Preface

We saw this book as a fertile soil for writing about research, practices, and concepts. The goal was to bring together different perspectives, preferably those that are "outside the box," innovative, and challenging, on what Nursing or perhaps tomorrow will look like.

The book's idea has been well-received by nurses, managers, researchers, and teachers around the world. There were more than 100 proposals and a wide range of themes, but the 11 chapters in this book stand out for their depth and quality, as well as their potential to be influential.

We depart from the conception that nursing is a discipline of knowledge and a profession that takes responsibility for continuous and evidence-based care of the sick and the dying as well as promoting the health of individuals, groups, families, and communities, helping them recover, rehabilitate, and reintegrate.

In addition to clinical practice, nurses are involved in patient advocacy, healthcare research, management, policy deliberation, higher education, and continuous training. Furthermore, nursing is the largest, most diverse, and most trusted profession in health care.

The State of The World's Nursing 2020 Report indicates that nursing is the largest occupation in the healthcare sector, comprising 59% of healthcare professionals. There are 27.9 million nurses in the workforce, of whom 19.3 million are professional nurses. Nearly half of healthcare workers are nurses and midwives, according to the WHO Director-General, who said the pandemic had reminded people "what incredible people are doing under incredible conditions." There are currently 27.9 million nurses in the world, which leaves 5.9 million short of what is needed.

In general, historians agree that Florence Nightingale was the catalyst for the development of professional and scientific nursing in the nineteenth century. As social, scientific, and technological changes, as well as the development and scientific legitimization of the profession have occurred since then, we have come a long way.

Nursing education has also evolved. Nurses are not recognized as much as they should be in many countries and contexts of care delivery. In spite of this, nurses have transformed hospitals, reorganized patterns of care to meet needs, brought care closer to homes and communities, and sought to mitigate inequalities.

As we reflect on the effects of the recent SARS-COV-2 pandemic (and likely in the future, as many consequences can be long-lasting, such as unredeemed bereavement), it becomes clear that nurses play a crucial role in crisis intervention, education, and literacy promotion.

There was also a change in the nursing education structure - nurses no longer had to rely on hospital-based training schools, higher education developed, and they were able to obtain a doctoral degree in nursing. A master's degree is typically required for specialized nursing practice or advanced nursing practice. In accordance with the International Council of Nurses (ICN), the scope of nursing practice "encompasses autonomous and collaborative care of individuals of all ages, families, groups, and communities, sick or well and in all settings."<sup>1</sup> By establishing practice standards and codes of ethics, national nursing associations clarify the scope of nursing practice.

The ICN has chosen the motto "*Our Nurses.Our Future*" for this year's International Nurse Day celebration. "Nurses provide care and leadership to address global health challenges everywhere, often at great personal risk. They are the essential life force for health, yet our healthcare systems worldwide have fallen short and failed to **value, protect, respect and invest** in this precious resource. The world has mistakenly taken nurses for granted, treating them as an invisible and inexhaustible resource. That must now stop for the sake of nurses and global health."2

The reflection on professional identity becomes evident when nurses ask themselves who they are, what they do, what specific characteristics the profession has, what goals they pursue, what activities they perform, what skills they develop, what is their purpose, what impact does it have on the care provided to people, how does it benefit their health? This territory is naturally plural, with forms of identity that differ, probably according to personal, social, and institutional identities, but come together in the shared statements about themselves and the dynamic nature of this social construction that converge. We are who we are because of the processes of professionalization and the paths of professionalism (understood as the development of competencies in the exercise of the profession throughout working life).

In addition to epistemology, ontology, ethics, hermeneutics, aesthetics, and deontology, nursing supports the professional identity, as well as science, technique, and praxis. We will all agree that nursing operates in health, in the healthcare spectrum, which both reports to population health, individual health and self-care, and primary and hospital healthcare – therefore is a liberal, self-regulated, higher educated profession. Every country in the world integrates the social mandate of the profession into the professional identity.

Our attention should be focused on the trends and developments occurring today in order to anticipate the future.

In order to fulfill this promise, we organized the 11 chapters into three sections, each serving as a potential challenge for nursing thought. We first introduce innovation and technology as approaches that can really raise debate and transform clinical

**V**

practices in the section. A deeper understanding of teaching and learning processes can be gained in the second section. Furthermore, in the last section we have included other trends and developments, including general and diverse challenges

CIDNUR - Nursing Research, Innovation and Development Centre of Lisbon,

**Sandra Xavier, Ph.D.**

Lisbon, Portugal

Lisbon, Portugal

**Lucília Nunes, Ph.D.**

 Nursing Department, Setúbal, Portugal

Setúbal, Portugal

Nursing School of Lisbon (ESEL),

Department of Community Health Nursing,

Nursing Research Unit for South and Islands [UIESI],

School of Health, Polytechnic Institute of Setúbal,

NURSE'IN – UIESI Nursing Research Unit for South and Islands,

related to management, clinical and health policy, and nursing.

<sup>1</sup> International Council of Nurses. Definition of Nursing. In https://www.icn.ch/nursing-policy/ nursing-definitions.

<sup>2</sup> International Council of Nurses. https://www.icn.ch/news/value-respect-protect-invest-icnlaunches-international-nurses-day-posters.

practices in the section. A deeper understanding of teaching and learning processes can be gained in the second section. Furthermore, in the last section we have included other trends and developments, including general and diverse challenges related to management, clinical and health policy, and nursing.

### **Sandra Xavier, Ph.D.**

Nursing School of Lisbon (ESEL), Department of Community Health Nursing, Nursing Research Unit for South and Islands [UIESI], Lisbon, Portugal

CIDNUR - Nursing Research, Innovation and Development Centre of Lisbon, Lisbon, Portugal

### **Lucília Nunes, Ph.D.**

School of Health, Polytechnic Institute of Setúbal, Nursing Department, Setúbal, Portugal

NURSE'IN – UIESI Nursing Research Unit for South and Islands, Setúbal, Portugal

**1**

Section 1

Inovation and Technology

Section 1
