1. Burton, Erica MPH, RN


Editor's note: The International Council of Nurses (ICN) is a federation of more than 130 international nursing organizations. For more information, see the ICN website at


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More than 5,000 participants from 120 countries attended the 2019 biennial congress of the International Council of Nurses (ICN), which was hosted by the Singapore Nurses Association in the Republic of Singapore. The conference began on June 27 and ended on July 1, which marked the ICN's 120th anniversary. Over the four-day scientific program, nurses and nurse allies explored numerous topics within the overarching theme "Beyond Healthcare to Health," and discussed how nurses can work toward achieving health and well-being for all.

Figure. Nurse delega... - Click to enlarge in new windowFigure. Nurse delegates celebrate a memorable Congress at its closing ceremony. Photo courtesy of the International Council of Nurses.


ICN president Annette Kennedy and chief executive officer Howard Catton opened the event, and were joined by Halimah Yacob, president of the Republic of Singapore. In her address, Yacob memorably said, "If you save one life, you are a hero; if you save 100 lives, you are a nurse." Elizabeth Iro, chief nursing officer of the World Health Organization (WHO), gave a keynote speech in which she highlighted the need for nursing's voice to be heard and integrated into decision making. The ICN has been working closely with Iro to ensure that nursing informs the WHO's work.


Safe staffing. Linda Aiken, world-renowned nurse researcher and director of Penn Nursing's Center for Health Outcomes and Policy Research, and Matthew McHugh, the center's associate director, presented the latest evidence on the impact of safe nurse staffing regulations and interventions on nurse retention and patient outcomes. Aiken noted that "the same things that cause nurses to burn out are the same things that cause patients to be dissatisfied with their care."


Expanding on the idea of patient safety and nurse staffing as two sides of the same coin, Abdulelah Alhawsawi, director general of the Saudi Patient Safety Center, highlighted the impact of unsafe staffing ratios on patient outcomes and on the safety of the health care workforce. He also took the opportunity to introduce the ICN and Saudi Patient Safety Center's white paper, Nurse Staffing Levels for Patient Safety and Workforce Safety.


Nobel Peace Prize nominees. Kim Hwang-sik, former prime minister of the Republic of Korea, spoke about two Austrian nurses, Marianne Stoeger and Margareta Pissar, who are being nominated for the Nobel Peace Prize. The nurses arrived in Korea in the 1960s to volunteer at a hospital for patients with Hansen's disease (commonly known as leprosy) on Sorok Island. The nurses spent decades working to improve living conditions for the patients, providing them with food, medications, and financial support, and to restore their dignity.


The year of the nurse and midwife. Participants were delighted to welcome a surprise guest speaker, WHO director-general Tedros Adhanom Ghebreyesus, who addressed the need to confront abuse and discrimination in the workplace. "Discrimination and abuse, including violence and harassment, must have no place in our societies, and especially not in our health systems," he said. Ghebreyesus also announced that, as part of the celebration of 2020 as the International Year of the Nurse and Midwife, the WHO is "proposing that every country bring one nurse and one midwife to the World Health Assembly next year."


Lord Nigel Crisp and Sheila Tlou, cochairs of the Nursing Now campaign, officially launched the Nightingale Challenge, asking employers of nurses and midwives to provide those ages 35 and younger with opportunities for personal and leadership development, aiming to have at least 20,000 benefit from this challenge. Tlou urged, "If we are serious about achieving rapid and high-quality health for all, governments, employers and health leaders must make investing in nursing and midwifery their number one goal for 2020."


Human trafficking. Cindy McCain, philanthropist, educator, humanitarian, and widow of former U.S. Senator John McCain, delivered a keynote speech on providing compassionate care to victims and survivors of human trafficking. McCain sits on the board of the McCain Institute, and works to increase human trafficking awareness, which she identified as essential for frontline health workers. Kevin Hyland, member of the Council of Europe's Group of Experts on Action Against Trafficking and former UK Independent Anti-Slavery Commissioner, discussed strategies nurses could use to identify victims of human trafficking and to bring human trafficking to the forefront of our work.


Interactive and main sessions. For the second time, the ICN Congress held Policy and Advocacy Cafes, interactive sessions in which participants and high-level speakers and nursing leaders could discuss key issues, share information, and raise questions on specific themes. Popular cafes were "Nursing Workforce Challenges," "Creating a Cohesive and Consistent Approach to Advanced Practice Nursing," and "Disaster Nursing: How Prepared Are We?"


Main sessions addressed noncommunicable diseases, tobacco control, disaster nursing, nursing innovations in primary health care, nursing leadership and policy across generations, nursing ethics, the health and well-being of the nursing workforce, innovations in Africa to advance global agendas, nursing regulation, nurse migration, retention and the health workforce, and the United Nations' Sustainable Development Goals. Hundreds of concurrent sessions were held on a variety of topics.



Leading up to the opening of the ICN Congress, two important sessions were held: the ICN's governing body, the Council of National Representatives (CNR), met over the course of three days to discuss the agenda for the future work of the ICN. A one-day policy forum, "Data and Dialogue: The Art and Science of Strengthening Nursing Impact Locally and Globally," was held on June 25 and looked at policy opportunities, advocacy strategies, and initiatives that maximize the nursing profession's contribution to global health, including universal health coverage and the United Nations' Sustainable Development Goals. Participants discussed how countries can leverage this work to strengthen nursing nationally. Speakers included Jim Campbell and Carey McCarthy from the WHO, the ICN's immediate past president Judith Shamian, the World Bank's Khama Rogo, Nursing Now's Barbara Stilwell, and Jhpiego's Leslie Mancuso and Peter Johnson.


More than 340 nursing students attended the ICN Nursing Student Assembly, a full-day meeting prior to the congress that allowed nursing students and new nurses to discuss issues they identified as priorities. The morning's presentations included social media and mental health, transition to practice, early career leadership, and student engagement at the ICN. The students then had the afternoon for group work to provide feedback to the ICN on these issues. Student engagement at the ICN was a hot topic. The ICN is currently developing a nursing student engagement strategy that will frame how it will work with the student population to raise its profile and influence in the ICN's work. The students' in-depth discussions were later presented to the CNR to support their ongoing discussions on these issues.


Planning is already underway for the next ICN Congress, which will be hosted by the Emirates Nursing Association and held June 5-9, 2021, in Abu Dhabi.