The International Council of Nurses (ICN) launched an exciting new campaign – “Our Nurses. Our Future.” – on International Nurses Day, May 12, 2023. A key resource is a ten-point Charter for Change that provides guidance for the future.
The first point sets the tone for global health action:
“Protect and invest in the nursing profession to rebuild health systems that can deliver the Sustainable Development Goals and Universal Health Coverage to improve global health. Recognise and value health and health care as an investment not a cost. Secure commitments for investment to maintain equitable and people-centred care.“
Each point is worth attention and action this year. I will reflect on point 8 as we prepare for the ICN Congress in Montreal this July:
“Actively and meaningfully engage national nursing associations as critical professional partners in all aspects of health and social care policy, delivery and leadership as the experienced and trusted voice of nursing. Build local, national and globalmultilateral partnerships.”
On this day, I am reminded of warm connections with international colleagues I have met through partnerships, exchange visits and conferences over many decades. In particular I’m thinking about the nurses, faculty members and students at Guru Nanak College of Nursing in Punjab and my friends at the Canada India Education Society and UBC School of Nursing. The hospitality and conversations were wonderful! Also remembering nurse leaders I met and admired in the Japanese Nursing Association and the Democratic Nursing Organization of South Africa (DENOSA). Thank you and best wishes for International Nurses Day and beyond!
The World Health Organization (WHO) Executive Board met recently from January 30 to February 7 in Geneva. A major theme this year is Universal Health Coverage (UHC) in preparation for the UN High-Level Meeting on UHC in September 2023. The previous High-Level Meeting on UHC in 2019 resulted in a commitment “to ensuring that, by 2030, everyone, everywhere will be able to receive quality health services without suffering financial hardship.” Further, UHC “covers the full continuum of essential health services, from health promotion to prevention, treatment, rehabilitation, and palliative care across the life course.” (WHO 2022).
There is an important connection between primary health care and sustaining the workforce to achieve the goal of UHC. I like the way it was expressed by the United Nations Foundation following the Executive Board meetings:
“Member States emphasized that stronger primary health care delivery and a robust health workforce were force multipliers that could jointly serve UHC and pandemic preparedness, response, and resilience goals and the Sustainable Development Goals writ large.” (UN Foundation 2023).
The International Council of Nurses (ICN) delivered statements at the Executive Board meetings as part of civil society coalitions urging Member States to commit to investing in the health workforce for UHC. Themes of equity, patient advocacy, emergency preparedness & response and quality of care came through in the statements. A summary of ICN interventions on health care issues during this Executive Board session is worth reading to see the topics covered.
In keeping with the strong global health presence of ICN and its national nursing association members, the next ICN Congress holds promise for discussion of global policy directions. The ICN Congress co-hosted by the Canadian Nurses Association is taking place in Montreal from July 1-5. I have enjoyed participating in past congresses and look forward to attending this one on Canadian soil. The theme – Nurses Together: A Force for Global Health – provides optimism amidst troubling times for the profession and the world. I expect to hear perspectives on current global health challenges and examples of solutions to common issues: nursing retention, Sustainable Development Goals and contributions to achieving UHC. There will be symposia profiling national nursing associations and their activities, plenary sessions, a student assembly, posters and concurrent presentations.
Another feature is the Policy Cafés – highly informative and interactive as I observed in Singapore in 2019. For this congress ICN describes them as: “Located in the exhibition hall, the two Cafés give the opportunity for small group discussion with a panel of experts on a key ICN policy or priority topic. Arranged in an informal setting, the Cafés allow delegates to ask in-depth questions and interact with keynote speakers.” For registration and further details, please visit the ICN Congress Site and follow updates on social media.
As I write this reflection in late autumn 2022, the topic of the Canadian nursing workforce is on my mind. In the context of my consulting work I am often engaged in discussions on recruitment and retention of nurses in Indigenous communities. We look for ideas from many sources and consider strategies that will be most effective in the local context on Vancouver Island.
