum standards for staffing? To do so would guarantee better care. But it runs afoul of ideological debates about government’s role in businesses. According to National Nurses United, the absence of such standards put nurses and patients in precarious conditions. 

One World: Global solidarity for recovery and resilience by Sharan Burrows, General Secretary, ITUC

One World: Global solidarity for recovery and resilience by Sharan Burrows, General Secretary, ITUC

So for better policies for better lives, the critical question to ask is this: how can we best take care? In order to really honour nurses, perhaps it is time for our societies to become a bit more curious and act to see the world as they do: in terms of the need for really good care for everyone.

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