Why should NZNO belong to ICN? Belonging to ICN is a privilege--active engagement is good for NZNO members and the global community.

NZNO is the New Zealand member of the International Council of Nurses (ICN) and every NZNO member is a member of ICN. What does this mean for members and what does membership of ICN entail?

ICN is a federation of national nurses' associations (NNAs), representing nurses in more than 128 countries. New Zealand has belonged to ICN since 1912, eight years after it was formed. In many ways ICN is an international NZNO where NNAs are NZNO's regional councils. ICN has three primary goals: to bring nursing together worldwide; to advance nurses and nursing worldwide; and to influence health policy. It has both a professional and an industrial (socio-economic welfare) focus. A 15-member board of directors and president govern ICN, much as the NZNO board of directors governs NZNO--there's no Te Runanga equivalent, however.

A meeting of ICN's Council of National Representatives (CNR) takes place every two years, equivalent to NZNO conference. Each NNA holds one vote and is entitled to send four delegates. NZNO's practice has been to send the president, Te Runanga chair and chief executive (CEO) to every CNR, with the addition of the National Student Unit (NSU) chair to every second CNR. This year, the CNR was held in Yokohama, Japan, from May 27-29 and NZNO was represented by Marion Guy, Brenda Close and Geoff Annals. NSU chair Daniel Jackson and Tauira Aronui representative Tracy Witehera also participated in a meeting of students from around the world considering a proposal to establish an international nursing students' association (see p28).

Review of ICN's key strategies was a major topic at the 2007 CNR. It was decided the existing vision and mission remain current and discussion focused on ways of working more effectively to achieve them. The CNR felt ICN needs to be invigorated by a closer relationship with its NNAs. Some suggested ICN needs to take a stronger lead in planning, co-ordinating and monitoring actions taken by NNAs locally within an integrated international plan.

A challenge to Romanian membership was made by the Romanian nursing regulatory body against the current Romanian ICN member, the Romanian Nurses' Association. The outcome of the challenge appeared uncertain, as not all NNAs have such unambiguous membership criteria as NZNO. A vote was deferred until 2009 and CNR resolved to establish a working party to review membership criteria and make recommendations to broaden ICN membership.

ICN reported that moves to establish a United Nations (UN) agency for women to advocate for women's rights and gender equity have been stalled for six months, with many countries and the current UN agencies with women's advocacy roles all opposing the proposed agency. Nurses have been crucial in getting gender issues on the UN agenda and the CNR called for increased activism on the issue. Only 29 percent of UN posts are held by women and the number of nurse posts in the World Health Organisation is declining.

ICN CEO Judith Oulton formally announced her resignation after 11 years in the role. An international search has begun for her successor. Many NNAs paid tribute to her work, which will end in October next year.

'Nurses at the forefront'

The biennial ICN conference comprises a scientific programme built around a major theme and a dozen concurrent sessions. This year's theme was "Nurses at the forefront: dealing with the unexpected". Around 2000 nurses attended, including 20 from New Zealand.

Presentations I attended varied in quality and relevance. Most were simply further elaboration on findings already reported and generally not well applied. I focused on workforce issues and heard little new. I attended an update on the international nursing turnover study, which included Nicola North's New Zealand component (see last month's issue, p7).

United States researcher Linda Aiken overviewed continuing work on the relationship between staffing and patient outcomes and the slow development of common measures applicable across settings.

Massey University, Wellington, senior lecturer Annette Huntington reported on the nurses' and midwives' e-cohort study (see Kai Tiaki Nursing New Zealand, April 2006, p7). Christchurch Polytechnic Institute of Technology lecturers Chris Taua and Isobel Jamieson presented work on nurses returning to practice. Head of the Auckland University school of nursing, Judy Kitpatrick, presented on the schools' rural nursing postgraduate programme.

Safe staffing symposium

I presented a symposium on safe staffing and healthy workplaces in conjunction with West Coast District Health Board nursing director Jane O'Malley and Ministry of Health chief nursing adviser Mark Jones. We discussed the background to the Committee of Inquiry, the process, findings and progress to date. O'Malley also presented on rural nursing.

The regulation conference followed immediately after the ICN conference. This had three concurrent streams; competence assessment, education and discipline. New Zealand presenters included Nursing Council CEO Marion Clark, Huntington and College of Midwives' CEO Karen Guilliland, who gave a compelling presentation on the regulation of midwives in New Zealand. The most valuable session from my perspective was the keynote address by United States (US) author Rosemary Gibson. Her book The Wall of Silence details the cover up of medical error in the US. Her presentation caused me to reflect on the need for a strong public lobby for safe staffing in New Zealand.

From time to time members question the value of NZNO belonging to ICN. Objective consideration must be given to this question and indeed the board of directors does this. The answer has been: we see membership as a privilege and we must challenge ourselves to ensure the quality and extent of our engagement with TCN is ideal for ICN and delivers high value to our members. Just as member participation is good for NZNO, our active engagement with ICN is good for us, good for ICN and good for the global community.

By NZNO chief executive Geoff Annals