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International Council of Nurses’ Congress focuses on access and equity in healthcare

Special report from INMO delegates at the ICN congress in Australia

Allison O’Connell writes:
The opening ceremony of the International Council of Nurses’ (ICN) 25th quadrennial congress was full of colour, excitement and anticipation. ‘Equity and access to healthcare’ was the theme of the event, which took place in Melbourne, Australia.

Approximately 4,000 nurses travelled from 120 countries across the globe for the event, the opening ceremony of which took place on May 18. In her opening address, ICN president, Rosemary Bryant, spoke about closing the gap and increasing access to healthcare for patients, and increasing access to education and support for nurses.

During the five-day congress, attendees listened, shared wisdom, debated and learned from people whose lives are spent caring for the health of individuals, families and communities.

It became apparent that there is one consistent theme across the continents: All healthcare systems are dependent on the nursing workforce. The role of nurses and midwives will only continue to expand in the future and the only thing certain in healthcare is change. Therefore, we should be proactive rather than reactive.

Globally, health budgets are being reduced and as a result, nurse numbers are being reduced. This leads to poorer outcomes in quality and safety for patients.

At the congress, the question was ask ed: “Why is inequity increasing?” The rich are getting richer, and the point was made that health is not an expenditure, it is an investment.

In developed and developing countries, mental health and wellbeing are being threatened by workplace violence, conflict and post traumatic stress disorder.

Pictured at the ICN congress were (l-r): Elizabeth Adams, director of professional development, INMO; Aisling Maher, former student member of the Executive Council; and Allison O’Connell, Executive Council member

Communication is key
Prof Phillip Della, chief nurse officer in Australia, spoke about his research into clinical handover and patient safety. He stated that ineffective communication is a major cause of critical incidents. Communication errors are found to be responsible for twice as many deaths as clinical inadequacy. This is exacerbated by rising numbers of staff rotations and a reduction in resources and investment.

Swaziland Wellness Centre
RK Mall inson‘s evaluation of outcomes at the Swaziland Wellness Centre was presented by Muzi Dlamini at the congress. The ICN and the Danish Nurses Organisation provided funding for this extremely worthwhile project in 2006.

At ICN congress, we learned that:

  • 1.3 million people live in the kingdom of Swaziland
  • HIV seroprevalence is 27%
  • Approximately 50% of people with HIV are aged 25-35
  • Sub Saharan Africa has 25% global burden of disease, yet receives less than 3% funding for healthcare.

In 2004, the overwhelming workload of healthcare workers in the area led to increased mortality, declining resources, colleagues dying, losing hope and leaving Swaziland.

These healthcare workers were very reluctant to seek healthcare for themselves for several reasons, including a lack of confidentiality and the fact they had to queue with their patients, which undermined professional respect and trust. For them, healthcare was an unwelcome expense.

At the Wellness Centre, these workers receive primary care for non-urgent illnesses and non-communicable diseases. The centre also provides outreach activities, such as home care visits and client recruitment and education programmes.

INMO president, Claire Mahon, and the rest of the INMO delegation in Melbourne found this information very beneficial. It will help us build on the foundation put in place by previous INMO president, Sheila Dickson, two years ago for a Wellness Centre in Ethiopia.

INMO well represented
The highlight for the INMO delegation to the Congress in Melbourne was without doubt the election of Annette Kennedy to the board of ICN. She has subsequently been elected as one of the vice presidents of the Council – a first for Ireland. How proud we are that her qualities, experience and continuing support for constant professional development for nurses and midwives around the world has been recognised.

The INMO was also represented by Elizabeth Adams, INMO director of professional development. Ms Adams has an abundance of knowledge of the ICN and its work having spent many years working with the Council and the WHO.

Allison O’Connell is a senior staff nurse at Regional Hospital, Portlaoise, and INMO Executive Council member

Avilene Casey writes:
There was so much on offer at the ICN congress that it proved a challenge to decide what sessions and workshops to attend.

It was emotional when the award for Health and Human Rights was awarded to former President of Ireland, Mary Robinson.

Ms Robinson was unable to attend the conference to accept the award in person but she accepted the prize via a video message, in which she gave a wonderful tribute to Irish nursing and nursing worldwide. The INMO Executive Council is to be commended for recommending her for this award.

The plenary session of the conference offered presentations on a variety of topics, such as: the prevention of illness; wellness in the nursing workforce; ethics and human rights; clinical care; quality of care; and patient safety. The concurrent sessions offered further insight into these topics and also covered regulation, nurse education, eHealth, the history of nursing and many more subjects.

Opportunities
The ICN Congress presented numerous opportunities to build alliances with other nurse leaders. The experience of attending it has broadened understanding of healthcare globally and encouraged me to think about how we, as nurse leaders, can strengthen our capacity to influence policy change and strategic planning.

