Immediately before the World Health Assembly – WHO’s parliament – it proved a huge success, with government nurses from 40 countries attending. Global meeting Ms Salvage’s remit was to organise a global meeting of government chief nurses, which would be the first meeting of its kind held by WHO. But there could be change in the air, if only for the negative reasons of the global nursing shortage and the problems of recruitment and retention. Picture credit: Anthony Hibbert She found the situation was similar in many of the countries she had contact with during her four-month stint working as nursing and mid-wifery adviser in Geneva.
Nursing Standard Royal College of Nursing (RCN) It’s like the debate about the United Nations – we can all criticise it but we sure as hell need it.’ However in countries where nurses have almost no support from anywhere, it is incredibly important for them to know there is an authoritative, global organisation that has important things to say and important resources, materials and networks for them. ‘There are many ways in which it does not function as well as it could. Crucial support Although critical of WHO’s workings – and understanding of its difficulties in terms of funding – Ms Salvage remains convinced of its importance. ‘The care component of that is important,’ says Ms Salvage, ‘but when I looked at the HIV department in WHO there was not a single nurse working there.’ Having been challenged by the nurses attending the government nurses meeting, the director of the HIV department has said he inten ds to employ some.
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It makes sense – partly it’s a motivation to stay and of course if nurses are on the treatment they will be much more informed about how to help other people.’ This ties in with WHO’s incoming director general’s pledge to treat three million people with antiretrovirals by 2005 – the ‘3 by 5’ campaign. ‘One project being tried in Zambia, with the support of the International Council of Nurses and the national nursing association, is to give nurses free antiretrovirals. Above all, those countries that are losing staff need help to strengthen their overall health and nursing systems.’ Ms Salvage points out that retention is an issue not just for developing countries: ‘If we cannot retain staff in the UK, will we be able to retain the overseas nurses who come here? Or will we continue to be a staging post for the United States, which is predicted to have a shortfall of a million nurses?’ But strengthening health systems is a tough call in countries where, for example, many staff are dying with HIV/AIDS. ‘Just saying “we will not allow any overseas recruitment” is not the point, although of course there need to be ethical controls. The understanding that there is no quick fix to this is growing,’ Ms Salvage says. ‘What was coming through strongly was the anger of developing countries at losing their staff. And a big issue at the World Health Assembly was nurse recruitment and retention. Not surprisingly, given the global shortage of nurses, the need for statistical information was on the agenda. ‘Government nurses have an important job leading policy and advocating nursing in ministries of health – but they may only have one nurse working in the ministry with no budget or control over what they do.’ The aims of the meeting included mapping out a way of developing nursing policy at national level and deciding what evidence base was needed to underpin that. ‘These were people like our chief nurse, in countries that had them,’ says Ms Salvage, who has now returned to working as an independent health consultant.
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