WEBVTT
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- [Elizabeth] Good afternoon, everyone.
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President Julia George,
Board of Directors, and, of course,
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CEO, David Benton, greetings.
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Ladies and gentlemen, it is
a great pleasure to be with you all
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here at this annual meeting of the
National Council of State
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Boards of Nursing.
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I feel very honored having come from a
background where I was also a regulator
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for the Cook Islands in a very small
island stage and to be among some of you
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distinguished guests, distinguished
participants and delegates,
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looking at this very, very
important function that will guide
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the work of nurses and midwives
going forward beyond 2020.
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The NCSBN is an important partner,
especially as we plan to develop the World
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Health Organization's first State of the
World's Nursing Report.
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It is great to have David Benton on the
steering committee for this work.
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Since taking up my post as the WHO chief
nursing officer, I have witnessed this
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amazing synergy with the nursing
and midwifery organizations.
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They be in education,
practice and welfare, civil societies,
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or regulations in policy at local,
national, or international level.
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I think many of us would've felt this
movement of the coming together of these
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really important professions.
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Galvanizing this energy among the nursing
and midwifery workforce has been possible
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with your interventions.
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As a political appointment to the
World Health Organization,
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I am mindful that some of you have been
instrumental in mobilizing and
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influencing my appointment.
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At the same time, I know that the
director-general of WHO is committed
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to the provision of health for all
and recognizes the contribution that
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nurses and midwives can make
to achieve this vision.
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I believe my appointment was part of his
transformation of the WHO organization.
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As David mentioned, I have been in this
role as chief nursing officer
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since January, 2018.
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Just a little bit more about my
background, I was born in,
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I grew up and went to school in the
Cook Islands, a small island
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with population of about 17,000 people.
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I decided to be a nurse for three reasons.
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One was not one of those that was
mentioned earlier on that David mentioned
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as to why we get into this profession.
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I got into this profession...
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I decided when I was 16 years old
that I wanted to be a nurse,
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one, because I could see the job security,
I could get a job anywhere.
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I heard that if I had a New Zealand
qualification, I could get a job anywhere
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in the world.
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And two, the training was
three years, it is not too long.
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And third, I wanted to travel and I could
get a job anywhere in the world.
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So those were my reasons
for getting into this profession.
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Health for all was not a focus in my
very early career decision.
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However, in my journey since,
it has clearly been the focus.
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I have been a president of the Nursing
Association of the Cook Islands affiliated
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to the International Council of Nurses.
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I was the registrar of the Cook Islands
Nursing Council and in nursing leadership
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roles prior to taking on the role as
secretary of health for the Cook Islands
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Ministry of Health.
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Without realizing it,
this was my somewhat preparation
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of over 30 years for my transitioning
from a local to a global platform.
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So, my association and collaboration
with the National Council of State Boards
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of Nursing as the global leader in nursing
regulations to improving the safety and
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welfare of patients through education,
research and service, and
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public protection can only enhance the
work we do to strengthen our profession.
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And for this, I commend you.
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Today, it is my intention to draw from my
work as the chief nursing officer
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of World Health Organization and to share
priorities of the World Organization's
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13th program of works and how
nursing can contribute to this.
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And second, to provide an update on the
Nursing Now campaign, and the State of the
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World's Nursing Report, and the planned
events that will take place to commemorate
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the Year of the Nurse and the Midwife.
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And thirdly, I want to explore the role
regulators will play in realizing the full
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potential of nursing in supporting
universal health coverage and
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the health systems.
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As I mentioned earlier,
the World Health Organization is entering
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a new era and it's recognition of the
contributions of nursing and midwifery.
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The WHO Director-General.
Dr. Tedros has stated, and I quote,
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"We simply cannot achieve universal health
coverage and the health-related targets
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in the SDGs unless we empower
and equip nurses and midwives
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and harness their power."
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There are significant efforts underway
to better engage the global nursing and
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midwifery communities to accelerate
collaboration and progress on the
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achievement of UHC and the
health-related SDGs.
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One of my initial courses of action upon
starting my role as the chief nursing
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officer at the World Health Organization
was to establish a task force on nursing
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and midwifery that was open to any nurse,
midwife, or champions of these professions
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working through our WHO at headquarters,
at the six regional offices, and
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at country offices.
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The intention was to provide a platform
to strengthen nursing leadership,
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advocate for political commitment,
develop research and evidence,
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improve coordination,
and embed nursing and midwifery
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perspectives in WHO's work
and global health initiatives.
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This remains a work in progress.
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This taskforce aligns well with the 13th
WHO general program of work,
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often referred to as GBW 13.
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It sets out WHO's next 5-year
strategic plan with 3 priorities,
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with each priority targeting 1 billion
more people benefiting from universal
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health coverage, a billion more people
better protected from health emergencies,
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and a billion more people enjoying
better health and wellbeing.
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This is the triple-billion target of WHO.
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This new program of work for WHO seeks
to promote health, to keep the world safe,
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and to serve the vulnerable.
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The health workforce is a critical
component to achieving these targets and
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more so, especially nurses and midwives,
who make up 50% of the workforce globally.
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The sheer magnitude of the nursing and
midwifery workforce, coupled with the vast
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range of health services they provide
in different health care settings,
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their collaboration, and coordination
of services makes nurses
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and midwives integral to improving health
and wellbeing around the world.
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But we should not only focus on the
numbers, we must focus on quality
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of nursing and midwifery care.
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Increasing evidence shows that death due
to poor quality of health care in low
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middle-income countries accounts for 10%
to 15% of all deaths and between 5.7
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and 8.4 million deaths annually are from
poor quality of care, including access.
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Globally-speaking, we are dealing with
some critical issues confronting the
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nursing and midwifery professions.
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Issues such as gender bias, low pay,
limited scope of practice,
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low staffing ratios, accreditation
and regulations issues, all
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continued to hold nurses back from
reaching their full potential or
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from having the powerful positive global
impact that they could contribute to.
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Training more nurses and midwives is
critical to address the 9 million
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shortfall the WHO has projected will be
needed to achieve and sustain UHC by 2030.
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This shortfall mainly effects low
and middle-income countries,
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but how they are educated and where they
work is even more important.
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Last week, I was honored to visit some
of the Pacific islands with Dr. Tedros
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and it highlights with me some of
these challenges in small island states,
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and the capacity-building options
available, and why we need to consider
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options such as training hubs in regions,
and make human capital investments, and
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increase service education,
particularly education institutions
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in rural areas, as well as recurrent
investment such as employment and
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retention of health workers.
