Global campaign gives nurses the chance to showcase their value

The International Council of Nurses’ president says the Nursing Now campaign being launched in 2018 is an opportunity to address shortages worldwide

The International Council of Nurses’ president says the Nursing Now campaign being launched in 2018 is an opportunity to address shortages worldwide

  • Addressing issues related to nurse migration is a priority for the ICN
  • Africa, Latin America and the Philippines cannot afford to lose their nurses
  • Similar problems are faced by governments worldwide and must be addressed

Nurses at work in the Philippines. Picture: Alamy

Nurses around the globe need to be better valued and better treated to ensure they return to their home countries after working abroad, says an international nursing leader.

International Council of Nurses (ICN) president Annette Kennedy said nurses worldwide face similar workplace difficulties such as staff shortages and burnout. She was speaking as preparations are finalised for the launch of Nursing Now, a global campaign to demonstrate the value of nursing.

Delivering RCN Northern Ireland's annual lecture in Belfast, Ms Kennedy said the solution to these problems lies in improving working conditions in nurses' home countries, because otherwise staff will continue to emigrate from places that can ill afford to lose them.

She also said paying nurses properly was important to their health and well-being.

Education and value

Nurse migration, along with nurse education and universal health coverage, is among the ICN's top priorities, she said in the lecture, titled Nurses Working Across Borders.

Ms Kennedy, who is from the Republic of Ireland, said: 'It's one thing to have enough nurses and midwives. It's another thing to retain them. Certainly in the Republic of Ireland we are not retaining them.'

She added: 'The same workforce issues are everywhere. Nurses are overworked, stressed and affected by burnout. They are not getting the education or value they deserve.'

‘To take from the countries that are most in need is not right’

She said Africa, Latin America and the Philippines could not afford to lose their nurses.

Ms Kennedy said: 'We all have a responsibility to see how we keep our nurses in our countries. That doesn't mean we don't allow them to have a choice. We all want to travel and learn, but I want them to come back because they feel the people appreciate what they do and the working conditions are good. To take from the countries that are most in need is not right.'

ICN president Annette Kennedy

Ms Kennedy listed several countries afflicted by nurse shortages, including:

  • Slovenia has a 25% nurse vacancy rate, rising to 40% in some regions.
  • Spain needs an additional 50,000 nurses to reach the European Union average per 100,000 head of population.

Focus on homegrown staff

She added that in low to middle-income countries worldwide there was a total shortfall of 18 million health workers such as nurses and doctors, and that this figure rose to 40 million when other staff such as cleaners and porters are included.

Her words echo those of ICN interim chief executive Thomas Kearns, who told Nursing Standard in October 2017 that richer countries should focus on developing homegrown staff rather than draining overseas countries of nurses.

‘We all want to travel and learn, but I want nurses to return home because they feel appreciated’


Global campaign

She said that when the ICN was formed almost 120 years ago the organisation did not think about borders but rather the best way to support nurses.

She said in the lecture that nurses need to talk more about what they do, and highlighted the importance of the Nursing Now campaign led by former NHS chief executive Lord Crisp, which aims to raise the profile of nursing globally.

'Nurses save lives, and we should be proud of that fact. It's not just doctors who save lives,' she said.

Population health

Ms Kennedy said nurses represent about 50% of the global health workforce, and in some countries the proportion is between 70% and 100%.

She stressed the importance of preventive healthcare and how nurses were leading the way in this area.

'Health has always been seen as a burden to the economy and every time there's an increase in cost it's “we must reduce”,' she said.

Picture: iStock

She added: 'I don't understand this short-term vision. Globally around 40 million people die every year from chronic diseases such as diabetes, chronic heart disease and hypertension. That's 70% of all people who die, and a lot of that is preventable.'

Ms Kennedy cited examples of preventive care such as the Dutch Buurtzorg model, which translates as 'neighbourhood care'. This approach sees nurses spend around two thirds of their time with patients in the community, helping them to live independently.

Pushing the boundaries

She said that in Malawi a nurse told her of a simple measure to ensure people are tested for tuberculosis.

'A nurse was telling me that people in the community who have a cough tend to go to a pharmacist and look for a cough medicine bottle and keep going back for it. They have TB and are not tested,' she said.

'Nurses decided to talk to pharmacists so they would tell members of the community that if they are coughing for seven, eight or nine days to come to the clinic to get tested. These kinds of things are so effective.'

She said nurses all over the world were 'trying to push the boundaries', and these efforts needed to be highlighted to improve patient care and talk up nursing.

On the shoulders of giants

The International Council of Nurses will be 120 years old in 2019. It was founded in 1899 by three women – Ethel Gordon Fenwick from England, Lavinia Dock from the United States and Agnes Karll of Germany – who were deeply involved in women's rights movements.

Ethel Gordon

Ms Kennedy said the trio wanted to improve the conditions of employment for nurses and standards of care for patients.

'That was 120 years ago and it was revolutionary because that was before women had even got the vote,' she said.

'Sometimes I think it's on the shoulders of giants that I stand.'

The ICN is now a federation of 135 nursing associations, representing 20 million nurses around the world.

The 2019 ICN biennial conference will be held in Singapore.

Helping overseas nurses to earn, learn and return

The NHS in England has developed an 'ethically robust' programme in which international nurses plug staffing gaps and learn new skills before returning home.

The 'earn, learn and return' approach has already seen nurses from India come to England for a fixed period while learning a new postgraduate skill.

A pilot scheme is under way in Harrogate, North Yorkshire, with the aim of 500 nurses coming to England from India by the end of March, building up to around 5,500 international nurses.

Ethically robust

A similar scheme is being developed with the Philippines, Health Education England chief executive Ian Cumming told the Commons health committee in November 2017.

Professor Cumming said: 'We believe that doing it this way is more ethically robust, in that we aren't denuding a country of their valued resource, but allowing people to come here for a fixed period of time to help us with a staffing shortage that we have got, but also to learn, earn money and take that back into their own country.'


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