Since the onset of the pandemic, nurses and midwives have been asked in some facilities to work without personal protective equipment. Nurses have been sent home and lost their jobs simply because they insisted on following evidence-based practices, such as wearing masks. Some question whether the masks, gloves, gowns, and other commodities in short supply are more important than nurses who question the ethics of showing up when essentials aren’t available.

Nurses make up 59 percent of the professional health workforce, yet were invisible in terms of the media-driven conversation in the early phases of the pandemic. As nurses and midwives, we are frightened, fatigued, and sometimes angry. Nurses are the experts who, together with an interdisciplinary team of professionals, run our health systems. Our majority female voice—90 percent of nurses and midwives are women—should be commensurate. Women in the profession must not be expected to stand back and wait to be listened to. We must not allow men to control the discourse around the current pandemic. This includes our physician colleagues, hospital administrators, and even men in nursing like myself.

As a nurse and a midwife and, not inconsequentially, a 62-year-old white male who holds a position of leadership in my beloved professions, I represent part of a pervasive problem: the impact of gender bias on women’s power and status to lead in the health sector.

Having dedicated almost four decades to the global advancement of nursing and midwifery, I offer a humble and unique insider perspective about why nurses and midwives—most notably those who are female—lack sufficient voice and control in health systems that frankly would fall apart without them.

My 40-plus years in nursing and midwifery are a blip relative to the centuries of care provided by those women who established and nurtured these occupations. The professions always have and always must embrace and personify what society regards as feminine values, such as thoughtfulness and tolerance, as well as sensitivity and consideration. It is because of these values that nurses are consistently identified as the most trusted of health professionals.

If this inaugural global report doesn’t wake up the world to the need to elevate nursing and midwifery, then the unprecedented pandemic should compel the world to see that our future depends on nurses and midwives.

I am a grandfather as well as a father and husband of nurses and midwives on the frontlines battling the novel coronavirus. As a global health professional with passion for my family, community, and profession, I am deeply concerned about what we are confronting in our daily work. 

No matter whether you are a man or a woman, if you are a nurse, you are less likely than physicians to get the resources you need to be able to provide high quality care to your patients, or have the personal protective equipment to protect yourself and the family waiting at home for you.

My daughter, who is a nurse caring for women in labor for example, undertakes an elaborate cleansing routine before returning to the embrace of her husband and 2-year-old son. Even so, we fear that she and the family she loves will be exposed to serious illness because of the profession that she also loves. My wife, a practicing midwife, made the very difficult decision to socially distance from me and our family to protect us from infection. 

Sadly, the challenges that nurses and midwives like my daughter and my wife are grappling with during the Covid-19 pandemic are stark and urgent but not new. 

In a world where women still strive for equal pay and opportunity, we cannot ignore the influence of our societal gender-based biases on the extraordinary challenges faced by nurses and midwives. Failure to do so may lead to nurses making the difficult yet ethically justified decision to enact “Safety Stops,” during which they refuse to engage in direct patient care until they are provided with the personal protective equipment called for by the World Health Organization, Centers for Disease Control and Prevention, and other global experts.  And they may simply not show up until their very real and urgent needs under the pandemic are met.  

I am challenging men both in and outside of my professions to join me at this unique time in history, in raising women’s voices and embracing all that’s female in the nursing and midwifery professions. Here’s how:

• Institute government Chief Nursing and Midwifery Officer positions in 100 percent of WHO countries and ensure that they have the voice, autonomy, and resources that they need to lead. Ensure that these positions are filled by nurses and midwives and that appointment is not biased towards men within the profession. 
• Empower nurses and midwives to support survivors of gender-based violence, particularly in times of economic hardship and social isolation.
• Establish midwifery-led care units alongside hospitals as the norm for maternity care in our country.

A trusted female nurse friend pointed out the important difference between mentorship and sponsorship, emphasizing that while a mentor supports, a sponsor positions others for opportunities to succeed and make more of a difference.

As a privileged white man advanced in my career, I will aggressively seek opportunities to sponsor those already strong and emerging women leaders around the world who will make all the difference in reimagining service delivery and creatively managing our workforce.

At the same time, I call on all men who care about the health systems and the communities that they serve to seek out and elevate women at all phases of their nursing careers: Make room at the table where critical decisions are made and prepare them and help them succeed in the future we all want to imagine—one in which we ultimately achieve all our global goals. 

Additional Resources: 

• White Ribbon Alliance COVID-19 Respectful Maternity Care Guidance