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Regulatory function is critical in these
situations, but what would this look like?
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WHO has developed policy documents
and strategies to provide a framework
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for broad-based actions
to enhance capacity of nursing
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and midwifery developments.
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The Global Strategic Directions for
Nursing and Midwifery 2016-2020 reinforces
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the preexisting Global Strategy for Human
Resources for Health: Workforce 2030,
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which outlines policy options for
countries, the WHO secretariat,
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and other stakeholders such as yourselves
to optimize the health workforce and
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progress towards UHC and the SDGs.
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The 2016 United Nations High-Level
Commission on Health Employment and
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Economic Growth concluded that investment
in the health workforce can result in not
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only improved health outcomes and that
health workers are not a cost,
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they're an investment,
an investment that pays
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a triple return for health, gender
equality, and economic growth.
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The WHO recognizes that health workforce
and services are important building blocks
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of a health system, but mere availability
of health workers is not sufficient.
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Only when they are equitably distributed
and accessible by population, when they
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possess the required competency, and are
motivated and empowered to deliver quality
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care that is appropriate and acceptable to
the expectations of the communities and
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people, and when they are adequately
supported by the health system,
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can we say that there is
effective service coverage.
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This is a challenge for many countries,
especially those with weak health systems,
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small island states and why some countries
will require development assistance
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in the long term.
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This assistant can fall within the
regulator support mechanisms as well.
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In recent times, we have seen this
energized focus on nursing globally.
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The launch of the Nursing Now campaign has
seen the strength and collaboration of key
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partners, WHO, ICN, and Nursing Now, with
the Burdett Nursing Trust and the uptake
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of over 200 Nursing Now groups
in over 80 countries globally.
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In 2018, the 3-year Nursing Now global
campaign was initiated to improve global
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health by raising the profile of nurses.
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The campaign was based on the findings
from the Triple Impact Report, which
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showed that by empowering nurses
and midwives, it would also contribute
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to improvements in gender equality,
strengthen economies,
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and improve health globally.
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This movement aims to have nurses
and midwives playing central roles
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to addressing the 21st-century
health challenges and threats,
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and they are doing so in various
roles and positions
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from the frontlines
to the levels of leadership.
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Now, more than ever, nurses are
using their voices and drawing
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from their unique perspective to shape
policy and find solutions.
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What is also exciting is Nursing Now has
launched a Nightingale Challenge, which
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aims to equip and empower the next
generation of nurses as practitioners,
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advocates, and leaders in health.
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The Nightingale Challenge asks every
health employer to provide leadership
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development training for a group of young
nurses and midwives during 2020,
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the Year of the Nurse and the Midwife.
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The aim is to have at least 20,000 nurses
and midwives aged 35 and under benefiting
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from this in 2020, with at least
1,000 employers taking part.
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Each employer will determine how best
to respond to the Nightingale Challenge.
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Programs can be any mix of formal
course, mentoring, shadowing,
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or learning from other
professions or sectors.
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Organizations are welcome to involve other
age groups and other professions in their
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program as well, but only nurses
and midwives under 35.
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Age 35 and under will count
towards the 20,000 goal.
00:13:53.440 --> 00:13:56.561 position:50% align:middle
By participating in the Nightingale
Challenge, you can demonstrate that you
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are committed to investing in your nurses
and midwives in particular during the year
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when the two professions
will be in the spotlight.
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Already over 200 employers have signed up.
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I hope you can distribute this
information to your networks.
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Find out more and accept
the Nightingale Challenge.
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You can log into the website,
www.nursingnow/nightingale.
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Another exciting activity that has seen
the collaboration of many key partners
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such as ICN Nursing Now, WHO Collaborating
Centers for Nursing and Midwifery,
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government chief nursing and midwifery
officers, or the equivalent,
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the World Innovation Summit for Health,
[inaudible], and NCSBN is the development
00:14:46.980 --> 00:14:50.208 position:50% align:middle
of the first State of the
World's Nursing Report.
00:14:50.940 --> 00:14:55.260 position:50% align:middle
The report will provide a global picture
of the nursing workforce and its
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contributions to WHO triple-billion goals.
00:14:58.864 --> 00:15:03.790 position:50% align:middle
It will inform national policy dialog
and drive development of national nursing
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workforces to optimize their contributions
towards UHC and primary health care at the
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same time, progress across the SDGs.
00:15:16.859 --> 00:15:21.260 position:50% align:middle
And we anticipate that the data and policy
dialog will unlock investment
00:15:21.260 --> 00:15:25.935 position:50% align:middle
in nursing, the health workforce,
and the gender equity agenda.
00:15:26.880 --> 00:15:30.900 position:50% align:middle
The report will provide us with valuable
data that will help to identify the major
00:15:30.900 --> 00:15:35.060 position:50% align:middle
gaps in nursing practice,
specifically the data collected will help
00:15:35.060 --> 00:15:39.878 position:50% align:middle
to shape policy and shed a light
on countries' specific needs.
00:15:40.320 --> 00:15:44.690 position:50% align:middle
This provides the opportunity to shape
better nursing regulation and
00:15:44.690 --> 00:15:46.167 position:50% align:middle
standard of practice.
00:15:46.630 --> 00:15:51.805 position:50% align:middle
What more does this mean for country,
regional, and global nursing regulations?
00:15:52.260 --> 00:15:56.936 position:50% align:middle
I'll look to the support advice
from NCSBN to guide us in this.
00:15:58.050 --> 00:16:03.590 position:50% align:middle
The report will identify the active stack
of nurses, the number, demographics,
00:16:03.590 --> 00:16:08.648 position:50% align:middle
distribution, looking at geographicals
and service category.
00:16:08.960 --> 00:16:12.640 position:50% align:middle
It'll look at the nursing education,
the duration, the standards,
00:16:12.640 --> 00:16:16.990 position:50% align:middle
and annual graduates, the accreditation,
fitness for practice assessments.
00:16:17.600 --> 00:16:22.262 position:50% align:middle
It also looks into the nursing
regulations, the nursing council model.
00:16:23.270 --> 00:16:28.060 position:50% align:middle
The labor market flows will provide us
with informations on graduate
00:16:28.060 --> 00:16:33.750 position:50% align:middle
starting practice, the unemployment rate,
the foreign-born and trained and also
00:16:33.750 --> 00:16:37.620 position:50% align:middle
looks into the employment characteristics
in terms of working conditions and
00:16:37.620 --> 00:16:42.044 position:50% align:middle
entry-level wages, social protections
in various countries.
