This year's International Nurses Day featured a new Charter for Change, released by the International Council of Nurses (ICN). The Charter emphasises the need to ‘urgently address and improve support for nurses' health and well-being by ensuring safe and healthy working conditions and respecting their rights’. It also states that, ‘nurses are key to healthier communities, responsive societies, thriving economies and powerful nations’ (ICN, 2023a).
Nurses are also advocates. As readers know, the current nursing strikes in the UK were never just about pay stagnation, but also to highlight the lack of structural government support for over a decade, leading to nurses' deep concerns over patient safety.
Similar industrial action has been mirrored across the globe, and, for many, it was COVID-19 that lit the fuse. It exposed the vulnerability of nursing, weaknesses in staffing and safety, and threats to the physical and mental health of nurses.
ICN also promotes the interests of nurses working in war-torn Ukraine. Here, the majority of nurses continue to provide care, in spite of personal risk (ICN, 2023b). According to a chief nurse at Kharkiv Oblast Hospital, ‘I haven't fled because I love my colleagues and care about our patients’ (World Health Organization, 2023).
To achieve truly global health, there must be significantly more investment in nursing workforces, especially because there are upcoming threats hiding in plain sight. The first is another novel infectious disease with a similar impact to COVID-19. Studies suggest that the probability is about 2% in any year, which over a person's lifetime is about 38% (Joi, 2022).
The second is increasing population movement. Warfare, as in Ukraine, leads to rapid mobility into neighbouring countries for asylum or safety. Sudan is caught up in a vicious internal conflict, with large numbers of people moving across borders. In the context of climate change, population movement is already happening in places such as Bangladesh because of rising sea levels.
Nurses across the world should therefore be prepared for increasing numbers of refugees fleeing their homes. For HIV and sexual health nurses, there are crucial factors to consider. The UN High Commissioner for Refugees (UNHCR) has stated that, ‘many refugees and displaced persons may not have had access to HIV awareness information, diagnostics, or treatment in their country of origin, or they may have had their treatment interrupted during their flight’ (UNHCR, 2023).
So, preparedness, by learning from seismic events such as COVID-19 and anticipating future scenarios, is key. One approach is through continuing education, and this supplement includes an article describing the launch and reception of a new podcast, HIV Matters, which offers a new methodology for self-development and knowledge sharing, by Heggie and Croston (S4).
Understanding how other diseases affect people living and ageing with HIV is addressed by Hainsworth and Piercy (S7), who report on an initiative for patients living with HIV and cancer. Nixon et al (S15) provide data from a feasibility study into co-designing health services for people living with HIV and with multimorbidity.
The Association of Nurses in AIDS Care (ANAC) has stated that nurses are ‘viewed as trustworthy, compassionate and knowledgeable,’ and they instinctively advocate for patients (ANAC, 2022). Nurses should never underestimate their influence on health outcomes and in wider policy domains. Over just the past 3 years, they've faced up to a global pandemic, international conflict, and stubborn governments. Nurses are already prepared for any fight. Bring it on!