For the past few days, the messages on social networks have been a tsunami of complaints, questions and sentiments from various nursing professionals in Mexico.

By Karla Ivonne Mijangos Fuentes

The murmurs and whispers that invade these social networks have a name and a common cause, specifically, the silent and almost pronounced abandonment of the members that made up the Permanent Nursing Commission (CPE), who have been replaced by a new collegiate body, which no one knows, many assume and others deduce, because there has been no official and national designation of the new members, as well as the pronouncement of the official report of the former leaders.

To better understand the situation regarding what is happening in Mexico, it is worth mentioning that the CPE was established in the agreement of 25 January 2007, in the Official Journal of the Federation (DOF) as the governing body in nursing, which from its formal position in the Ministry of Health defines the guidelines that regulate the professional practice and training of nurses in Mexico (Ministry of Health, 2007).

Thus, the CPE in Mexico is the most important body because it represents nursing at national and international level, and it is through this governing body that inter-institutional coordination and regulated work is effective and linked to educational, care and social purposes, therefore, its mission is to be an academic advisory group at national level as far as nursing is concerned. (Ministry of Health, 2007; PAHO, 2011).

This governmental body was conceived from a democratisation of health policies, due to the fact that nurses represent more than 50% of the total number of health personnel. As of 2017, a total of 300,000 nurses were registered on the National Institute of Statistics and Geography (INEGI) website to provide care to more than 100 million Mexicans, 85 per cent of whom are women.

In this sense, it should be pointed out that, being the personnel with the largest population within the health system, they had the least capacity for agency in the institutionalisation of public policies on health and care. This is why the establishment of the CPE was presented as an agreement that reconciled nursing agency in the protection and promotion of the health of the Mexican population; however, in the election of the members of this body there was still a gap, a vacuum and a violation of democratic rights and representation.

In this sense, these interstices and processes not so well defined in the DOF (2007) on the election and appointment of the members of the CPE, which have been translated as Internal Rules of Internal Operation of the Commission, which end up indicating that the appointment is directly directed by the General Coordinator, thus distorting the democratic processes and the systems of pluriverse representation in nursing.

In this regard, the voices that were heard among the social networks were derived from the lack of knowledge of these regulations, but, above all, due to the anti-democratic processes and the violation of the rights of nurses in Mexico.

That is why we decided to engage in a conversation with Dr. Verónica M. Barrón, who is a lawyer, nurse and activist against gender violence, and who has more than thirty years of active service in the Secretariat for the Defence of Human Rights.

During our conversation with Dr. Verónica, she pointed out that among the most important irregularities was the lack of a statement of the new designation. In this regard, she said “as nurses we do not know how the director of the CPE is appointed (…) and the law does refer to how a minister is appointed”.

She continued, alluding to the following: “The appointment shall be made by a two-thirds vote of the members of the Senate present within a non-extendable period of thirty days. If the Senate does not decide within this period, then the position of minister will be filled by the person designated by the President of the Republic from among the short list of three.

She also referred that in this promotion of the new commission there was no process of disclosure about such election and authorisation. And sadly, she noted that the parameters under which the new members were appointed were not even known. But as she pointed out, from article 3 of the DOF of 25 January 2007, it clearly reads in paragraph I that the CPE will be preceded by the Secretary of Health of the current administration and not directly by the head of nursing.

On the other hand, Dr. Barrón mentioned that there was no handover ceremony by Dr. Claudia Leija Hernández as Director of Nursing and General Coordinator of the CPE, therefore, this generated many discussions and discomfort among nursing professionals, because the rights of nurses continue to be trampled upon. It is as if nursing still does not matter at the level of governance and governability.

These discomforts felt and perceived by Dr. Verónica Barrón, are the same discomforts that many nurses in Mexico show, because the designation of such an important body as the CPE should not be blurred from the political and social participation of the same staff that conforms it.

From this perspective, the discomfort arises from a historical suffering that has been accompanying and shaping the profession, i.e., the false empowerment on which the profession is being emphasised is the same romanticised discourse of the term of inclusion at the public policy level, because inclusion itself is the cause and effect of the historical exclusion of the profession.

In this respect, it is observed that the functions established by the International Commission of Nursing (ICN, 2002), are still being narrower to be validated in Mexico, for example, the ICN refers that advocacy, promotion of a safe environment, research, participation in health policies, in the management of patients, health systems and training, are the strategies that every country should implement, however, this political invisibility of nursing in Mexico, makes nurses do not have the possibility of self-government, self-management and autonomy.

As we recalled together with Dr. Barrón, the empowerment, leadership and global impact of nursing members to influence and design health, social, educational and economic policies are one of the four strategic priorities of ICN (2002), however, these continue to be part of a utopian discourse of the Mexican health system, and even for the nursing professionals themselves who have positioned themselves in the political arena in Mexico.

It is worth noting that nursing has contributed to improving the performance and health goals in the provision of services in Mexico with specific actions and programs of care, training, research, leadership and organisation of health systems, and that now with this pandemic, this has been confirmed (PAHO, 2011), therefore, it is fair that its political participation does not have a condescending incidence of other bodies and institutions.

As has been observed through the historical processes of shaping and configuration of nursing in Mexico, and throughout Latin America, there is a historical, political, social, economic and humanist debt owed by the people to nurses, because they not only have an influence on the health of the territories, but nurses sustain the life of the people through the practice of care.

Therefore, and from this sentiment of the nurses of Mexico, we join their humanitarian cause and advocacy for the protection of the health of the people of Mexico and around the world, because there is no better health personnel who know the main needs of the people’s wellbeing than nursing professionals.

 

REFERENCES

ICN (2002). Definitions of nursing. International Council of Nurses. Available at: https://www.icn.ch/es/politica-de-enfermeria/definiciones

PAHO (2012). Regulation of nursing in Latin America. https://www.paho.org/hq/dmdocuments/2012/nursing-regulacion-alatina-2011-esp.pdf