00:16:43.530 --> 00:16:45.437 position:50% align:middle
At the same time, governance
and leadership
00:16:45.437 --> 00:16:48.008 position:50% align:middle
will also be highlighted
in the report,
00:16:48.748 --> 00:16:53.150 position:50% align:middle
identifying chief nursing and midwifery
officer positions, the leadership
00:16:53.150 --> 00:16:56.921 position:50% align:middle
development programs,
and the leading care teams in countries.
00:16:57.590 --> 00:17:02.694 position:50% align:middle
The gender and nursing composition pay
gaps will also be highlighted.
00:17:03.430 --> 00:17:07.131 position:50% align:middle
This report would compromise
four main sections.
00:17:08.020 --> 00:17:11.855 position:50% align:middle
One, how the nursing workforce will help
deliver the triple-billion goals,
00:17:11.855 --> 00:17:17.614 position:50% align:middle
and two, results of aggregated country
data and modeling to present a global
00:17:17.614 --> 00:17:22.215 position:50% align:middle
picture of the nursing workforce,
and three, a forward-facing policy agenda
00:17:22.215 --> 00:17:25.319 position:50% align:middle
for advancement towards 2030 targets.
00:17:25.850 --> 00:17:29.480 position:50% align:middle
And four, the country profiles,
detailing the nursing workforce and
00:17:29.480 --> 00:17:32.976 position:50% align:middle
projections for meeting
population health needs.
00:17:36.030 --> 00:17:42.099 position:50% align:middle
This report will be launched on April the
7th, World Health Day, in 2020.
00:17:43.011 --> 00:17:48.010 position:50% align:middle
I'm really excited about this report
although it appears very ambitious,
00:17:48.010 --> 00:17:53.660 position:50% align:middle
but I think it will actually allow
countries to make decisions based on their
00:17:53.660 --> 00:17:56.194 position:50% align:middle
data and their health needs.
00:17:56.390 --> 00:17:59.970 position:50% align:middle
And I think our role in supporting
countries around policy
00:17:59.970 --> 00:18:02.928 position:50% align:middle
dialog is critical.
00:18:03.300 --> 00:18:10.589 position:50% align:middle
And I mean us regulators, WHO,
and all the partners engaged in this work.
00:18:12.130 --> 00:18:17.700 position:50% align:middle
At this year's World Health Assembly,
members agreed that 2020 is the
00:18:17.700 --> 00:18:20.453 position:50% align:middle
International Year of the Nurse
and the Midwife.
00:18:21.140 --> 00:18:27.850 position:50% align:middle
The World Health Assembly is made up of
194 member countries represented at the
00:18:27.850 --> 00:18:31.515 position:50% align:middle
World Health Assembly through the
ministers of health.
00:18:32.000 --> 00:18:37.500 position:50% align:middle
And it's a decision-making body and we're
really pleased that this year that they
00:18:37.500 --> 00:18:41.839 position:50% align:middle
have designated 2020 the Year
of the Nurse and the Midwife.
00:18:42.528 --> 00:18:47.889 position:50% align:middle
This decision effectively shines the
global spotlight on nursing and midwifery
00:18:47.889 --> 00:18:50.800 position:50% align:middle
and the significant contributions that
they bring to achieving
00:18:50.800 --> 00:18:52.238 position:50% align:middle
universal health care.
00:18:53.500 --> 00:18:59.394 position:50% align:middle
We must take the approach that 2020 is
a year of opportunity for us all.
00:18:59.850 --> 00:19:03.480 position:50% align:middle
We not only have the opportunity
to highlight the global contributions
00:19:03.480 --> 00:19:08.160 position:50% align:middle
of nurses and midwives to better health
for all, but I would also challenge each
00:19:08.160 --> 00:19:13.510 position:50% align:middle
of you to consider how you can use this
year to move forward in a strategic and
00:19:13.510 --> 00:19:18.312 position:50% align:middle
empowered way in your current
projects and areas of expertise.
00:19:18.840 --> 00:19:24.487 position:50% align:middle
We must use this opportunity to initiate
nursing agendas for beyond 2020.
00:19:24.487 --> 00:19:29.640 position:50% align:middle
It's not just a year of celebration of our
successes and where we've been,
00:19:29.640 --> 00:19:34.480 position:50% align:middle
but I think it's an opportunity to look
beyond 2020 and what more can we
00:19:34.480 --> 00:19:36.607 position:50% align:middle
contribute to health for all.
00:19:39.667 --> 00:19:41.954 position:50% align:middle
Some of the key dates noted.
00:19:41.954 --> 00:19:47.218 position:50% align:middle
In 1st of January, a kickoff to 2020
Year of the Nurse and the Midwife,
00:19:47.320 --> 00:19:51.630 position:50% align:middle
we aim to get as many global health
political leaders to share a message
00:19:51.630 --> 00:19:55.005 position:50% align:middle
of support or refer to the
Year of the Nurse and the Midwife
00:19:55.005 --> 00:19:57.058 position:50% align:middle
in their New Year addresses.
00:19:57.650 --> 00:20:02.340 position:50% align:middle
You can influence your leaders in your
areas to also highlight or
00:20:02.340 --> 00:20:03.981 position:50% align:middle
amplify this message.
00:20:04.720 --> 00:20:08.940 position:50% align:middle
On the 7th of April, of course,
as I mentioned, the global launch of the
00:20:08.940 --> 00:20:13.350 position:50% align:middle
State of the World's Nursing Report,
the main international launch is planned
00:20:13.350 --> 00:20:19.471 position:50% align:middle
for Geneva with simultaneous launchers
events held in WHO regions.
00:20:20.610 --> 00:20:24.380 position:50% align:middle
The report launch toolkit will be
developed with partners to encourage
00:20:24.380 --> 00:20:28.950 position:50% align:middle
countries and key stakeholders to get
involved in organizing policy dialog
00:20:28.950 --> 00:20:30.897 position:50% align:middle
events to launch the report.
00:20:31.250 --> 00:20:35.784 position:50% align:middle
The toolkit will contain key messages,
social media, and infographics.
00:20:37.320 --> 00:20:40.300 position:50% align:middle
Other key dates are in May
the 5th is the International Day
00:20:40.300 --> 00:20:41.430 position:50% align:middle
of the Midwife.
