17 October 2022
Article from October 2022 edition of INPractice
Global nursing chief tells us to focus on growing and training our own workforce.
The Chief Executive Officer of the International Council of Nurses has criticised Australia for poaching nurses from developing countries.
ICN chief Howard Catton says Australia should focus on training and growing its own workforce instead of recruiting nurses from overseas countries which can ill afford to lose them.
Prime Minister Anthony Albanese has already said overseas nurses will play a role in staffing the aged care sector under new staffing requirements such as 24/7 RNs at all sites by July 2023.
Mr Catton said nursing had come to the forefront during the pandemic and that the war in Ukraine, climate change, natural disasters and other recent challenges had all shown the centrality of health to the safety and security of the planet and the leading role that nurses play in responding to these threats to health.
However, along with these recent challenges, the world is still facing the same pre-pandemic threats to health, such as access to health care, poverty, noncommunicable disease (NCDs), infectious diseases, lack of vaccination coverage, humanitarian crises, ageing populations, and an increase in mental illness.
These increasing threats to health, combined with a severe global nursing shortage, mean that many high-income countries are recruiting nurses from lower-income countries which cannot afford to lose their workforce.
Mr Catton underlined the point he made in a recent Nursing Times story on the UK Government’s plans to recruit nurses from Nepal despite global restrictions. He stressed that the UK has more than four times the number of nurses per head of population than Nepal and that access to health care for millions of Nepalese is already a major challenge.
He noted that international recruitment, particularly from countries that cannot afford to lose their nurses, will only widen inequalities. Calling for strengthened global regulations and improved national workforce planning, Mr Catton said governments must address their own shortages by increasing the number of home-educated nurses and investing in retaining their current nurse workforce.
“We have to be vocal on the economics, on the ethics and on the local health implications of what we are seeing. What is the root cause? It comes back to underinvestment in the nursing profession,’’ he said.
It is the policy of the ANMF that:
1. The implication of global competition for nurses and midwives necessitates ethical consideration, as aggressive recruitment from developing countries may have potentially unwanted consequences for the health systems of the source country(ies).
2. Overseas recruitment programs must not be used as a primary strategy to overcome nursing and midwifery shortages in Australia and internationally, or as an alternative to educational opportunities for the existing nursing/midwifery workforce.
3. Governments must commit more resources for workforce planning, education and improving pay and conditions in order to attract and retain domestic nurses and midwives.
Recent reports from ICN, the World Health Organization, the WISH Foundation and others provide the evidence that investment in retaining and recruiting domestic supplies of nurses and developing advanced practice nursing (APN) roles can provide the solution to these challenges.
“Nurse-led services should be central to expanding and strengthening health systems around the world,” Mr Catton said, adding: “Now is the time for countries to introduce, increase and grow nurse-led models of care. Nursing is the golden thread that links health care policy and practice. It holds the solution to many of the health care problems the world is facing, and that is why we are calling for governments to urgently invest in nursing. The return on investment in nursing for global health is priceless.”
“We have the evidence: we see around the world how APN roles and nurse-led services are delivering high quality, accessible, timely, people-centred and cost-effective health care,’’ Mr Catton said. “And we have the strategy. Now we need to do more to see nurse-led models of care used in health systems.”
Mr Catton gave an example from Ireland where an APN-led cardiology chest pain service has been implemented. Within the first year of this service, admissions to the ward reduced by 36% and to emergency department trolleys by 60%, contributing to significant savings for the hospital and timely diagnosis and treatment for patients.
A case study from the USA, where 36,000 nurse practitioners graduate each year, showed that APNs are helping to meet demands for the shortfall in general practitioners, thanks to the lessening of restrictions on APNs during the pandemic in order to meet demand.
ICN’s case studies show that nurse-led care is key to improving integrated care including adherence to follow-up, improved diagnosis time, improved self-care management, improved quality of life, reduced mortality, lower readmission, and reduced hospitalisation costs.
Mr Catton gave another example, that of a hospital on a train in South Africa which brings access to health care to reach patients. This is a nurse-led service which provides multiple primary health care services to disadvantaged communities.
“This is what countries and health care systems should be funding,’’ Mr Catton said. “And this is what APNs need to get out there and advocate for.”
Mr Catton pointed out that lower income countries have invested in educating and training the nurses that are then being poached.
“If this was climate change, we’d say, ‘How can we offset the impact when we know it’s going to have a detrimental effect elsewhere?’ We could do something like that with nursing. Say, if you’re going to recruit nurses from a low-income country, pay for a nursing school in that country, for example.
“I don’t think that the ethical codes that exist have sufficient teeth. I don’t think that we’re monitoring the numbers sufficiently. There are shortages in India and the Philippines. It’s not as though those countries have more nurses than they need. They’ve got issues in meeting their own health needs.’’
Click
here to read the October 2022 edition of INPractice.