By Maureen Shawn Kennedy, AJN editor-in-chief

Old capitol of Malta, the walled city of Mdina

Since many readers may not know about international nursing, here’s a primer (for those who are interested) that provides some context for my upcoming blog posts from the International Council of Nurses (ICN) meeting in Malta (accompanied by some photos of the city from my morning bus ride).

The Council of National Representatives (CNR), the governing body of the ICN,  meets before the actual ICN meeting. Members are the representatives of the 134 national nursing associations (NNAs) of member countries—there’s one official voting member representing each NNA, but there can be additional nonvoting representatives, depending upon the various membership options (I won’t bore you with more details here—you can find details here on the ICN Web site). The ICN was established in 1899 and meets every two years. 

Grand Harbor in Valetta, Malta

The CNR meetings cover a lot of policy and procedure issues and the like, but they also provide a venue for feedback from member countries about problems and issues that the ICN should address. This year, the issues forums were on

  • changing labor markets.
  • social determinants of health.
  • nurse prescribing.
  • speaking with one voice.

On Tuesday, I ran into Lucille Joel on the way to the labor forum. Lucille, a professor at Rutgers University College of Nursing, is a former president of the ANA and a former first vice-president of the ICN; she was also the editor-at-large at AJN in the 1990s. We agreed that the issues we were hearing about were not so different from those raised in prior ICN meetings and not so different among the various countries, though they vary in extreme between developed and developing countries. The requests and suggestions made to rectify them were not so different either.

The ‘burning issue.’
During one session, I asked ICN president, Rosemary Bryant of Australia, what was the “burning issue” of this ICN meeting. She immediately said, “The global economical downturn—it’s driving everything else.”

Yes, we’d been wrestling with many of the issues—nurses migrating from poor countries to richer countries, the unequal distribution of illness and basic resources among the poor, no standardized basic nursing school curriculum in many countries, lack of nurses in leadership positions, and the need for nurses to speak with one voice, to name a few—for a long time before the global economic downturn. But the global nature of the downturn has led to an unprecedented lack of resources as countries and organizations that could be counted on to support programs have had to cut back or cut off this support.

In some developing countries, nurses are working but not being paid. Associations depend on member dues to support themselves; in turn, ICN is supported by member dues from associations. With many countries experiencing membership declines, ICN dues go partially paid or unpaid . . . which in turn reduces its resources to support nursing worldwide.

The irony is not lost on Bryant—she says that at the time support is most needed, the resources to supply it are dwindling as well.