00:20:41.430 --> 00:20:48.464 position:50% align:middle
We also intend to amplify some of our
messages around this date as well as the
00:20:48.464 --> 00:20:51.593 position:50% align:middle
International Nurses Day,
which is May the 12th.
00:20:51.850 --> 00:20:58.210 position:50% align:middle
The celebration in Geneva, hosted by WHO,
ICN, and Nursing Now as a kickoff to the
00:20:58.210 --> 00:21:02.200 position:50% align:middle
Global Forum of Government Chief
Nursing and Midwifery Officers and
00:21:02.200 --> 00:21:03.710 position:50% align:middle
the triad meeting.
00:21:04.260 --> 00:21:08.990 position:50% align:middle
On May the 13th to the 15th,
WHO will host the global forum,
00:21:08.990 --> 00:21:13.717 position:50% align:middle
a meeting of government chief nursing
officers and midwives, to discuss the
00:21:13.717 --> 00:21:18.770 position:50% align:middle
State of the World's Nursing findings and
inform national delegations of the policy
00:21:18.770 --> 00:21:21.751 position:50% align:middle
recommendations for countries and regions.
00:21:24.540 --> 00:21:29.090 position:50% align:middle
We have encouraged delegations that are
attending the World Health Assembly
00:21:29.090 --> 00:21:33.325 position:50% align:middle
to include their government chief nursing
and midwifery officers as part of their
00:21:33.325 --> 00:21:38.534 position:50% align:middle
official delegation, but they come
prior to the World Health Assembly
00:21:38.534 --> 00:21:41.299 position:50% align:middle
to attend this WHO forum.
00:21:42.870 --> 00:21:49.590 position:50% align:middle
The triad meetings of WHO, ICN and ICM,
and the regulators, and I think this is a
00:21:49.590 --> 00:21:58.490 position:50% align:middle
really key meeting to ensure that
you are engaged moving forward.
00:21:58.490 --> 00:22:05.140 position:50% align:middle
I think we're used to seeing ICN taking
the lead in the regulatory work when David
00:22:05.140 --> 00:22:06.600 position:50% align:middle
wasn't CEO.
00:22:06.600 --> 00:22:13.416 position:50% align:middle
But I think we need to revisit the space
and see how this engagement can actually
00:22:13.416 --> 00:22:20.280 position:50% align:middle
be embedded in this triad meeting so that
we've got key partners at the table when
00:22:20.280 --> 00:22:21.844 position:50% align:middle
we're making decisions.
00:22:23.920 --> 00:22:28.320 position:50% align:middle
So that an opportunity for widened
discussions among nursing stakeholders
00:22:28.320 --> 00:22:30.961 position:50% align:middle
on the findings of the State
of the World's Nursing Report
00:22:30.961 --> 00:22:34.998 position:50% align:middle
and implications for policy
investment is made.
00:22:35.690 --> 00:22:40.880 position:50% align:middle
On May the 18th to 23rd is
the 73rd World Health Assembly.
00:22:42.051 --> 00:22:47.440 position:50% align:middle
This is an opportunity to ensure nursing
and midwifery is firmly on the agenda and
00:22:47.440 --> 00:22:51.760 position:50% align:middle
champion through relevant discussions
with potential participations
00:22:51.760 --> 00:22:55.367 position:50% align:middle
of high-level champions
and health ministers.
00:22:55.910 --> 00:23:04.370 position:50% align:middle
In addition, a Walk the Talk,
an event that WHO holds annually and is
00:23:04.370 --> 00:23:09.600 position:50% align:middle
held just prior to the start of the World
Health Assembly, we anticipate a main
00:23:09.600 --> 00:23:14.131 position:50% align:middle
feature showcasing nursing
and midwifery during this event.
00:23:14.131 --> 00:23:17.266 position:50% align:middle
And you're quite welcome
if you're in Geneva to join us.
00:23:20.960 --> 00:23:26.340 position:50% align:middle
We continue to explore opportunities for
official events and side events during the
00:23:26.340 --> 00:23:27.740 position:50% align:middle
World Health Assembly.
00:23:28.507 --> 00:23:34.290 position:50% align:middle
Really critical that we do this because,
you know, political leaders from 194
00:23:34.290 --> 00:23:39.632 position:50% align:middle
countries will be attending this meeting,
so I think this is the opportunity we
00:23:39.632 --> 00:23:41.063 position:50% align:middle
can't afford to miss.
00:23:41.063 --> 00:23:48.480 position:50% align:middle
We need to maximize the exposure that it's
offered us as part of the Year of the
00:23:48.480 --> 00:23:49.887 position:50% align:middle
Nurse and the Midwife.
00:23:51.590 --> 00:23:57.820 position:50% align:middle
Then in September to October,
WHO has regional committee meetings and we
00:23:57.820 --> 00:24:03.840 position:50% align:middle
anticipate to highlight nursing and
midwifery and see their commitments
00:24:03.840 --> 00:24:08.606 position:50% align:middle
on their health workforce during their
discussions and deliberations.
00:24:09.630 --> 00:24:14.300 position:50% align:middle
This is our early discussion on activities
and as they get finalized,
00:24:14.300 --> 00:24:20.090 position:50% align:middle
we want to amplify our messages throughout
the year by linking with our networks.
00:24:20.090 --> 00:24:23.850 position:50% align:middle
I encourage you to share any of your
planned activities so we can
00:24:23.850 --> 00:24:25.332 position:50% align:middle
achieve this together.
00:24:27.910 --> 00:24:32.720 position:50% align:middle
The State of the World's Nursing Report
offers opportunity to consider impact
00:24:32.720 --> 00:24:36.865 position:50% align:middle
of regulatory functions at country,
regional, and global levels.
00:24:37.407 --> 00:24:42.330 position:50% align:middle
And I look forward to working with NCSBN
to see how we can best support countries
00:24:42.330 --> 00:24:45.128 position:50% align:middle
and regions to advance in this area.
00:24:45.820 --> 00:24:52.770 position:50% align:middle
The Global Regulatory Atlas puts the
world's nurses at your fingertips.
00:24:52.770 --> 00:24:59.104 position:50% align:middle
It was really quite exciting to hear that
you have 200 countries on this platform.
00:25:01.690 --> 00:25:06.645 position:50% align:middle
This is so important in an
increasingly connected world.