National organizations have issued statements and reports this month that highlight the urgency of human resources in the Canadian health system. In conjunction with a meeting of provincial and territorial ministers of health with the federal health minister, many organizations held meetings and issued briefing notes. The Canadian Medical Association (CMA), Canadian Nurses Association (CNA) and HealthCareCAN issued a “prescription for hope” that received media attention at that time. A follow-up letter to the Council of the Federation Chair of was issued on November 22 by the Canadian Federation of Nurses Unions (CFNU), CNA and CMA requesting an “urgent meeting” on finding solutions the health care crisis. I follow all these organizations on social media and appreciate seeing frequent updates and timely media releases. The media release and link to the letter are available here: Nurses and doctors engage Council of the Federation around solutions to Canada’s health crisis (cna-aiic.ca)
On November 17, the Canadian Health Workforce Network and the CFNU released a comprehensive report: Sustaining Nursing in Canada. I recommend working your way through the entire document when time permits as I’m doing at present. For a quick overview, I suggest the “Strategic Priority Actions” on page 9 followed by the Executive Summary. The “multi-layered solutions” offered are most welcome. We do need to think of steps and layers in a coordinated way and not a piecemeal approach. See also page 23 for a figure summarizing key points around retaining, returning and recruiting nurses.
Workforce planning is a strong theme of Sustaining Nursing in Canada with three steps identified on page 14: 1) Embed nursing workforce planning, 2) Enhance nursing data to support inter-professional workforce planning and 3) Enable nursing workforce partners access to evidence. In terms of priority actions, some are directed at employers and governments. I see a cluster of proposed actions that would help in nursing education and in mentoring students and new graduates as well as attention to supporting nurses over the course of a career. It’s intriguing to consider the idea of the national health workforce agency (pages 52-53) and I think that we may hear more about implementing something similar in Canada.
It is both a worrying and hopeful time as we reflect on media stories and personal experiences. I do hope that governments are paying attention at long last and that we will see solutions become a reality.
I end this post with images from earlier this fall when I visited the beautiful provinces of Nova Scotia and Newfoundland. I carry these memories with me with optimism for improvements in health care for people and communities in all parts of our country.
I’m writing this update at the end of June in advance of our summer break in Canada. World events in the first half of 2022 have left us shaken and concerned about the future as we grapple with climate issues, global conflicts, food security, and population health. As I follow the daily news, I also turn my attention to developments in nursing and look for statements and opportunities for advocacy.
The 75th World Health Assembly took place in May. It was interesting to follow on social media as it generated considerable attention this year. The International Council of Nurses (ICN) was active in presenting ‘Interventions’ on specific resolutions. See ICN’s summary here.
ICN along with the International Confederation of Midwives and the WHO met for their 9th Triad meeting in May. The representatives issued the 2022 Triad Statement focusing on health care workforce issues and reporting on what countries are doing in response to the Global Strategic Directions for Nursing and Midwifery 2021-2025. Howard Catton, ICN CEO, has been interviewed by many news media this year speaking about the war in Ukraine and related humanitarian crises and on the scale of the nursing shortfall globally.
The Canadian Nurses Association (CNA) and the Association of Nurses and Nurse Practitioners of BC (NNPBC) held their annual meetings in June. Both were open to all members and observers in a virtual format. The CNA Meeting of Members was noteworthy because it marked the first time that individual members could vote to elect candidates for the Board of Directors and vote on AGM motions. The previous federation model of territorial and provincial member associations carrying votes has ended. As a member who is following these changes, it will be interesting to see how the new membership structure will work and how the new Board will communicate with members throughout the country.
After both meetings, I was left somewhat disappointed that there wasn’t more substance presented on what our associations are doing to demonstrate leadership during the current health care staffing crisis and other major issues in 2022 (I receive newsletters and view social media updates but others may not). I do recognize that annual meetings present highlights and financial statements on the previous year and are always six months out of date for the current year’s activities. It makes me wonder if members would be interested in (and commit to attending) an organizational update given in the autumn each year. We could meet the new Board members, hear their priorities for the current year, and ask questions – all through a virtual format, and in a less formal manner than at an annual meeting.
Annual meetings and major events aside, I do appreciate the ongoing work of our professional associations at all levels to bring a nursing perspective to provincial, national, and global health challenges and policy change.
