“The greatest threat to global health is the workforce shortage” - International Council of Nurses International Nurses Day demands action on investment in nursing, protection and safety of nurses

The International Council of Nurses (ICN) today launched its International Nurses Day (IND) toolkit, Nurses: A Voice to Lead – Invest in nursing and respect rights to secure global health to help nurses, other healthcare providers, governments and international organisations turn global strategy into meaningful local action and improved clinical practice on the ground.

ICN President Dr Pamela Cipriano said:

“Nurses have given their all in the fight against COVID-19, Ebola, in disaster areas and in war zones. Yet, they continue to face under-staffing, lack of protection, heavy workloads, and low wages. It is time now to take real action to address workplace safety, protect nurses and safeguard their physical and mental health.

‘Women form 70% of the global health workforce, but only 25% of leadership roles. They bear the burden of lower-paid, undervalued jobs and unpaid care and domestic work. We can help to empower women and promote gender equality by investing in nursing.

‘Recent reports have shown that investment in nursing is needed now if we are to meet the healthcare challenges of the future. We can no longer continue to undervalue and underinvest in nursing. Now is the time for action.

‘We have the recommendations from WHO, which have been agreed by the Member States. We know what to do. We need to move on from the talk and see action to support our nurses – and that is exactly what ICN’s IND toolkit provides.”

ICN Chief Executive Officer, Howard Catton said:

“The value of nurses has never been clearer not only to our healthcare systems but also our global peace and security. Nor could it be any clearer that not enough is being done to protect nurses and other health workers, tragically underscored by the more than 180,000 health worker deaths due to COVID-19. We should not shy away from calling out that this is a question of policy and politics because the policies to rectify this lamentable situation do exist but they are not being implemented.

‘The scale of the world-wide nursing shortage is one of the greatest threats to health globally, but governments are not giving it the attention it deserves. Access to healthcare is central to safe, secure, economically successful and equitable societies, but it cannot be achieved unless there are enough nurses to provide the care needed.

‘Governments should be urgently prioritising investment in nursing and the health workforce on that basis, and proportionate to its importance for the future of societies everywhere.”

The 2022 IND report acts as a strategic toolkit that aligns with key documents including the WHO Global Strategic Directions for Nursing and Midwifery: 2021-2025 (SDNM); the WHO State of the World’s Nursing and the International Centre for Nurse Migration’s Sustain and Retain in 2022 and Beyond. In particular, this work supports the implementation of the SDNM by providing practical guidance required by multiple stakeholders for effective realisation of their aims. It also showcases case studies as real-life examples in action. As such, it is a toolkit that provides multisectoral guidance to multiple stakeholders.

The toolkit looks at the four policy focus areas of the SDNM: education, jobs, leadership and service delivery and discusses the benefits of investing in each of these areas, the evidence of underinvestment; the expected outcomes of meaningful investment; as well as the actions required for successful delivery and monitoring of these priorities.

In addition, the IND report focuses on two vitally important strategic priorities that have come to the forefront over the last two years: investing in and prioritising the safety of health care workers and caring for the health and wellbeing of nurses.

The report examines the extra burden that the pandemic has put on health systems and on the nursing workforce; highlights the risks to and lack of protection of the profession; and presents evidence of underinvestment in nursing, globally. ICN has referred to this combination of factors leading to an increased burden on the nursing workforce as the COVID Effect.

• While health workers represent less than 3% of the global population, they represented around 14% of COVID-19 cases. In some countries, the proportion can be as high as 35%.
• About 20% of nurses in Japan reported they had experienced discrimination or prejudice amid the spread of the virus. In the US, 64% of nurses felt overwhelmed and 67% reported difficulty in sleeping.
• Healthcare workers, especially nursing staff, are also more likely to be exposed to offensive behaviours, including sexual harassment, than other professions. In the United States, rates of violence from clients against health-care workers were estimated to be 16 times higher than any other service profession.
• In the 2014-2016 Ebola outbreak in West Africa, the risk of infection among health workers was 21 to 32 times higher than in the general adult population.
• Virtually all WHO Member States report pandemic related disruption to health services, and two-thirds (66%) have reported that health workforce-related factors are the most common causes of service disruptions.
• Due to existing nursing shortages, the ageing of the nursing workforce and the growing COVID-19 effect, ICN estimates up to 13 million nurses will be needed to fill the global nurse shortage gap in the future.

ICN has produced other resources to support IND, including: an IND logo, posters, social media banners, a virtual background, and Facebook frame and other digital tools to promote #IND2022 on social media. These can all be downloaded from the ICN website. ICN has also published an interactive digital map with videos from ICN Board members discussing regional priorities and how the IND toolkit can strengthen nursing and national nursing associations in every region across the world.

International Nurses Day is celebrated around the world every 12 May, the anniversary of Florence Nightingale's birth. ICN commemorates this important day each year with the production and distribution of the IND resources and evidence. To access the report and other resources, as well as information of previous INDs, please go to https://www.icnvoicetolead.com/

Download the press release here

Footnotes

1. World Health Organization (2020). Policy Brief: Gender, equity and leadership in the global health and social workforce.

2. World Health Organization (2020). Keep health workers safe to keep patients safe. News release, 17 September 2020.

3. The Mainichi (2021). Japan Nurses Faced Discrimination, Quit Jobs Amid COVID-19 ‘First Wave’: Survey – The Mainichi.

4. American Nurses Foundation (2020). Pulse on the Nation’s Nurses COVID-19 Survey Series. Mental Health and Wellness Survey #2.

5. Franklin, P. (2020). Violence and harassment in the year of the nurse. HesaMag # 22 – 2nd semester 2020. European Trade Union Institute.

6. World Health Organization (2015). Health worker Ebola infections in Guinea, Liberia and Sierra Leone: a preliminary report.

7. World Health Organization (2021). Second round of the national pulse survey on continuity of essential health services during the COVID-19 pandemic: January-March 2021.

8. International Council of Nurses (2021). The Global Nursing Shortage and Nurse Retention.