00:25:07.940 --> 00:25:10.230 position:50% align:middle
But at the same time,
I acknowledge the work in the different
00:25:10.230 --> 00:25:14.360 position:50% align:middle
countries and regions as nurse leaders
strengthen nursing practices
00:25:14.360 --> 00:25:19.690 position:50% align:middle
through strengthening regulatory functions
and some because gaps were identified due
00:25:19.690 --> 00:25:25.210 position:50% align:middle
to changes in models of care as nurses and
midwives in response to the continuous
00:25:25.210 --> 00:25:30.435 position:50% align:middle
changes in practices, for example,
of HIV treatment without the necessary
00:25:30.435 --> 00:25:35.095 position:50% align:middle
regulations to support the shifting of
practice from physician to midwives.
00:25:36.690 --> 00:25:42.069 position:50% align:middle
While the concept of task sharing was
endorsed by the WHO in 2008,
00:25:42.069 --> 00:25:48.950 position:50% align:middle
many of the regulations throughout
Sub-Sahara… Sorry, Sub-Saharan Africa
00:25:48.950 --> 00:25:52.492 position:50% align:middle
failed to support the
changes taking place.
00:25:52.965 --> 00:25:57.320 position:50% align:middle
Regulations involving scopes of practice,
licensure examinations,
00:25:57.320 --> 00:26:01.444 position:50% align:middle
pre-service education, etc.,
that are central to HIV treatment
00:26:01.444 --> 00:26:03.473 position:50% align:middle
were largely overlooked.
00:26:04.020 --> 00:26:08.960 position:50% align:middle
Therefore, the African Health Professional
Regulated Collaborative aimed to engage
00:26:08.960 --> 00:26:13.030 position:50% align:middle
countries where treatment for HIV
was largely being carried
00:26:13.030 --> 00:26:15.003 position:50% align:middle
out by nurses and midwives.
00:26:16.160 --> 00:26:19.320 position:50% align:middle
Some strategic developments of regional
regulatory functions came
00:26:19.320 --> 00:26:23.970 position:50% align:middle
out of regulatory systems strengthening
in response to many changes,
00:26:23.970 --> 00:26:29.460 position:50% align:middle
challenges faced, including limited
numbers of personnel in small, low,
00:26:29.460 --> 00:26:31.130 position:50% align:middle
and middle-income countries.
00:26:31.858 --> 00:26:37.080 position:50% align:middle
One answer is to regionalize efforts among
countries that share common histories,
00:26:37.080 --> 00:26:41.730 position:50% align:middle
cultural values, languages,
and economic conditions to work together
00:26:41.730 --> 00:26:47.400 position:50% align:middle
to establish more efficient systems
such as the one established in the
00:26:47.400 --> 00:26:49.267 position:50% align:middle
Caribbean Regulatory System.
00:26:49.790 --> 00:26:55.340 position:50% align:middle
This initiative has helped to enhance
sustainability in resource constraint
00:26:55.340 --> 00:27:00.368 position:50% align:middle
contexts such as building human resource
capacity in nursing and midwifery.
00:27:01.820 --> 00:27:06.240 position:50% align:middle
Another example of cross-regulatory
initiatives includes the Western Pacific
00:27:06.240 --> 00:27:10.210 position:50% align:middle
Government Chief Nursing and Midwifery
Officers Alliance, where small island
00:27:10.210 --> 00:27:14.630 position:50% align:middle
nations provide aid for each other by
mobilizing their nursing and midwifery
00:27:14.630 --> 00:27:20.484 position:50% align:middle
workforce during disasters due to climate
change such as hurricanes and cyclones.
00:27:20.940 --> 00:27:25.659 position:50% align:middle
These initiatives can deploy nurses and
midwives where they are most needed.
00:27:25.760 --> 00:27:30.415 position:50% align:middle
These are just two examples of how nurses
and midwives can formulate strategies
00:27:30.415 --> 00:27:33.074 position:50% align:middle
and align influence for the greater good.
00:27:34.100 --> 00:27:37.710 position:50% align:middle
I believe that the first State of the
World's Nursing Report will identify
00:27:37.710 --> 00:27:44.100 position:50% align:middle
critical gaps in education, registration,
practice, advanced practice that can be
00:27:44.100 --> 00:27:46.750 position:50% align:middle
addressed through
strengthened regulations.
00:27:48.520 --> 00:27:52.370 position:50% align:middle
Telemedicine has been shown to have
success in overcoming geographical
00:27:52.370 --> 00:27:57.041 position:50% align:middle
challenges that limit access to quality
health care around the world.
00:27:57.280 --> 00:28:01.480 position:50% align:middle
However, there are still many barriers
that need to be addressed in order
00:28:01.480 --> 00:28:03.158 position:50% align:middle
to ensure its success.
00:28:03.158 --> 00:28:09.650 position:50% align:middle
As in all areas of medicine,
telemedicine is only successful if staff
00:28:09.650 --> 00:28:15.873 position:50% align:middle
receive adequate training and management
to maximize healthy results.
00:28:16.030 --> 00:28:20.220 position:50% align:middle
Therefore, what are we going to ensure the
competencies in regulations
00:28:20.220 --> 00:28:22.258 position:50% align:middle
for telemedicine practice?
00:28:23.430 --> 00:28:28.800 position:50% align:middle
Advanced practice roles are developing
globally and opportunities for advanced
00:28:28.800 --> 00:28:34.015 position:50% align:middle
practice nursing are expanding worldwide
due to a need for expert nursing care
00:28:34.015 --> 00:28:36.063 position:50% align:middle
at an advanced-level practice.
00:28:36.560 --> 00:28:42.640 position:50% align:middle
It is well acknowledged globally that APRN
practice encompasses several components,
00:28:42.640 --> 00:28:46.490 position:50% align:middle
including the ability to diagnose,
prescribe medication,
00:28:46.490 --> 00:28:50.640 position:50% align:middle
prescribe treatments, perform and
interpret diagnostic tests, among other
00:28:50.640 --> 00:28:51.995 position:50% align:middle
aspects of care.
00:28:52.630 --> 00:28:56.500 position:50% align:middle
However, as the advanced practice role
continues to develop,
00:28:56.500 --> 00:29:01.550 position:50% align:middle
we must ensure that we are addressing the
existing barriers that prevents APRNs
00:29:01.550 --> 00:29:06.078 position:50% align:middle
from practicing within their full scope
of training and education.