The International Council of Nurses (ICN) has launched a #NursesforPeace social media campaign to join nurses around the world in solidarity with the nurses of Ukraine.
ICN in partnership with the European Federation of Nurses Associations (EFN) and the European Forum of National Nursing and Midwifery Associations (EFNNMA) issued a powerful statement on March 3, 2022. Speaking on behalf of the global nursing community, they condemn the illegal invasion of Ukraine and call for an immediate ceasefire.
ICN is encouraging nurses around the
globe to participate in the social media campaign and to add our support by
signing the statement.
Thank you to ICN and European partners for your strong leadership at this critical moment and for demonstrating support for the Ukrainian people in this call for humanitarian action. For updates and suggested actions, please visit the ICN website.
Whyte – March 3, 2022
acknowledge with respect that I live on the Unceded traditional territory of
the K’òmoks First Nation.
A highlight of 2021 was the opportunity to participate in the International Council of Nurses (ICN) Congress, held in a virtual format for the first time. The ICN Board and Staff team along with congress partner Emirates Nursing Association did an outstanding job of hosting the three-day event attended by 5,000 nurses and guests from around the globe. Speakers and participants added to the richness of the discussions on key topics relevant to nursing today and conveyed the sense of urgency on workforce issues and equity in global health. Among the important documents discussed was the Global Strategic Directions for Nursing and Midwifery 2021–2025 released in April 2021 by the World Health Organization. Four focal areas for health systems – education, jobs, leadership and service delivery – were important strategic directions covered in congress sessions.
I enjoyed the daily keynote presentations and the continuity provided by ICN leaders who conveyed the enthusiasm and spirit I had experienced at past congresses. However, I did miss the informal social gatherings and memorable encounters with nurses from other countries at congresses in Singapore (2019), Barcelona (2017) and Durban (2009).
Prior to the congress, I was pleased to continue my collaboration with Patrick Chui and Susan Duncan in planning a presentation delivered by Patrick as a pre-recorded oral concurrent session. The presentation drew on previous work and explored policy advocacy leadership by Canadian nursing organizations using a current example of COVID-19 vaccine equity. We discussed ways in which nursing organizations demonstrate policy advocacy leadership in highly complex and evolving contexts. In our conclusion we proposed areas of research that will be useful in generating knowledge to strengthen nursing organizations’ influence on health systems and policy.
Professional Development Highlights
Webinars were the way to go for professional development this year. I enjoyed sessions organized by the Canadian Nurses Association throughout 2021 and the Annual Marion Woodward Lecture hosted by UBC School of Nursing in November. A stimulating session in December was hosted by the International Collaboration for Community Health Nursing Research (ICCHNR): Dr. Barbara Stilwell delivered the annual Lisbeth Hockey Lecture on The Power of the Nursing Narrative. I liked Barbara Stilwell’s call to nurses: “Let’s power together” as she concluded her lecture. Thank you to the organizers and speakers for contributing to my learning and thinking during the past year.
A New Roadmap
Looking to this new year and beyond, the WHO Regional Office for Europe has published Building Better Together: Roadmap to Guide Implementation of the Global Strategic Directions for Nursing and Midwifery in the European Region. As noted in the foreword by Hans Kluge, WHO Regional Director for Europe, “…we will work over the next five years to ensure that nurses and midwives have the capacity to contribute to key areas of public health, primary care, long-term care and post-COVID-19 recovery. We will put this into practice through relevant education, improved working conditions, the promotion of leadership opportunities and clear career pathways.” (WHO, 2021, p. v). Taking into account regional and global policy contexts, it lays out key directions and monitoring mechanisms. It’s an excellent resource that may serve as a guide for other regions to follow.
I end my
year in review comments with a special note of appreciation to all the
colleagues who continue to involve me in fascinating projects and who stay in
touch through regular email exchanges and on social media. Thank you to my
By Nora Whyte – January 4, 2022
I acknowledge with respect that I live on
the Unceded traditional territory of the K’òmoks First Nation.
