Lessons learned from the 2023 International Council of Nurses Congress

The International Council of Nurses (ICN) met in Montreal, Canada from July 1–5, 2023. Approximately 6000 nurses from 130 countries attended the first in-person event held since 2019. The theme of the Congress was Nurses Together: A Force for Global Health. I was struck by the juxtaposition of hope, progress and ongoing challenges within the profession presented at the various presentations I attended. Indeed, it is true that nurses represent the largest group of healthcare providers globally. It is also true that we are the most trusted profession and that there would be no health without nurses. It was heartwarming to see representatives from brand new nursing organizations attending what was their first global meeting. It was encouraging to hear that there was consensus among the nursing organizations that what is needed is monumental investment in nursing globally in the areas of education/practice preparation, a decent salary, nursing practice and healthcare policies, workforce expansion and development and infusion of mental health skills and knowledge across the nursing profession. There were discussions about optimizing roles and responsibilities across the continuum of our profession, and the need to demand and garner respect for the work of nurses by our fellow healthcare providers. A few notable presentations for me included 'After Your Parent is Gone: Stories from the Girl Child Education Fund' which educates and mentors young girls in numerous countries. This presentation focused on countries in Africa including Eswatini, Kenya, Uganda and Zambia. Jhpiego, the presenter, in partnership with Johns Hopkins University has been involved in innovative strategies across the globe, championing the health of women and families in poorly resourced environments since the 1970s. In another presentation I attended, I learned more about the application of the Project ECHO Model to healthcare. It highlighted valuing solving needs of the underserved using accessibility of information and an all teach all team approach to solve healthcare challenges. The model was discussed in the context of its stated beliefs of teamwork, trust and respect, innovation and learning, accountability and service. More on the ECHO Model can be found at https://hsc.unm.edu/echo/about-us/echo-values.html. Dr. Madeline Naegle, globally known mental health and substance use healthcare practitioner and Dr. Mark van Ommeren, Head of the World Health Organization presented at a plenary titled, 'Shaping the Future of Mental Health Care: The Pivotal Role of Nurses in Transforming Mental Health for All.' A summary of the WHO World Mental Health Report was presented initially followed by clear and practical recommendations from Dr. Naegle on what nurses across diverse communities can do to advance mental health care. These recommendations included calling out stigma whenever and wherever it occurs, providing care that is person-centered and human-rights based, integrating mental health care in primary care, providing care in the community, expanding and providing more training for the mental health workforce, and more fully and intentionally engaging those with lived experiences as partners in innovative solutions to meet their mental health care needs. American Nurses Association representatives Drs. Ernest Grant and G. Rumay Alexander along with representatives from the Canadian Nurses Association were panelists on a symposium titled, 'Addressing Racism Within the Nursing Workforce.' The presenters discussed what each organization is doing to confront and eliminate racism within the nursing profession. The action items include acknowledging past and current racist behaviors, engaging in difficult conversations, and identifying and dismantling systems that maintain oppressive and racist practices. While there were many positive things that came out of the Congress, what was challenging for me as I reflected on the overall experience, was the absence of the voice of First Nation nurse members at the opening ceremony and during key plenary sessions. I think this was both a missed opportunity and an indication that our work specific to inclusion and respect for the rich heritage within our own profession was not intentionally attended to. I am also left wondering what steps our profession should take to accelerate the work needed to obtain crucial resources. Human and financial resources along with innovative strategies are needed in order to build the profession and workforce to meet the complex and variable healthcare needs across different global communities. You can learn more about the Congress and other activities related to ICN at https://www.icn.ch/news?page=1.