Perspectives: New realities of leadership during the Year of the Nurse and Midwife.

As I reflect on leadership, during the World Health Organisation’s (WHO) Year of the Nurse and the Midwife, I am struck by how leadership can be displayed in any nursing role. Our professions have had lingering notions that leaders have formal positions or job roles. In reality, leaders are required everywhere. This has been especially true during COVID-19, when nursing hierarchies have suddenly flattened. Nurses have been redeployed, and pushed to learn new skills very quickly. There is also a need for local leadership to make decisions and adapt work minute-to-minute. I hope these shifts will change how we understand different nursing roles. The barriers between nursing roles have caused considerable problems in our professions, and the current climate is an opportunity for us to move past these divisions, once and for all. After I transitioned from working clinically to working in other roles in nursing, I was asked, ‘Do you miss real nursing?’ This question came from well-intentioned members of the public, but also from nurses themselves. Two weeks after I started a management role, my colleagues from my previous clinical job would no longer associate with me. I had crossed over and joined the dark side, which meant I was no longer an ally in their work. Not only was this hurtful, it limited my ability to engage with my former colleagues, with genuine attempts to improve their working environments. The animosity between different nursing roles is pervasive, and does real damage as it stifles attempts to work together to support patients. Sadly, these hierarchies are as old as the nursing profession itself. Florence Nightingale used a variety of strategies to give her fledgling profession more credibility, at a time when nursing was considered little better than prostitution (Wuest 1994). Nightingale recruited many of her middle-class friends to be nursing instructors and managers, trying to elevate the status of the profession. The majority of their pupils were working class; these women already did the bulk of caring work in society and were willing to do some of the more socalled distasteful work nursing involved. The class divide between instructors and pupils, and ward managers and nurses created animosity that has persisted in various forms ever since.