00:29:06.550 --> 00:29:10.870 position:50% align:middle
Complex issues relate to role
clarification, access to education
00:29:10.870 --> 00:29:16.210 position:50% align:middle
programs globally, lack of respect for the
nursing profession, variation in scope
00:29:16.210 --> 00:29:23.192 position:50% align:middle
of practice, and more complicate promotion
of global-uniformity APRN practice.
00:29:24.832 --> 00:29:28.970 position:50% align:middle
As a global nursing community,
we must continue to support programs
00:29:28.970 --> 00:29:30.181 position:50% align:middle
such as these.
00:29:30.181 --> 00:29:34.690 position:50% align:middle
Now is the time when we must closely
evaluate what is globally taking place
00:29:34.690 --> 00:29:36.240 position:50% align:middle
on the ground.
00:29:36.240 --> 00:29:40.090 position:50% align:middle
To further advance the nursing and
midwifery professions and to achieve
00:29:40.090 --> 00:29:45.200 position:50% align:middle
universal health coverage,
we must pool all our resources together
00:29:45.200 --> 00:29:48.378 position:50% align:middle
and offer support where it
is very much needed.
00:29:48.969 --> 00:29:53.636 position:50% align:middle
NCSBN continues to play a pivotal role
in supporting global recollective
00:29:53.636 --> 00:29:57.789 position:50% align:middle
standards that ensure to advancement
of the profession of nursing.
00:30:00.390 --> 00:30:07.060 position:50% align:middle
Altogether, I hope you can see how our
mandates are being used globally in high
00:30:07.060 --> 00:30:09.933 position:50% align:middle
and low-middle income countries
to serve the public.
00:30:11.360 --> 00:30:15.580 position:50% align:middle
"You are," I quote, "envisioning and
refining recollection systems
00:30:15.580 --> 00:30:19.860 position:50% align:middle
for increased relevance and responsiveness
to changes in health care,
00:30:19.860 --> 00:30:25.140 position:50% align:middle
championing regulatory solutions to
address borderless health care delivery,
00:30:25.140 --> 00:30:30.500 position:50% align:middle
expanding the active engagement and
leadership potential of all members, and
00:30:30.500 --> 00:30:35.297 position:50% align:middle
pioneering competency assessments to
support the future of health care and the
00:30:35.297 --> 00:30:38.089 position:50% align:middle
advancement of regulatory excellence.
00:30:39.642 --> 00:30:45.130 position:50% align:middle
But we as a nursing profession must have
our own mandate, one that ensures that
00:30:45.130 --> 00:30:50.540 position:50% align:middle
nurses and midwives have equal educational
opportunities and standards of quality
00:30:50.540 --> 00:30:54.132 position:50% align:middle
practice regardless of regions,
country, or community.
00:30:54.700 --> 00:30:58.060 position:50% align:middle
We're hearing about some of the exciting
work that is being done from a global
00:30:58.060 --> 00:31:02.680 position:50% align:middle
perspective and we must take the momentum
from the International Year of the Nurse
00:31:02.680 --> 00:31:04.935 position:50% align:middle
and the Midwife in 2020.
00:31:05.392 --> 00:31:08.989 position:50% align:middle
Nurses and midwives are key vessels
of change in their communities
00:31:08.989 --> 00:31:10.303 position:50% align:middle
around the world.
00:31:10.930 --> 00:31:15.990 position:50% align:middle
NCSBN and WHO have key roles to play
in the global empowerment
00:31:15.990 --> 00:31:17.519 position:50% align:middle
of the nursing profession.
00:31:17.519 --> 00:31:22.410 position:50% align:middle
And I truly believe that if supported,
the ambitious triple-billion target
00:31:22.410 --> 00:31:23.816 position:50% align:middle
can be achieved.
00:31:24.190 --> 00:31:29.270 position:50% align:middle
I anticipate the results of 2020 with
great hope and I look forward to seeing
00:31:29.270 --> 00:31:34.720 position:50% align:middle
how we can all work together to elevate
the global nursing profession and achieve
00:31:34.720 --> 00:31:35.941 position:50% align:middle
health for all.
00:31:38.200 --> 00:31:40.240 position:50% align:middle
I conclude with a quote.
00:31:40.240 --> 00:31:43.868 position:50% align:middle
Ms. Julia, she mentions that
people normally conclude with quotes.
00:31:44.997 --> 00:31:52.267 position:50% align:middle
And I actually take one of Dr. Tedros',
the WHO DJ's statement
00:31:52.267 --> 00:31:57.570 position:50% align:middle
from the ICN Congress,
where he says, and I end,
00:31:57.570 --> 00:32:02.870 position:50% align:middle
"Together we can ensure that nurses and
midwives get the education, the training,
00:32:02.870 --> 00:32:07.310 position:50% align:middle
the jobs, the conditions,
the opportunities, the dignity,
00:32:07.310 --> 00:32:09.200 position:50% align:middle
and the respect they deserve."
00:32:09.200 --> 00:32:10.295 position:50% align:middle
Thank you very much.
00:32:18.972 --> 00:32:21.690 position:50% align:middle
- [David] So we have some time
for some questions.
00:32:21.690 --> 00:32:27.620 position:50% align:middle
If you want to go to the microphone and
I'll recognize whoever's at the microphone
00:32:27.620 --> 00:32:30.763 position:50% align:middle
and you can then ask your question.
00:32:30.763 --> 00:32:34.450 position:50% align:middle
And while people are thinking that one
through, I have a question
00:32:34.450 --> 00:32:35.632 position:50% align:middle
for you, Elizabeth.
00:32:36.293 --> 00:32:43.850 position:50% align:middle
I want to draw on you're very impressive
resume in terms of making policy change
00:32:43.850 --> 00:32:45.530 position:50% align:middle
in the Cook Islands.
00:32:45.530 --> 00:32:50.800 position:50% align:middle
And here at NCSBN at the moment,
we're going through a process of reviewing
00:32:50.800 --> 00:32:56.980 position:50% align:middle
our model act and rules, and one of the
issues that we have recognized is that
00:32:56.980 --> 00:33:02.800 position:50% align:middle
to be as agile as we need to be to keep
peace with the very changing
00:33:02.800 --> 00:33:07.050 position:50% align:middle
health care demands, the changes
in education, etc.,
00:33:07.050 --> 00:33:12.870 position:50% align:middle
we need to write that act in a way
that is sufficiently permissive
00:33:12.870 --> 00:33:15.004 position:50% align:middle
to enable rapid change.
