Nurses and midwives are being urged to move beyond traditional clinical roles and use innovation, community outreach, research and advocacy to expand access to healthcare, particularly for underserved populations.

The call is contained in an article by Benson Owusu, PhD, MPH, BSN, RN, of the School of Nursing and Midwifery at Central University, Ghana, which highlights the need for greater courage and leadership among nursing and midwifery professionals in responding to emerging health challenges.

The article, titled “The Courage of Nurses and Midwives to Care in Challenging Times,” argues that healthcare professionals can extend their impact beyond hospitals through digital health education, community-based medical outreach, evidence-based research and attention to patients’ spiritual needs.

Below is the full article

The Courage of Nurses and Midwives to Care in Challenging Times

Benson Owusu, PhD, MPH, BSN, RN
Affiliation: School of Nursing and Midwifery, Central University, Ghana
Email: bowusu@central.edu.gh
ORCID: https://orcid.org/0000-0002-4061-490X

Abstract

The nursing and midwifery professions have undergone significant evolution over the years, with the COVID-19 pandemic highlighting the adaptability and resilience of these roles. Notably, the crisis demonstrated that certain aspects of nursing and midwifery care can be delivered remotely, thus expanding the boundaries of traditional practice.

To effectively care for both individual patients and broader communities, nurses and midwives must adopt innovative approaches tailored to their specific geographical and sociocultural contexts. This includes leveraging social media for health education, organizing medical outreach programs in underserved areas, and engaging in research to inform evidence-based practice.

In times of crisis, healthcare professionals are called not only to maintain care standards but also to transcend barriers with compassion and creativity—thereby embodying the highest ideals of service and advocacy.

Keywords: Courage in Nursing/Midwifery, Spiritual Care, Holistic Compassion

Nursing is defined as a profession which is dedicated to upholding everyone’s right to enjoy the highest attainable standard of health through people-centered, culturally safe care, advocacy, and collaboration (White et al., 2025). This highlights the important role nurses/midwives play in the healthcare system.

The function of the nurse/midwife goes beyond administering medication, performing bed bath, or delivering babies, but even those activities are intangible. This emphasizes the pivotal role of nurses and midwives in addressing the spiritual well-being of those in their care. In an era characterized by increasing medicolegal scrutiny within healthcare practice globally, the provision of care that encompasses the spiritual dimension demands exceptional courage, ethical sensitivity, and professional integrity.

While hospitals serve as primary sites for healthcare delivery, it is important to recognize that patients who seek care in these facilities represent only a fraction of the population in need of nursing services. A substantial number of individuals, particularly in underserved communities, remain unreached due to barriers such as fear, limited access, or misconceptions about hospital care.

Nurses and midwives, with their broad training and community orientation, are well-positioned to address this gap. By developing and implementing innovative, technology-driven, community-based interventions such as using digital health platforms, mobile applications, and data-guided health education campaigns, nurses and midwives can promote healthy lifestyles, reduce the burden of preventable diseases, and extend the reach of healthcare beyond institutional boundaries.

In this way, they play a critical role not only in clinical care but also in driving innovation, public health leadership, and community empowerment.

Nurses’ and midwives’ capacity to recognize the specific health needs within their communities and to take proactive steps toward addressing them reflects their unique role in healthcare. This commitment demonstrates the strength, compassion, and courage that define their profession, embodying the spirit of service and care that aligns with the example of Christ’s healing ministry.

In the year 2020, when the World Health Organization (WHO) declared the year of the nurse and the midwife, little did we know it was the time to step out as courageous nurses and midwives to give strength and hope to the world. The COVID-19 pandemic made the world recognize the critical role nurses and midwives play in sustaining the health system. With the world currently facing numerous health challenges, it will take courageous nurses and midwives to step forward and lead the fight to address them (WHO, 2020b).

This article highlights several initiatives that nurses and midwives, regardless of their practice setting, can adopt to become effective agents of change. One key avenue is the strategic use of both traditional and social media to advocate for health and influence policy.

With over 4.9 billion people worldwide using social media platforms (Forbes, 2023), these channels offer an unprecedented opportunity to disseminate health information and promote positive behavioral change. By consistently sharing evidence-based messages on healthy living, disease prevention, and innovative approaches to strengthening national health systems, nurses and midwives can extend their impact beyond clinical environments.

Such sustained digital engagement not only educates the public but also has the potential to attract the attention of policymakers and stakeholders, thereby amplifying the collective voice of the nursing and midwifery profession in shaping health policy and social transformation.

Furthermore, a 2022 report by Statista identified Facebook as one of the most widely used social media platforms globally, underscoring the increasing relevance of digital platforms in contemporary health communication (Statista, 2022). This trend presents a valuable opportunity for healthcare professionals, including nurses, midwives, physicians, and allied health workers, to utilize social media as a tool for disseminating health information, engaging with communities, and advancing public health initiatives across diverse populations, regardless of geographical location.

Nurses and midwives can affect meaningful social return by organizing medical outreach programs to deprived communities. Such outreach may be operationalized through the establishment of non-governmental organizations, competitive grant applications, or strategic partnerships with governmental and civil-society stakeholders, mechanisms that have been shown to increase service and population coverage in low- and middle-income settings (Sanadgol et al., 2021).

