In September 2013, nursing organisations from Australia, Canada, Denmark, Finland, Iceland, Ireland, Japan, the USA and Sweden met at the offices of the Irish Nurses and Midwives Organisation to deliberate and comment on trends and developments in the employment conditions of nurses. The ICN Workforce Forum is an advisory committee to the ICN Board and makes recommendations in relation to the developments on industrial and employment issues affecting nurses globally. At this meeting the main points discussed included:
Developments in nursing working conditions:
The dominant theme reflected in the country reports was nurses’ employment and conditions had been adversely impacted in a number of ways due to the austerity measures or fiscal restraint programmes in the majority of countries represented.
Inadequate staffing in most countries was the major issue, although it manifested itself in different ways: the failure of long term workforce strategies, the ageing of the nursing workforce and the impending retirement of nurses and an insufficient number of nurses completing pre-registration education. However in contrast to this were reports from New Zealand, Australia and Ireland where nurse graduates were having difficulties and delays in obtaining work. The situation was very bleak in Ireland with the national government offering nursing graduates seeking to gain one of the diminishing number of nursing jobs, a salary of 80% of the entry level rate for a registered nurse.
Advance practice nursing:
There were interesting and informative reports and discussion on advance practice nursing (APN). While it was acknowledged by all that APN is the application of advance levels of knowledge, skill and experience by nurses who are typically educated at post graduate level, there was little agreement as to the optimum role or job title. Across the representative countries APN was an umbrella title comprising roles such as Clinical Nurse Specialist and Nurse Practitioner with some countries not having any formal titles or categories. It was noted that while currently APN numbers were relatively low in certain settings, it was expected that the role would continue to develop and become much more prevalent across the nursing workforce.
The impact of social media:
A discussion on the expanded use of social media by nurses and nursing organisations was one of the highlights of the workshop. All countries reported consistent growth in the use of social media with some reporting that over 50% of nurses in their country regularly use facebook and/or twitter. It was noted that the expanded use of social media had led to the development of guidelines by health providers and nursing associations on the relationship of social media to professional boundaries, ethics, standards of practice and professional conduct.
While all countries noted the positive importance of social media as a tool for communication, information dissemination and enhanced research capability, issues of privacy and confidentiality remained important.
The impact of nurses working into their seventh decade:
In part, due to the global financial economic downturn many countries were increasing their qualifying age for people to access the old age pension. This in turn resulted in many nurses working longer and not retiring as planned from the workforce. The Workforce Forum noted that while for most countries the retirement age remained between 60 and 65 years, in some countries it was now as high as 67/68 years.
It was broadly agreed that as nurses age, they find shift work (including long hours and rotating shifts) and the physical requirements of the job increasingly challenging. Also, a lack of flexibility in rostering often makes work/life balance nearly impossible.
The meeting noted the body of evidence that showed the ageing process posed additional risk of ill health such as cardiovascular disease, diabetes, hypertension and other health problems and, in a predominantly female profession, advancing age has an impact on the health of some nurses, and thus their ability to nurse.
The meeting agreed that all nurses, including older nurses would benefit from a work redesign to make clinical nursing practice easier as many tasks and challenges become more difficult with age. Various studies and reports documented that older nurses are more likely to extend their work life if they have certain workplace conditions in place. These include supportive workplaces, valued expertise, healthy working relationships, being able and equipped to do the job and flexible working hours and rostering arrangements.
Finally, the Forum noted that superannuation and other retirement benefit arrangements had an impact on the decision of nurses to retire from the workforce. It was agreed that these issues would be brought to the attention of the ICN Board and placed on the next meeting agenda of the ICN Workforce Forum.
All the background papers on matters discussed at the Workforce Forum will be available at the ICN website: www.icn.ch/
The next meeting of the Forum will be held in Sydney in September 2014.
Senior Federal Industrial Officer