00:33:15.230 --> 00:33:20.030 position:50% align:middle
Part of the problem is obviously getting
legislative time and that can
00:33:20.030 --> 00:33:20.770 position:50% align:middle
take some time.
00:33:20.770 --> 00:33:26.250 position:50% align:middle
Any advice you can offer us in terms
of how we might come up with that
00:33:26.250 --> 00:33:32.890 position:50% align:middle
next-generation legislative framework that
really keeps peace with all of the demands
00:33:32.890 --> 00:33:34.102 position:50% align:middle
that we're facing?
00:33:35.428 --> 00:33:39.013 position:50% align:middle
- I think, you know,
any legislative change is
00:33:39.013 --> 00:33:45.080 position:50% align:middle
always challenging, but I think for me,
I would like to say that, you know,
00:33:45.080 --> 00:33:51.910 position:50% align:middle
before kind of moving on to that process,
I think the State of the World's Nursing
00:33:51.910 --> 00:33:59.050 position:50% align:middle
Report is going to be a critical report
that can actually inform the way forward
00:33:59.050 --> 00:34:02.410 position:50% align:middle
in regards to legislative changes.
00:34:03.411 --> 00:34:08.870 position:50% align:middle
I think the key thing would be about
consultation, is how widely you consult
00:34:09.633 --> 00:34:19.030 position:50% align:middle
because I think there are experts in this
area and I think it's important to also
00:34:19.030 --> 00:34:26.270 position:50% align:middle
ensure that you've captured the
differences in our context because if
00:34:26.270 --> 00:34:29.990 position:50% align:middle
you're making some changes,
that's going to be forward looking,
00:34:29.990 --> 00:34:34.490 position:50% align:middle
I think it's important that you actually
capture what exists right now in terms
00:34:34.490 --> 00:34:35.620 position:50% align:middle
of people's needs.
00:34:35.620 --> 00:34:39.800 position:50% align:middle
And that's why I kind of say that the
State of the World's Nursing Report is
00:34:39.800 --> 00:34:44.590 position:50% align:middle
going to be a key document that can
actually inform on that process as well.
00:34:46.190 --> 00:34:49.733 position:50% align:middle
Process itself though, as you know,
it's not that simple.
00:34:49.817 --> 00:34:52.182 position:50% align:middle
It's a long process.
00:34:52.182 --> 00:34:58.400 position:50% align:middle
It's really about getting the right people
to the table and as part of that
00:34:58.400 --> 00:35:04.550 position:50% align:middle
consultation… Sorry, David,
I don't have any kind of easy reference
00:35:04.550 --> 00:35:07.254 position:50% align:middle
for this because it's not an easy process.
00:35:08.214 --> 00:35:13.571 position:50% align:middle
- Well, I'll give a little shoutout for
the Texas Board of Nursing's Act
00:35:13.571 --> 00:35:20.810 position:50% align:middle
because it has a provision in it which
enables, "pilot work" to be done.
00:35:20.810 --> 00:35:25.450 position:50% align:middle
And I think that's a very…it protects the
public, but it also gives some
00:35:25.450 --> 00:35:26.710 position:50% align:middle
flexibility as well.
00:35:26.710 --> 00:35:30.990 position:50% align:middle
And I think we need to look at those
examples, whoever has got those examples
00:35:30.990 --> 00:35:34.370 position:50% align:middle
that find solutions, and to bring them
together so that we can all
00:35:34.370 --> 00:35:35.803 position:50% align:middle
learn from them.
00:35:36.487 --> 00:35:37.393 position:50% align:middle
Thank you.
00:35:38.827 --> 00:35:41.460 position:50% align:middle
Any questions for Elizabeth?
00:35:42.230 --> 00:35:43.788 position:50% align:middle
If not, I have another one.
00:35:47.440 --> 00:35:55.133 position:50% align:middle
So, let me ask another question in terms
of how we might work with you to help
00:35:55.133 --> 00:36:00.286 position:50% align:middle
really make 2020 a springboard
for the future.
00:36:01.266 --> 00:36:09.050 position:50% align:middle
As you know, the World Health Organization
is one of almost 200 UN agencies and many
00:36:09.050 --> 00:36:13.150 position:50% align:middle
of them touch upon the work that we do.
00:36:13.799 --> 00:36:17.660 position:50% align:middle
The International Labor Organization
obviously looks at some of the issues
00:36:17.660 --> 00:36:21.030 position:50% align:middle
around how many people are there
and what conditions they have.
00:36:21.030 --> 00:36:28.360 position:50% align:middle
But in today's world with both nurses
and patients being highly mobile,
00:36:28.360 --> 00:36:32.130 position:50% align:middle
the World Trade Organization,
the International Organization
00:36:32.130 --> 00:36:39.800 position:50% align:middle
of Migration, and many other groups,
how might we embrace those other parts
00:36:39.800 --> 00:36:46.520 position:50% align:middle
of the UN so it's not… And it's great that
the World Health Organization is really
00:36:46.520 --> 00:36:50.970 position:50% align:middle
embracing nursing, but if we can get some
of these other parts, particularly,
00:36:50.970 --> 00:36:55.090 position:50% align:middle
as regulators, the World Trade
Organization, the way that people move
00:36:55.090 --> 00:36:58.010 position:50% align:middle
is something that we are
very interested in.
00:36:58.010 --> 00:37:01.370 position:50% align:middle
How might we work together to kind
of raise the profile within these
00:37:01.370 --> 00:37:03.320 position:50% align:middle
other UN agencies?
00:37:04.310 --> 00:37:09.160 position:50% align:middle
- I think, you know, this is about how
you influence key movers
00:37:09.160 --> 00:37:11.582 position:50% align:middle
and shakers within those organizations.
00:37:11.760 --> 00:37:17.070 position:50% align:middle
I think with the ILO, they've
definitely got a place there where
00:37:17.070 --> 00:37:23.690 position:50% align:middle
I think nursing has an entry point in
regards to the Convention for Nursing
00:37:23.690 --> 00:37:30.870 position:50% align:middle
Personnels and I think we probably have an
opportunity to revise what that definition
00:37:30.870 --> 00:37:35.217 position:50% align:middle
might be because I think
that has impact on regulations.
