Dear Editors,
May 12 is celebrated as International Nurses Day and as the birthday of Florence Nightingale, the founder of Modern Nursing (International Council of Nurses, 2021). For nurses around the world, this is a momentous occasion reflecting on the state of nursing and how nurses are advancing the profession. Highlighted by the International Council of Nurses are three issues; COVID-19 infections and deaths among nurses and other healthcare workers; stress and burnout in the nursing profession; and nurse shortage and retention (International Council of Nurses, 2021). Regarding issues affecting the discipline and professional practice of nursing, nurses in Indonesia are austerely experiencing these issues because of the pandemic; of practicing professional nursing; and conducting research and enhancing nursing education.
First, with the COVID-19 pandemic, nursing practice has become more challenging. The invisible disease agent has caused untimely deaths of many healthcare professionals, making nursing practice much harder (Chatterjee & Kagwe, 2020) and less attractive as a profession. As of March 2021, the Indonesian National Nurses Association reported that more than 15,000 nurses were infected with COVID-19 and 274 have passed away (Guritno, 2021). Improvements in regulations related to COVID-19 management in hospitals and other healthcare institutions were imposed, such as increasing supplies of personal protective equipment (PPE) and prioritizing benefits for healthcare workers regarding staffing, including the nurses. This prioritized frontline healthcare workers, including nurses, to receive vaccinations against COVID-19 (COVID-19 Handling Acceleration Force, 2021).
Appreciations for nurses’ dedication to their professional practice during the pandemic were many, but still not significant enough, as nurses continue to risk their lives ― sometimes losing their lives ― in order to save their patients’ lives and the lives of other co-workers. This appreciation points to the realization that nurses and their practice deserve political and social actions for their valuable work, supporting a deserved salary raise (Gunawan, 2020). While the risks to nurses’ lives on the front lines is evident, the global society must finally realize the professional mandate that frontline nurses are soldiers-at-war, whose lives are valuable, therefore need protection by all costs from being uselessly exposed to an invisible organism and become patients themselves (Chatterjee & Kagwe, 2020).
Second, in Indonesia, there are various classifications of nurses based on education. The Indonesian Nursing Law No. 38 the Year 2014 described categories of nursing education into vocational education, academic education, and professional education. Vocational education is a three-year program, while the academic program prepares nurses for a baccalaureate degree in nursing, Masters in Nursing, and Doctor of Nursing. With an academic degree, professional nursing education qualifies nurses through internships in the nursing professional (Ners) and nursing specialty program (Government of Indonesia, 2014).
Despite the variety of educational levels and the limited number of graduate school programs, nursing education in Indonesia is steadily improving. With only 11 Professors of Nursing, there are now two Doctoral Programs in Nursing: a doctoral program at the University of Indonesia and the other at the Faculty of Nursing, Universitas Airlangga (Casman et al., 2020). Nevertheless, transforming the discipline to advance the professional practice of nursing requires more interdisciplinary collaboration, especially with expert nurse researchers from the international arena.
Third, the regulations from the Indonesian Ministry of Higher Education require faculty members in academic positions to publish scholarly articles (Ministry of Research and Technology of the Republic of Indonesia, 2017), and for university students to also publish their final projects, theses, and dissertations in key scientific journals as a requirement for graduation (Ministry of Education and Culture, 2012). These requirements are clear evidence affirming the flourishing of nursing research and knowledge dissemination in Indonesia. Today, the requirement for enhancing scholarly articles authored by Indonesian nurses and nurse educators in international journals has increased manifold, instigating the establishment of more rigorous nursing journals. However, even with the increasing processes for knowledge dissemination as evidenced by the number of publications, journals indexed in reputable national and international indices are still few. As of March 2021, only three nursing journals were indexed in reputable international databases, such as Scopus, Web of Science, and EBSCO. These journals are Belitung Nursing Journal, Nurse Media Journal of Nursing, and Nursing Journal of Indonesia (Jurnal Keperawatan Indonesia).
While this letter briefly highlights three current conditions as the basic informational needs of nursing practice, education, and research, focused attention on education, practice, and policies influencing scholarly nursing endeavors in Indonesia requires more recognition and appreciation. Editors, researchers, and practitioners of nursing need to be influential and establish nursing science journals in order to disseminate ground-breaking and important nursing work. With the nursing academe, further progress and recognition of nursing as a discipline of knowledge and a practice profession will materialize.
Reflecting on the future of Indonesian nurses during this momentous International Nurses Day leaves us to realize that, while professional nursing practice in Indonesia is advancing, more disciplinary and professional ‘homework’ is needed to move nursing as a valuable and integral health care practice. This consideration is a significant step towards growing Indonesian nursing to a level of professional practice that is integral to human health and well-being.