I traveled to Lithuania in October to the nursing department at the Lithuanian School of Health Sciences where I have been consulting on advanced nursing practice (ANP) for almost 10 years. I consider the faculty there not only colleagues but friends as well. Their hospitality is matched only by their enthusiasm and dedication in implementing a new role in the healthcare system. The first cohort of pioneer ANP students enrolled in September 2015 and graduated in May 2017. The successes and challenges since the concept of ANP was introduced to the Ministry of Health in Lithuania mirror the issues we encountered and continue to have in the US despite our 57-year history of the NP movement. For a new role, however, the NPs-particularly in primary care-are creating a niche for themselves, demonstrating that nurses with advanced knowledge, training, and skills can make a difference. Nurses worldwide have the same goals: they strive to provide the highest quality care to patients and seek recognition of the importance, value, and vital contributions of nursing in achieving positive health outcomes for a population.
International exchange
The exchange with faculty, ANP students and graduates, and hospital nursing and university administrators was motivating; continued integration of the ANP role in Lithuanian healthcare delivery seems assured. Everyone was interested in hearing about the NP role in the US, and many were excited to meet a real NP. My visit was part of the Erasmus+ program of the European Union, which supports opportunities for exchange of faculty and students to increase international cooperation among institutions in the European Union and abroad. Participating broadens my knowledge of other cultures and traditions, healthcare and educational systems, and global workforce issues. How does nursing prosper in a country relative to world influences?
The past and present
As I moved about Kaunas city for official activities and personal cultural experiences, I took notice of the seamless blend of old and new architecture. New construction is a sign that signals municipal commitment to progress and improvement. Being so close to the active Russian-Ukrainian war was a constant reminder of the present, but I wondered what strength lies within the walls of the past. Lithuania does not border Ukraine but is separated geographically to the south mainly by Belarus, a Russian-aligned country, and to the south and east by Kaliningrad Oblast, a Russian republic, and Poland, a NATO ally. A sense of calm, security, and normalcy prevailed in the country. Individuals old enough to remember the Russian occupation of Lithuania during World War II and after expressed personal support for the Ukrainian people's fight and right to remain a sovereign nation.
Our world today
My thoughts turned to the threats to democracy in the US that we currently face. Would Americans have similar resolve and strength to fight (vote) not only for the freedoms always afforded to a select group but also to extend those rights to all citizens, in practice and not just in doctrine alone? As 2022 draws to a close, I looked for words to guide me into the new year. How will I approach national and global issues that confront me? Epictetus, a Greek Stoic philosopher, wrote, "Happiness and freedom begin with a clear understanding of one principle: Some things are within our control, and some things are not. It is only after you have faced up to this fundamental rule and learned to distinguish between what you can and can't control that inner tranquility and outer effectiveness become possible." I do not propose stoicism in its true meaning, but I do promote involvement, risk taking, responsibility, and accountability. I am one and we are all citizens of the world of nursing.
Jamesetta A. Newland, PhD, FNP-BC, FAANP, DPNAP, FAAN
Editor-in-Chief mailto:[email protected]