00:37:35.640 --> 00:37:41.030 position:50% align:middle
So I think there's some entry,
definitely some…early conversations have
00:37:41.030 --> 00:37:47.450 position:50% align:middle
happened with WHO and ILO in regards
to what those classifications
00:37:47.450 --> 00:37:48.626 position:50% align:middle
might look like.
00:37:49.380 --> 00:37:54.790 position:50% align:middle
In terms of the World Trade Organizations,
I think, you know, this is
00:37:54.790 --> 00:38:03.626 position:50% align:middle
about organizations at the highest level,
getting our leaders engaged to actually
00:38:03.626 --> 00:38:07.254 position:50% align:middle
recognize the contributions
that nurses can make.
00:38:07.470 --> 00:38:15.128 position:50% align:middle
I think we have a place and I think
2020 is the opportunity we need to take.
00:38:15.300 --> 00:38:22.682 position:50% align:middle
And I think that this is about making
it...this is about collaborating so that
00:38:22.682 --> 00:38:28.844 position:50% align:middle
we're actually going forward as one unit
rather than, you know, various partners
00:38:28.844 --> 00:38:29.970 position:50% align:middle
taking their own initiative.
00:38:29.970 --> 00:38:34.664 position:50% align:middle
So I think we have opportunity
to actually, you know, get together
00:38:34.664 --> 00:38:38.658 position:50% align:middle
and maximize on how we influence
those organizations.
00:38:38.658 --> 00:38:39.743 position:50% align:middle
- Thank you.
00:38:39.910 --> 00:38:40.962 position:50% align:middle
Number one.
00:38:43.020 --> 00:38:44.570 position:50% align:middle
- [Woman] Good afternoon,
and thank you so much
00:38:44.570 --> 00:38:45.931 position:50% align:middle
for your presentation.
00:38:45.980 --> 00:38:50.910 position:50% align:middle
The question that I had to ask is how can
and/or what recommendations do you have
00:38:50.910 --> 00:38:55.680 position:50% align:middle
for local state boards of nursing
to prepare for, educate others,
00:38:55.680 --> 00:38:59.262 position:50% align:middle
and promote the 2020 Year of
the Nurse and Nurse-Midwife?
00:38:59.501 --> 00:39:01.048 position:50% align:middle
- Thank you. Great question.
00:39:01.060 --> 00:39:08.300 position:50% align:middle
I think that this talks to...speaks to
opportunity and I think what you do
00:39:08.300 --> 00:39:15.006 position:50% align:middle
as your organization and who you are
actually already networking with in terms
00:39:15.006 --> 00:39:17.663 position:50% align:middle
of countries.
00:39:18.816 --> 00:39:23.387 position:50% align:middle
If you don't have anyone,
I'd be happy to kind of link you to some
00:39:23.387 --> 00:39:30.394 position:50% align:middle
countries who are actually looking to
engaging with regulators to support what
00:39:30.394 --> 00:39:31.827 position:50% align:middle
they do in-country.
00:39:32.484 --> 00:39:38.219 position:50% align:middle
So I think that this is really your… We
don't want to be telling you what to do
00:39:38.219 --> 00:39:43.510 position:50% align:middle
to celebrate the Year of the Nurse,
but what I asked is that you actually
00:39:43.510 --> 00:39:50.110 position:50% align:middle
consider what existing projects you may
have or if you want to engage
00:39:50.110 --> 00:39:56.370 position:50% align:middle
with country-level regulators,
I'd be happy to link you with them because
00:39:56.370 --> 00:40:02.180 position:50% align:middle
I think this is the time and this is the
opportunity that perhaps we can maximize
00:40:02.180 --> 00:40:07.690 position:50% align:middle
and have the reach further than what
you're perhaps, you know, managing
00:40:07.690 --> 00:40:09.293 position:50% align:middle
within your organization.
00:40:10.110 --> 00:40:16.223 position:50% align:middle
So, you know, happy to talk to you
about some linkages and network.
00:40:16.590 --> 00:40:21.950 position:50% align:middle
I have to say, when I went to the Pacific,
I talked about coming to this conference,
00:40:21.950 --> 00:40:27.300 position:50% align:middle
to this meeting and I had a…Tonga
chief nursing officer was very excited and
00:40:27.300 --> 00:40:29.990 position:50% align:middle
wants to engage with this organization.
00:40:29.990 --> 00:40:35.350 position:50% align:middle
So, I do have some interested parties
already out there that wants to either
00:40:35.350 --> 00:40:38.461 position:50% align:middle
learn more or see what more
you can do together.
00:40:39.253 --> 00:40:44.870 position:50% align:middle
- And I would just add that Elizabeth's
agreed to be interviewed and Dawn Kappel
00:40:44.870 --> 00:40:49.850 position:50% align:middle
is going to write an article [inaudible],
so that that will be disseminated and you
00:40:49.850 --> 00:40:55.590 position:50% align:middle
can use that locally as well to help have
the discussion at your state
00:40:55.590 --> 00:40:56.754 position:50% align:middle
boards as well.
00:40:56.870 --> 00:41:03.920 position:50% align:middle
And Maryann Alexander and her team have
been analyzing the data within the
00:41:03.920 --> 00:41:07.250 position:50% align:middle
Regulatory Atlas and there will be a
special edition of the supplement
00:41:07.250 --> 00:41:13.110 position:50% align:middle
next year because the State of the World
Nursing Midwifery Report will have a
00:41:13.110 --> 00:41:20.256 position:50% align:middle
section related to regulation in there,
but it's limited in terms of the
00:41:20.256 --> 00:41:26.275 position:50% align:middle
page length, and therefore, because we
have the data, we're using that to really
00:41:26.275 --> 00:41:32.633 position:50% align:middle
do a very detailed analysis of the 320
jurisdictions that we've got data on, so.
00:41:35.175 --> 00:41:36.558 position:50% align:middle
Any more questions?
00:41:36.558 --> 00:41:39.371 position:50% align:middle
Everyone wants their dessert, I guess.
00:41:42.710 --> 00:41:43.538 position:50% align:middle
No?
00:41:44.120 --> 00:41:45.358 position:50% align:middle
Going once.
00:41:45.853 --> 00:41:46.615 position:50% align:middle
- Thank you very much.
00:41:46.615 --> 00:41:47.957 position:50% align:middle
- Going twice.
00:41:50.630 --> 00:41:51.413 position:50% align:middle
Okay.
00:41:51.580 --> 00:41:55.591 position:50% align:middle
Well, please join me again in thanking
Elizabeth for her wonderful presentation.