The COP26 conference opens in Glasgow on October 31, 2021 and is generating considerable interest in the weeks leading up to the event. Officially known as the 2021 United Nations Climate Change Conference, it is the 26th UN Climate Change conference. As explained on the COP26 website, “COP stands for Conference of the Parties – the signatories of the United Nations Framework Convention on Climate Change (UNFCCC) – a treaty agreed in 1994 which has 197 Parties (196 countries and the EU).”
It is heartening to see the growing public awareness of climate change impacts and the sense of urgency being expressed this year. Leading health organizations have formed coalitions to advocate for climate action. A recent open letter – Healthy Climate Prescription – issued by the Global Climate and Health Alliance (a coalition of organizations representing 45 million health professionals) is a good example of this important collaboration. Describing the climate crisis as “the single biggest health threat facing humanity” the authors of the letter call on world leaders to deliver on climate action. Among the key demands listed are: “a rapid and just transition away from fossil fuels; for high income countries to provide the promised transfer of climate funds; and for pandemic recovery investments to support climate action and reduce social and health inequities.” Likewise, leading international health journals have published a strong editorial that appeared in multiple journals in September with a vital message: “Reflecting the severity of the moment, this editorial appears in health journals across the world. We are united in recognising that only fundamental and equitable changes to societies will reverse our current trajectory.”
The annual Lancet Countdown: Tracking Progress on Health and Climate Change report was released on October 21, 2021. Key findings are presented in five domains: 1) climate change impacts, exposures, and vulnerabilities; 2) adaptation, planning, and resilience for health; 3) mitigation actions and health co-benefits; 4) economics and finance; and 5) public and political engagement. Indicators are provided under each of the domains to give a quick view of changes since the previous report.
In Canada, the Canadian Association of Nurses for the Environment (CANE-AIIE) has been active since 2009. Their website features articles, presentations, and campaigns. CANE was among the Canadian signatories to the Healthy Climate Prescription letter, along with the Canadian Nurses Association, Canadian Medical Association, Canadian Public Health Association, and other organizations. I found CANE’s definition of planetary health quite helpful in thinking about the health of populations and the natural world:
Planetary health is a recognition of the fact that human health depends on healthy natural environments/ecosystems, and moreover, that we as a civilization find ourselves at a tipping point. We have depended on our natural systems to promote human health to the point where the human population is healthier than ever before, but to achieve this, we have exploited the planet at an unprecedented rate. If we want to continue to safeguard human health, we also need to maintain the health of the planet and its natural systems on which we depend (CANE website, n.d.).
Nurses are being called upon to use our individual and collective influence. Writing in the International Nursing Review, Dr. Pamela Mitchell (2021) offers a thoughtful piece on Nursing’s mandate in climate change. She notes that nurses have written about climate change in the context of the UN Sustainable Development Goals, and now urges collective advocacy to move our focus to climate justice and equity.
Dr. Sally Thorne’s recent editorial in Nursing Inquiry, Awakening to the climate emergency, is a fitting reminder to nurses to pay attention to planetary health. As Editor-in Chief, she anticipates an increase in manuscripts on “a nursing response to the climate crisis” as we take up a shared goal (Thorne, 2021).
I believe that events of recent years are awakening us to the urgency to act as part of our organizations, coalitions, and nations in the quest for climate justice.
Post COP26 Update: The Global Climate and Health Alliance provided an assessment of what was achieved and what work remains. There is positive news in COP26’s Glasgow Climate Pact “that re-commits governments to limiting temperature rise to 1.5C, in line with the most recent science” with concern about the lack of substance in the countries’ commitments. Read more in the media release from Glasgow dated November 13, 2021.
The International Council of Nurses issued a strong statement on the final day of COP26: “ICN is calling for nurses and other healthcare workers to be included at the centre of climate change policymaking, underscoring that climate change is a health issue. As COP26 closes and leaders look ahead to COP27 next year, ICN says it is more important than ever that the voice of health professionals is heard on the climate change debate because if nothing changes nurses and health systems will suffer the consequences.” See full media release (November 12, 2021).
By Nora Whyte – October 24, 2021 (Updated November 22, 2021)
with respect that I live on the Unceded traditional territory of
the K’òmoks First Nation.
