International Nurses Day: New ICN report says ‘COVID-19 shows nurses must be architects of future healthcare systems’

12 May 2021
Thumbnail for website

A new report from the International Council of Nurses launched today on International Nurses Day calls for nurses to be the architects and designers of future healthcare systems, and not only the deliverers of care.

The report Nurses: A Voice to Lead – A Vision for Future Healthcare, demonstrates the vital roles nurses play in successful healthcare services, and argues for greater involvement of nurse leaders in all healthcare organisations and at all levels, including government.

The findings of the report call for:

• Nurses are the designers of healthcare systems, not just the people who deliver it.

  • Health is included in every government policy, and senior nurses provide leadership in all organisations within health systems and government departments.
  • Governments embrace the new global strategy for nursing and embed its recommendations into their national healthcare strategies.
  • Governments adopt long-term workforce plans and become self-sufficient in the supply of registered nurses, with transparent data to show their progress towards this goal.
  • The narrative that describes investment in nursing jobs, education and leadership as a government cost is changed to acknowledge that such expenditure is an investment in every citizens’ health, safety, security, and peace.

The report underlines that nursing has been at the heart of the response to the pandemic and the COVID Effect has taken its toll underlining the case for investment. The pandemic has highlighted that it has been nurses who have been leading the response, with 90% of care undertaken by them, and it is nurses who have seen at close quarters the weaknesses, the fragilities and the fault-lines that must be addressed for the design of future healthcare systems.

ICN’s report highlights the transformations that nurses have been leading during the pandemic, the support that the nursing workforce requires and the need for future health systems to go far beyond pandemic preparedness and be fit for purpose for all future healthcare needs.

Each year, ICN, the founder of International Nurses Day on 12 May, the anniversary of Florence Nightingale’s birth, leads the celebrations and the call to action.

ICN President Annette Kennedy said:

“This year we celebrate International Nurses Day and pay tribute to the world’s 27 million nurses who have shown exceptional courage, compassion, competence and leadership skills in the face of the pandemic. They have saved many lives but sadly thousands of them have sacrificed their lives. We remember them today and always.

‘ICN research suggests that 80% of nurses are suffering mental health issues, burn-out, depression, post traumatic stress disorder and COVID related violence, and that 13 million nurses will be needed to fill the the global nursing shortages in the next few years.

‘It is essential that governments act now to mitigate the risks of increased turn-over and improve nurse retention. Investment, improved pay and conditions, and retention strategies are non-negotiable if we are to save our global health systems.

‘If we have learned a lesson from this pandemic, it is that we need strong resilient health systems that are prepared for the unknown and will maintain a healthy society. We must also address the inequalities that are at the heart of our current healthcare systems, not the least of which is gender inequality. In a nursing profession that is 90% female, our voices are still not heard loud enough and that means we need more leadership positions.”

WHO and ICN data indicate 50% of countries have an authentic, functioning Government Chief Nurse (GCN). But even when there are GCNs and other expert experienced nurses in post, they are not being used effectively and are often excluded from important discussions and decision-making forums. For example, ICN’s survey of National Nursing Associations (NNAs) shows only 42% of GCNs had been involved in decision making, 44% of specialist nurses had been involved in decisions concerning infection prevention and control, and 40% of senior nurses had been involved in high level decision making.

ICN Chief Executive Officer Howard Catton said:

“ICN continues to call on all governments to appoint a functional Government Chief Nurse and I believe it is a scandal that many still have not. Nursing can lead us into a better healthcare future, but to do that the voices of nurses must be heard and acted on. Nurses are the ones who have seen the fault lines in our healthcare systems at close quarters during the pandemic and have the ability to transform them.

‘Our report underlines that nurses must be the architects and designers of our future healthcare systems and not only its deliverers. It is not just a question of having nurses in these key Government Chief Nurses’ roles, it is about ensuring that, when they are there, they are systematically and routinely consulted in important strategic decision-making.

ICN’s vision for future healthcare puts nurses front and centre and urges root and branch investment from top to bottom. More investment in nurse retention, jobs, leadership, and education is not a “nice to have”, it is a matter of national and global security. Our economies and safety stand and fall on the robustness of our healthcare systems which goes far beyond pandemic preparedness.“

International Nurses Day is celebrated around the world every 12 May, the anniversary of Florence Nightingale's birth. ICN commemorates this important day each year by selecting a theme and producing and distributing IND resources and evidence. All resources can be found on

Download the press release here