Abstract
In the first Editorial of this issue, we explored some of the media representations of nurses, during the coronavirus disease 2019 (COVID-19) pandemic, in Italy, the United Kingdom and the United States. There is much to celebrate regarding the incalculable contribution of nurses and there is also much to be concerned about regarding resources for nurses to fulfil their duty of care. This is particularly so in less affluent countries and it is important that focused political pressure is brought to bear by an international nursing organisation at this extraordinary time and beyond.
The highest profile and, arguably most influential, global organisation representing the interests of nurses is the International Council of Nurses (ICN). It was established in 1899 and is described ‘as a federation of more than 130 national nurses associations (NNAs)’ with a mission to ‘represent nursing worldwide, advance the nursing profession, promote the wellbeing of nurses, and advocate for health in all policies’. 1 In the ICN Strategic plan 2019–2023, the values and goals are set out and are worth bearing in mind as nurses are responding to the current global health emergency.
The four ICN goals are as follows: global impact (informing and influencing all aspects of global health policy to promote health for all); membership empowerment (strengthening NNAs’ contributions to practice, regulation and the welfare of nurses to address regional challenges; strategic leadership (providing leadership to advance the profession globally in response to current and future health and welfare needs); and innovative growth (developing business and revenue-generating opportunities in keeping with ICN values and goals). The four values, which make explicit the ethical focus of the ICN Strategic plan, are social justice (‘achieving equity and equality for society and the profession’); accountability (‘guaranteeing open, inclusive, transparent and informed decision-making and reporting’); inclusiveness (‘engaging a broad range of partners, members and perspectives’); and innovativeness (‘being creative, transformational, progressive, evidence-informed, and solution-focused’). 2
The ICN collaborated with the World Health Organization and Nursing Now to produce a seminal State of the World’s Nursing report. 3 This was published on World Health Day 4 on 7 April in this ‘International Year of the Nurse and Midwife’ 5 and 200th anniversary of the birth of Florence Nightingale. The report brought together data from 191 countries on critical topics such as education capacity; nursing workforce including conditions, salary and wages; and policy relating to the sustainability and development of the professional globally. The report findings revealed much to celebrate regarding the contribution of nursing and much to do to ‘drive and sustain progress to 2030’. 3 The report states that three areas of investment and contribution need to be prioritised: investment in much-needed growth of nurse education; creation of 6 million new nursing jobs, particularly in low-income countries; and strengthening of nurse leaders to embed nurses’ influence in current and future health policy and decision-making to improve health systems globally. During the pre-launch press conference for this important report, Howard Catton, ICN’s Chief Executive Officer (CEO), said that governments need to demonstrate as much courage as nurses, who are delivering care at this challenging time, to operationalise the report’s recommendations.
Mr Catton generously agreed to be interviewed for Nursing Ethics some weeks before the launch of the report. He detailed many of the ways that the ICN raises the profile of nurses and impacts global health positively. He talked of global changes and challenges such as BREXIT, professional migration, climate change and infectious diseases, including the current most pressing challenge of COVID-19. Mr Catton made the point that this is a time to look ‘outwards’ not ‘inwards’.
In response to my question about the role of ethics in ICN activities, Mr Catton said that ‘ethical considerations have moved more to the centre of thinking and decision-making’. He said he had ‘more of a lived sense of ethics in day to day considerations’ and gave the example of how ICN had taken a stand and ‘called out’ unethical behaviour that undermined humanitarian responses in countries such as Syria.
Mr Catton also pointed to ICN’s work in the areas of climate change and of human rights promotion where nurses play a central role globally. The promotion of human rights complements our own annual Human Rights and Nursing Awards. 6 Regarding the ICN Code of Ethics, 7 which is now under review, Mr Catton pointed out that the revision was timely, enabling the Council to take stock of societal and professional changes to ensure the Code is fit for ever-changing global contexts. The Code, he said, needs ‘to speak’ to nurses in all cultural contexts and assist them with decision-making in the most varied care scenarios. The Code is currently being prepared for consultation, and we can look forward to nurses (and nurse ethicists) around the world contributing their experience and expertise to the process.
Given the COVID-19 challenges nurses are currently engaged with, it was heartening to talk with ICN's CEO, to read the State of the World’s Nursing report and to better appreciate the genuine and committed collaboration among international bodies such as ICN, Nursing Now and the World Health Organization.
We have, as demonstrated in the first Editorial, never had so much in common, never had so much to learn from each other and never needed each other more. We have, therefore, never need strategic international leadership more, to steer us through these most turbulent waters and bring wisdom, solidarity and calm to bear…. There is an important role here also for our international nursing ethics community and for our journal in sharing perspectives, scholarship and research. At the time of writing, I’m reading Albert Camus’
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The Plague and was struck by much that is similar with our own time. For example, no longer were there individual destinies; only a collective destiny, made of [pandemic] and emotions shared by all…
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