Properly designed outreach activities enable systematic needs assessment and service planning, permitting the identification of population-specific health priorities and gaps in access (WHO, 2020). When outreach is conducted using community-based participatory approaches, practitioners integrate service delivery with rigorous documentation and data collection; this process both empowers communities and generates evidence that is suitable for evaluation and policy translation (WHO, 2020a).

By intentionally documenting processes and outcomes and disseminating results through peer-reviewed publications or policy briefs, nurses and midwives can supply policymakers with reliable baseline data and practical recommendations for addressing underlying health problems (National Academies of Sciences, Engineering, and Medicine, 2021).

To sustain and scale effective outreach initiatives, nurses and midwives should be encouraged to assume leadership roles across sectors including health administration, education, and politics, thereby translating frontline experience into institutional and policy change (National Academies of Sciences, Engineering, and Medicine, 2021; Gea-Caballero et al., 2022).

Nurses and midwives with strong leadership competencies should not remain passive while ineffective leadership prevails. They carry an ethical and generational responsibility to provide care that extends beyond clinical settings into the broader society. It is imperative that nurses and midwives exercise leadership that transcends institutional boundaries, contributing meaningfully to national development and societal well-being.

Through visionary, compassionate, and accountable leadership, nurses and midwives can collectively transform communities and advance the overall health and progress of their nations.

Under the leadership of Benson Owusu, and through the establishment of the non-governmental organization, Quik Medical Consult, a series of community health outreach initiatives have been implemented across deprived communities in Ghana. These programs mobilize teams of healthcare workers to provide free preventive, curative, and maternal health services to underserved populations with limited access to formal healthcare.

Beyond clinical interventions, the initiatives emphasize health education, disease prevention, and community empowerment, fostering sustainable improvements in population health.

In addition to these activities, Quik Medical Consult raises funds to support needy children requiring life-saving surgeries when their families are unable to afford treatment (Quik Medical Consult, n.d.). This compassionate and inclusive model exemplifies how nursing and midwifery leadership can transcend institutional boundaries to address broader social determinants of health, advance equity, and strengthen the profession’s ethical commitment to caring for society in times of challenge.

Another area of importance is the provision of spiritual care to patients. The importance of spirituality and spiritual care is well documented in literature (Puchalski et al., 2009).

While education on spiritual care is formalized in nursing curriculum in some countries, others do not have it! Spiritual care is seen as part of socialization, especially in Africa.

One characteristic of a nurse/midwife is his/her ability to advocate. In countries where spiritual care is not taught in schools, the nurse/midwife can lead the conversation and become an advocate for its inclusion in the national educational curriculum.

To achieve this, there is a need to prove to regulators the importance of spirituality and spiritual care in nursing/midwifery.

One such way is to conduct research to gather enough findings in your geographical location and present them to policymakers. Spiritual care formally taught in nursing/midwifery schools will help the students understand and appreciate the ethics surrounding it, being able to assess patients’ need for such care and rendering it or referring to the appropriate quarters.

Giske et al. (2022) in their research work titled “Developing and testing the EPICC Spiritual Care Competency Self-Assessment Tool for student nurses and midwives” have created an important tool for assessing spiritual care. The tool guides nurses and midwives on how to assess their knowledge, attitudes, and skills in relation to spirituality and spiritual care, to be able to render it.

In addition, nurses and midwives can play a vital advocacy role by promoting the inclusion of professionally trained chaplains within healthcare institutions to address patients’ spiritual needs (Puchalski et al., 2009; World Health Organization [WHO], 2021).

In many African countries, where dominant religious affiliations include Christianity, Islam, and traditional belief systems, it is essential that chaplaincy services reflect this diversity (Omonzejele, 2008). A pluralistic approach to spiritual care ensures that patients feel seen and supported within their faith context.

Moreover, the presence of trained chaplains may help to mitigate unsafe practices, such as the administration of unregulated spiritual substances by family members. These actions, often undertaken without medical supervision, carry serious risks, including aspiration pneumonia and, in some cases, fatal outcomes.

By institutionalizing culturally sensitive and professionally guided spiritual care, healthcare facilities can foster safer, more holistic healing environments (White et al., 2025).

There is an African proverb that says it is easier to break a single broomstick but impossible when the broomsticks are together. To wit, there is strength in unity. We are more than we are if we work as a team. Projects and initiatives that can change the face of nursing/midwifery can be achieved if nurses/midwives with like-mindedness are able to team up for a common goal.

In conclusion, nurses and midwives are encouraged to cultivate self-belief, resilience, and courage as they continue to serve as vital sources of hope and healing for their patients. Emulating the pioneering spirit of Florence Nightingale, they are called to extend their care beyond the confines of hospital walls, engaging with communities locally, nationally, and globally to promote health and well-being.

Nurses and midwives remain indispensable leaders within the health continuum, forming the backbone upon which effective health systems are built and sustained. It is therefore imperative that the nursing and midwifery professions embrace a renewed sense of purpose, one that transcends traditional boundaries, fosters innovation, and advances health equity across all levels of care.

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