Each year at this time I write a short piece to reflect on National Nursing Week in Canada and follow what others are posting on social media. This year there isn’t much to say that hasn’t been said already by nursing leaders and through Canadian media coverage of nursing during COVID times. I do want to commend leaders in nursing organizations and to thank colleagues for the tremendous work they have been doing under such difficult circumstances. I think about nurses I have known in India, Nepal, and South Africa and wonder how they’re doing. I hear stories about nurses in all parts of Canada who continue to be key to the COVID response and I learn from colleagues in my circle about their recent experiences with the vaccination rollout in British Columbia.
ICN celebrates International Nurses Day on May 12 each year. This year, it has released an excellent report Nurses: A Voice to Lead – A Vision for Future Healthcare. The report calls for nurses to become the “architects and designers” of health systems, not only the people who deliver care. Among the report’s key recommendations are that governments embrace this new global strategy for nursing and embed its recommendations into their national healthcare strategies.
A graphic that captures the vision for future health care is found on page 7 highlighting the report’s framework and recommendations. It lists six aspects of health care transformation and five ways to support nurses to leverage a better health system. Transformation includes a renewed emphasis on public health nursing, investments in innovation along with greater attention to quality and affordable care. Approaches for supporting nurses focus on safe workplaces, valuing the role of nurses, and better access to education and professional development. This year’s report provided information on a survey of National Nursing Associations on aspects of the COVID response and current issues for evolving the profession. The report is illustrated with country spotlights from the nursing associations and media reports.
Another major report published this month marks the culmination of the global Nursing Now campaign – Agents of Change: the story of the Nursing Now campaign. Although I had followed the campaign since its launch in 2018, I hadn’t been aware of all the impressive accomplishments described in the report. The appraisal of the process and outcomes to date are worth reviewing; it is interesting to know that the reach extended to 729 Nursing Now groups in 126 countries. There’s a strong message to build on the campaign’s momentum as noted on page 14:
“The Nursing Now campaign has generated tremendous energy from nurses and their allies. They have truly come together as agents of change. It is critical at this pivotal moment, as the world turns its attention to rebuilding health systems for the future, that nurses do not lose this momentum.”
Holloway et al. (2021).
A final note for nurses with an interest in global health policy, ICN’s Global Nursing Leadership Institute (GNLI) is worth exploring as a career development step. BC’s Angela Wignall shared her enthusiasm and described her recent experience as a GNLI scholar in a two-part blog for the Nurses and Nurse Practitioners of BC: Part 1 on the ICN Global Nursing Leadership Institute and Part 2 on Nursing Bodies: Learning from Global Examples. To learn more, please see the GNLI program overview with details about the program and the application process.
By Nora Whyte – May 22, 2021
I acknowledge with respect that I live on the Unceded traditional territory of the K’òmoks First Nation.
Holloway, A., Thomson, A., Stilwell, B., Finch, H., Irwin, K., and Crisp, N.(2021). Agents of Change: the story of the Nursing Now campaign. Nursing Now/Burdett Trust for Nursing. London.
International Council of Nurses. (2021). Nurses: A Voice to Lead – A Vision for Future Healthcare. Geneva.
This week I received the first newsletter for the 2021 International Council of Nurses (ICN) virtual congress taking place in November. This congress promises to be a highly relevant one for these times with the theme of “Nursing Around the World” using a virtual format that will increase access to the event.
Abstracts are due by March 11, 2021 for e-posters and oral concurrent sessions on eight sub-themes. Sub-themes include Nursing Workforce, Epidemics & Pandemics, Global Health Challenges, and Digital Health & Innovation. The concurrent sessions will be 10-minute pre-recorded video presentations grouped by sub-theme.
Having attended past ICN congresses – in Barcelona, Durban, Singapore, and Vancouver – I can attest to the value of meeting nurses from around the world, listening to their presentations, and learning about policy advocacy to apply to my own work. Along with colleagues, I have submitted abstracts and been part of presentations. And sometimes an encounter at a congress has led to later collaboration and exchanges.
Global Vaccine Equity
pandemic ICN has been vocal on the behalf of nurses and health workers globally
and is supporting the current WHO campaign on vaccine equity in the first
months of 2021, the Year of the Health and Care Worker.
