No them, only us: Why the RCN should rejoin the International Council of Nurses - Brian Dolan OBE

If there’s one thing I’ve learned in years of working in the UK, New Zealand, Australia, Ireland, and elsewhere, it’s that the only thing that really changes in healthcare is the accent. And, while we may be part of one global nursing and midwifery family, we also inhabit 1,000 villages within it.

Like all families and villages, we have our moments of dysfunctionality and squabbles which at the time seem important. Yet, across the arc of history we are reminded that we are part of something so much bigger than all of us. We are nurses and midwives and our greatest strength comes from a collective shared purpose, a space that allows for many conversations while encouraging a singular, coherent voice, one that chooses the courage and hope of idealism over the cowardice of cynicism. Amidst the din and distractions of our professional lives, we may not have noticed that the voice that’s listened to most closely these days by the WHO, the UN and by governments is the International Council of Nursing (ICN).

The ICN has been outstanding this year, stepping up to the challenge of conveying the impact of Covid-19 on nurses globally in a series of media briefings that have gained international attention. It has become the go-to organisation for the media when seeking to understand what’s happening to nurses and healthcare workers. Whether it’s collating, where known, the number of nurses who have died from Covid-19, pressuring governments to provide better access to PPE, or speaking about nursing as the collective voice of some 130 nations, the ICN has been there, drawing on years of quiet diplomacy and advocacy, a voice of reason in a wholly unreasonable year.

It could have been the UK’s nursing voice being represented as well on the international stage. But it isn’t. Instead, following a RCN Congress vote in 2013 that may have been passed in good faith but which has baffled many in the UK and internationally, we took ourselves out of the conversation, with cost of the ICN often being seen as more important than value – if it wasn’t, why has so much of the debate since been about the subscription fees of approx. £1/member? Instead of being part of an outward looking global alliance, we chose inward tribal allegiance. If Brexit should have taught us anything over the last four years, it’s that while ceding sovereignty to be part of something bigger can be painful, it’s nowhere as painful as irrelevance.

The nursing organisations of the ICN would love the RCN to rejoin and not, I suspect, because of the money. The ICN itself is a surprisingly small, tightly run ship led with distinction by former RCN staff member Howard Catton. The UK’s place in nursing history is already assured because it’s been a creator, originator and champion of so much innovation over the years. It’s the birthplace of modern nursing’s founder, our own Florence Nightingale, as well as almost countless nursing pioneers who were either born here or made it their home. Why wouldn’t the ICN want draw on that rich tradition?

The most important reason the RCN should rejoin the ICN, I believe, is this: we may have prehistoric emotions, medieval institutions and god-like technology but we also face challenges like never before. Whether it’s the ongoing impact of Covid-19, climate change, the rise of the far right, widening inequality, ageing populations, nursing shortages and so much more besides. Being a member of a body that speaks to nursing nations for nursing nations about these issues and more is to be part of something bigger than ourselves, cross-fertilising solutions at the decision-making tables rather being at the fringes indulging in inward looking self-isolation in an echo chamber of diminishing effect.

As I write this blog in Christchurch, New Zealand, I am reminded of the famous Māori proverb: ‘He aha te mea nui o te ao. He tāngata, he tāngata, he tāngata’ (What is the most important thing in the world? It is people, it is people, it is people). I fervently hope that the RCN, of which I’ve been a proud member for over 30 years, will rejoin the ICN. Globally our nursing organisations are so much more than the sum of our parts, and when it comes to the nursing and midwifery family, there should be no ‘them’ only ‘us’.

Brian Dolan OBE, RMN, RGN Director Health Service 360 (UK)

Visiting Professor of Nursing, Oxford Institute of Nursing, Midwifery and Allied Health Research (OxINMAHR) Honorary Professor of Leadership in Healthcare, Salford University

T: @brianwdolan