International Health, Nurse Staffing, the Power of Social Media

I previously posted on this blog in anticipation of attending my first international nursing meeting—the  2017 International Council of Nurses Congress in Barcelona—and wrote about it later in a joint post with AJN‘s editor-in-chief Shawn Kennedy. There will also be a full report in the August issue of AJN.

Based on subsequent reflection, here are some lasting takeaways:

International health is an American nursing problem.

“Shamian asked what American nurses do for their fellow nurses around the world.”

There was a lot I didn’t know about global health. I was thankful that I’d taken some time to study a few key concepts, especially the sustainable development goals (SDGs).

In the opening session, ICN president Judith Shamian charged all nurses to take seats at policy tables and draw upon their expertise. Through her passion, I began to see a part I could play in policy making simply by keeping abreast of issues and sharpening my nursing voice.

From the plenary speech by former Secretary of U.S. Health and Human Services, Mary Wakefield, I began to see the necessity of grounding policy work with reliable, relevant evidence. And in our interview with Shamian, policy and evidence met collaboration as Shamian asked what American nurses do for their fellow nurses around the world.

Nurses outside of developed countries suffer, but it had never occurred to me that I might have an opportunity to help them. ICN’s International Nurses Day publication highlights each of the 17 Sustainable Development Goals, alongside case studies of real nurses whose work contributes directly to each goal. One nurse shared his attempts to alert world health leaders to lack of food and water in his Syrian village, which was under attack. No one answered him until he sent photos of starving children to an American media outlet. But by the time help came, many of his patients had already died.

I began to consider my possible role in changing the arc of stories such as this through the use of policy, evidence, and collaboration.

Staffing problems are pretty universal, and there are many ways to address them.

“I have always struggled with the black-and-white nature of ratios . . . “

This topic, a perennial discussion point for American nurses, is a global one, and sessions confirmed that the science of safe staffing involves a lot more than just ratio-based care. Linda Aiken showcased her 20 years of evidence on the topic. With graph after graph, she showed consistent evidence attributing unsafe staffing to poor patient outcomes. Calling for action, Aiken challenged the audience to print her slides and bring them to managers, leaders, politicians.

I have always struggled with the black-and-white nature of ratios, believing that nurses are best experts within fluid acuity models. So I appreciated Jean White, the chief nursing officer of Wales, who in speaking of her recent victory pushing through nurse staffing legislation, led with the statement, “You will not find ratios on the cover of the Act.” She went on to describe a patient-centric, informatics-heavy, nurse-driven staffing plan that put the power of staffing with the nurses at the bedside. Both presenters received rousing audience responses.

Our direst need is in translating this evidence into public knowledge and creating a system that gets more and more transparent. If we are always ‘staff’ arguing about ‘staffing,’ why will anyone but our labor unions and professional ranks pay attention?

Social media mastery (AKA Twitter) is the key.

“Can we intentionally connect at the global level over these platforms that we so carelessly consume each day?”

Now that I’m home, social media as a means for developing a stronger nursing voice keeps coming to mind, especially when I think about the Syrian nurse’s story. What might have happened to his patients had he been able to reach out to nurses in America via Twitter to help him escalate his call for help? Can we intentionally connect at the global level over these platforms that we so carelessly consume each day? How far could we go in supporting our international colleagues and improving global health?

Having a blue ‘Prensa’ pass all week was a new experience, and as I talked to non-nurse press members, I became keenly aware of the unique power that I possessed in my dual role. I wondered how much more powerful we’d be as a profession if we linked journalism with nursing on a consistent basis.

If the ICN taught me anything, it is to pick something you’re passionate about and just start getting to work.

2017-07-10T07:54:39+00:00 June 30th, 2017|Conference reports, Nursing|6 Comments

About the Author:

I'm a nurse with a critical care background who works in administration in Manhattan. My blog is This Nurse Wonders. I also blog for Off the Charts and Healthcetera, and tweet as @ajandersonrn.


  1. K. Ables July 14, 2017 at 9:09 pm

    Hi Amanda. I also didn’t know much about global health (except of course the topics that make the main headlines). I am currently enrolled in a Global Health Nursing course and I’ve learned a great deal. Coincidentally, one of our very last assignments involved researching how nurses can become more involved in policy making, and mine was specifically on nurse patient ratios, so this blog was very refreshing. What happened with the Syrian nurse was very unfortunate. Your ideas of involving social media are very innovative and a great way to unite nurses. As it stands, I am currently a part of several nursing groups on social media platforms and am able to connect to other nurses internationally. Pushing it a step further as you described would be a great idea. There is strength in numbers, and social media platforms may just be a way to get policy makers to listen up and take action, making the changes we need to keep our patients safe. I enjoyed your blog post. Thanks for sharing.

  2. Dirly Bastida July 13, 2017 at 9:04 am

    It’s troubling to hear the story about the Syrian nurse. Although I know organizing a team to go help her may have taken some time, it appears she only received help after posting pictures on social media outlets. Social media is being used in so many ways. From Dr. Miami posting surgeries on snap chat to Dr. Pimple Popper’s you tube channel, social media is being used to educate the public about healthcare and procedures performed by healthcare providers. Global health is extremely important. How can we eradicate common communicable illnesses when low-income countries have a hard time treating them? The topic of global health is still very new to me but it is so important! I think using social media to spread information about global health would be beneficial to educating others about what is going on in other countries. It could also be used to educate the public regarding healthy lifestyle choices and how to improve their health. I hope that your article inspires nurses to step up and do something that could help people in other countries to improve health at a global level.

  3. Ashley Allen July 12, 2017 at 6:57 pm

    Hi, Amanda. I really enjoyed reading this blog post. I am currently enrolled in my last course as a RN-BSN student and it happens to be ‘Nursing in Global Health Care Systems.’ This post covers some of the topics I haved learned about this semester, such as nursing in developing countries, the nurse’s role in policy making, and safe staffing. Like you, there was (and still is) a lot I didn’t know about global health. While reading your post, I was excited to gain insight about another nurse’s perspective of these topics.

    I also appreciate your idea of utilizing social media as a means for developing a stronger nursing voice. I do believe we can intentionally connect at the global level through the social platforms we consume each day. Social media is changing the way we gather news and it is only right that the nursing profession adapt to these changes. We learn about the use of technology in nursing while in nursing school. Perhaps the potential of social media in nursing and global health should be considered and introduced to the curriculum.

  4. P.Phanor July 12, 2017 at 6:03 pm

    Dear Amanda,

    Thank you for shedding some light on the global issue in regards to nursing staffing and the help needed from the underdeveloped countries. Some of these underdeveloped countries suffer from shortage of nurses and supplies, and even clean water. This article made me recognize and realize the issues that our nurses may face in this country is minor comparing to the issues that some underdeveloped countries may face. The plan to make the most of social media to bring awareness of these global health issues and to also ask for help for these issues is a brilliant idea. Hopefully this article prompt us as American to do more to help these countries by donating our time, money, and supplies

  5. Juliet Gonzalez July 11, 2017 at 5:33 pm

    This article showed me very interesting points. It made me realize how little significant our everyday nurses’ issues at work seem in contrast with the world’s healthcare problems. We worry about having too many patients to attend when in other countries they don’t even have nurses or supplies to offer. It is a great initiative to utilize social media to inform and ask for help for projects and worldwide issues and get more people involved. We have very busy lives, that almost leave us no free time, but this article reminded me that we should be doing more for the other people in the world, either by collecting money or supplies or by going to countries and need and volunteer.

  6. Linda July 2, 2017 at 7:46 am

    Nice article

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