The WHO Declaration calls on “global, national and local leaders to accelerate the equitable rollout of vaccines in every country, starting with health workers and those at highest risk for COVID-19. This includes scaling up vaccine manufacturing and rejecting vaccine nationalism at every turn.”
WHO urges world leaders to increase contributions to the COVAX facility and also calls on Ministries of Health “to work with WHO and others to invest in and prepare their primary health care systems for distribution of COVID-19 vaccines to their health workers.” Further, as is expressed often these days, distribution of vaccines quickly and equitably will be key to ending the pandemic. Individuals and organizations can lend their support by signing the declaration and by getting messages out through social media. #VaccinEquity
Whyte – February 18, 2021
Iacknowledge with respect that I live on the Unceded traditional territory of the K’òmoks First Nation.
This is the time of year when membership fees are due and the reminders start rolling in. It is a time when I consider whether or not to renew my membership in various organizations and what commitments I’ll make in the year ahead. In particular at the start of 2021, I have been thinking about the privilege of membership in the Canadian Nurses Association.
As noted on its website, the Canadian Nurses Association (CNA) is “the national and global voice of Canadian nursing, working with nurses in all 13 jurisdictions across Canada to bring essential and meaningful change to health care and nursing in the country.” Membership is open to all regulated nurses who may join as individuals or through their membership in provincial and territorial associations in jurisdictions that are CNA members. Major changes in jurisdictional nursing organizations across Canada will continue to have an impact on national membership. For the first time, I will be taking out an individual membership because the annual membership fee in my provincial association, the Nurses and Nurse Practitioners of British Columbia (NNPBC), no longer includes CNA membership. I remain supportive of NNPBC and CNA and hope that we’ll see new membership models and fee structures in the coming years. Membership in CNA is a vital link to our dynamic global nursing body, the International Council of Nurses.
During the summer and fall of 2020, CNA conducted a member survey to build on dialogue and engagement sessions conducted in 2019 & 2020. For a good overview of survey results, see Your Voice, Your Association.
Survey respondents viewed
CNA in a favourable way with 81% noting that a national professional association
is essential. Communication is key to
engagement and three preferred methods are: direct email, social media &
webinars. Ideas for building a strong and effective association include:
Engage with membership on a grassroots level
Offer more mental health resources
Offer more continuing education opportunities
Forge strong partnerships with provincial and territorial associations
Highlights of the past year – shaped so dramatically and sadly by the pandemic – were linked to my longtime interest in professional associations and their role in policy advocacy clearly in evidence during 2020. It was satisfying to be a co-author with stellar colleagues, Patrick Chiu and Susan Duncan, on an article published in the Canadian Journal of Nursing Research:
In our abstract we
indicate how we drew on “recent key
national and global events including our systematic inquiry into Canada’s 2019
federal election, the Year of the Nurse and Midwife, and the Coronavirus
pandemic to examine how Canadian nursing organizations respond in highly
complex and evolving contexts.” Further, we used our observations to offer a
vision and chart a research agenda for the advancement of nursing
organizations’ influence on health systems and policy.
Another highlight that took place at the end of 2020 was receiving a Lifetime Achievement Award from NNPBC at a wonderful virtual 2020 Nursing Awards of Excellence Ceremony featuring music, dance, videos, and special messages from CNA and others. It was an emotional and proud moment to be among the group of BC nurses recognized for contributions to the profession in our province.
forward to staying connected to nursing’s collective presence and voice provincially,
nationally, and globally in 2021.
Whyte – January 19, 2021
I acknowledge with respect that I live on the Unceded traditional territory of the K’òmoks First Nation.
Postscript: February 21, 2021
For nurses from BC, the process of membership renewal in CNA was delayed at the start of this year. I was unable to renew in January as planned. Glad to see that the membership portal is working now and that we can renew or rejoin as BC registrants or retired members. Annual membership gives us access to the Canadian Nurse and opportunities to participate in our national association and the ICN. In fact, to submit an abstract (as first author) for the ICN Congress in November, one must belong to a National Nursing Association. I’m thankful that CNA is a member of ICN and that’s one of my primary reasons for renewing my CNA membership.