As a result of attending the Melbourne event, I have come to realise that there are many opportunities and support systems available to nurse leaders and I can only be enthused about the contacts I made there. I am sure that they will prove to be an invaluable resource to us.

Be proud
Irish nursing and midwifery have much to be proud of. For example, the regulation of our professions, prescription of medicines and x-rays, and our advanced nurse practitioners. We are certainly on a par with, or exceed, international standards.

It is clear that we now have a new global context in which healthcare is set: globalisation; regionalisation; urbanisation; individualisation; virtual connectedness; commercialism; and demography together form the new world context.

There is a growing tension between personal and societal responsibility for health, and the outcome of that tension may result in many ethical and human rights issues coming to the fore.

One of the most interesting presentations at the congress was ‘Obesity – Personal and social responsibility’ by Prof Joseph Proretto. This presentation, which is available on the ICN website at http://www.icn.ch/ , certainly challenged the audience to think differently about that subject.

A key statement at the congress was ‘Health is not expenditure, it is an investment’. In these financially constrained times, it would do policy makers and financiers well to reflect on this thought and to ensure that it informs their health strategies.

Avilene Casey is a director of nursing and midwifery at Kilkcreene Office Complex, Kilkenny

Kathleen Garvey writes:
There were many great Irish nursing leaders speaking at the ICN congress, including Annette Kennedy, one of the Council’s newly elected vice presidents.

Maura Pidgeon, CEO of the Irish Nursing and Midwifery Board, also gave a fine lecture on nursing regulation, while Kevin McKenna, from Dundalk IT, provided a workshop on dementia, which was extremely popular.

The main subjects addressed at the congress lectures were: AIDS; HIV; tuberculosis; and the importance of vaccinations for everyone, including care and health workers.

Dr Anne Marie Rafferty, dean of nursing in the Florence Nightingale School of Nursing at King’s College, London, gave the Virginia Henderson lecture. One of Dr Rafferty’s objectives was to increase awareness of the importance and value of nursing work.

HIV/AIDS
Meanwhile, Karen Daley, president of the American Nurses Association also presented at the event. Ms Daley campaigns in the area of HIV/AIDS. She contracted HIV while working in A&E when she was pricked by a needle protruding from a sharps box. Her bravery and professionalism in speaking out against needle stick injuries was inspiring.

While in Melbourne, I visited a hospital in Dandenong that had two 25-bed psychiatric units. I also met a Wexford girl who had been nursing there for 26 years and who loved it.

The hospital had state of the art facilities and the nurses were keen to inform us of the variety of jobs available.

Busy schedule
The conference was intense with sessions and workshops running concurrently and posters changing daily. It was necessary to keep an eye on the book of abstracts so as not to miss the vast array of subjects being covered. There were also a large number of trade stands and recruitment agencies offering job opportunities and college places in Australia, the US, Europe and many other countries.

Many thanks to INMO president, Claire Mahon, for her professionalism and friendliness and the INMO Executive Council for their assistance in organising the trip.

Kathleen Garvey is a senior clinical staff nurse at St Vincent’s Centre, Athlone

Kevin McKenna writes:
It was a great privilege to be invited to join almost 4,000 nursing colleagues from more than 100 countries for the 25th ICN Congress.

In addition to the invaluable opportunity to learn from expert colleagues and network with international colleagues, I had the opportunity to contribute to the conference in two ways.

The first of these contributions was joining Dr M McPhee (Canada), and Prof Lian-Hua Huang (Taiwan) in a plenary session of the Socio-Economic Welfare Network exploring the challenges confronting nurses’ well-being within increasingly complex healthcare environments.

For the second contribution I was joined by Prof Needham (Switzerland) in presenting a workshop on how the use of humanities in nursing can enhance our efforts to provide care which is as humanistic as it is technically expert.

The highly interactive format drew upon an anthology of works from the humanities to explore the ‘care experience’ from the perspectives of both recipient and provider. One highlight of this workshop was the distribution of a piece of creative writing by Niamh Flaherty, a third-year nursing student from Dundalk Institute of Technology.

These contributions, while quite diverse, reflect two key messages from the conference. The first is that nurses universally are struggling in healthcare environments characterised by increasing economic and workload pressures, and diminishing remuneration and professional opportunities. These difficult conditions pose very real challenges to nurses and nursing. The second message is that, within such environments, it is arguably even more important that we preserve our awareness that we are collectively bound by humanistic care as our raison d’être.

I would like to express my gratitude to the INMO for their generous support in facilitating my conference attendance.

Kevin McKenna is a lecturer in the School of Nursing Midwifery and Health Science, Dundalk IT

International Council of Nurses’ Congress focuses on access and equity in healthcare

 

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