Nurses across the world are “at breaking point”, experiencing burnout, wage stagnation and increased levels of violence at work, according to a major new report.
The International Council of Nurses (ICN) has called on global healthcare leaders to prioritise long-term sustainable investment, over short-term solutions, to address the root causes of the health workforce emergency.
“We must take urgent and decisive action to put nurse wellbeing at the centre of health systems”
Pamela Cipriano
It comes as the body today published a report and a survey that have laid bare the scale of the crisis in nursing across the globe.
The report, International Nurses Day 2025: Caring for nurses strengthens economies, has provided evidence of the strain many nurses are experiencing due to chronic underinvestment.
It comes ahead of the annual nursing event, celebrated on 12 May every year, which this year is focusing on the wellbeing of nursing staff, and how a healthy and secure workforce is crucial to the overall functioning of global healthcare.
Within the new report, the RCN has published the Caring for Nurses Agenda, which sets out the interventions needed to protect nurses’ wellbeing.
Meanwhile, the ICN has also today published the findings of a survey into the experiences of its national nursing association (NNA) members.
Undertaken by the Rosemary Bryant Research Centre, the research gathered responses from 68 NNA presidents to understand trends affecting the global workforce from 2021 to the present day.
Nursing Times has broken down some of the key findings of the report and survey, and what actions the ICN would like to see from healthcare leaders to tackle some of the key problems impacting nurses across the globe.
Increasing demands on the workforce
The ICN survey of NNAs found that almost 62% reported growing demands on nurses since 2021.
Despite this, 38% of the associations said their country’s capacity to meet the current healthcare needs of their nation was “poor” or “very poor”.
The survey also identified trends in the number of people applying to be nurses, as well as leaving the profession.
NNAs from low-income or lower middle- income countries reported the highest proportion of increases in undergraduate nursing applications (74%) while high-income countries reported the lowest proportion (16%).
Concerningly, almost half (48%) of NNAs reported a significant increase in nurses leaving the profession, exacerbating workforce shortages.
The survey also found that the majority of NNAs (72%) reported that nursing salaries had seen “little or no increase” since 2021.
Considering factors like inflation, more than one third (36%) reported that this constituted a real terms salary decrease since 2021.
Nurses facing greater risks to their safety and wellbeing
The report warned that nurses across the world were facing “an escalating threat to their safety”, particularly from workplace violence.
Over 86% of NNA respondents to the ICN survey said nurses in their country experienced violence from patients or the general public, while more than two-thirds (71%) said they faced violence from co-workers.
It comes as a recent survey by Nursing Times and Unison revealed that almost all nursing and midwifery workers in the UK had experienced physical violence at work.
“We have clear evidence that supporting and caring for nurses is not a cost: it is a smart and strategic investment in the health and prosperity of all people”
Howard Catton
The ICN survey found that two-thirds of NNAs (68%) reported that their country had policies to prevent workplace violence against staff.
Just under half (48%) said they had policies to ensure that nurses had access to psychological or mental health support at work.
Meanwhile, the survey also identified gaps in the workplace in relation to safe staffing and proper support for newly registered nurses.
Around two-thirds of NNAs (64%) said their country’s healthcare system was experiencing a shortage of nursing staff that was making it difficult to achieve a safe environment for patient care.
A similar number reported not having policies to ensure appropriate skill mix (64%) nor adequate staffing levels (70%).
The survey also found that only around half of NNAs (51.5%) reported having policies to support new graduates or inexperienced staff.
Imbalance in migration of nurses across the world
The survey found that nursing emigration was “adversely related to a country’s income group”.
Some 67% of NNAs from low-income and lower middle-income countries reported a moderate to great increase of emigration, compared to 21% from high-income countries.
NNAs from low-income or lower middle-income countries were also more likely to strongly disagree that their government was managing nursing emigration effectively, and more likely to agree that it was making it hard to maintain the workforce needed to meet current demands.
The top five factors contributing to nurses leaving the country, according to the associations, were: poor salary; poor working conditions; lack of opportunity for career advancement; nurse contribution undervalued by government and policy makers; and lack of employment opportunities.
Conversely, immigration of the nursing workforce was also related to income groups, with 43% of NNAs from high-income countries reporting a moderate or great increase in overseas recruitment, compared to 20% of those from low-income or lower middle income countries.
The top five factors driving immigration were: abundance of employment opportunities; internationally competitive salary; good healthcare infrastructure; low level of crime; and supportive national policy.
Solutions to improve nurse wellbeing
In the International Nurses Day report, the ICN argued that the solutions to the nursing workforce crisis were “clear, proven and urgent”.
The report said: “The need for action is urgent. Despite clear evidence of the nursing workforce crisis, health systems continue to underinvest in nurses’ wellbeing.
“This neglect is not only a healthcare issue; it threatens the sustainability of global health systems and economies.”
As such, the ICN has published the Caring for Nurses Agenda, which sets out seven long-term strategies to address the nursing workforce crisis across the globe.
The strategies are:
Ensure adequate staffing and skill mix for effective care;
Invest in the right resources and equipment;
Provide safe and decent working conditions;
Support education, professional development and optimal scope of practice;
Build supportive, high-performing organisational cultures;
Improve access to healthcare and wellbeing support;
Value nurses with fair, competitive compensation.
ICN president Dr Pamela Cipriano said: “The publications we are launching today show that many of the world’s nurses are at breaking point, pushed into burnout and facing enormous physical, mental and emotional pressures.
“Unacceptable working conditions, inadequate compensation, and a failure to protect nurses from workplace violence and occupational hazards, or provide opportunities to advance and practice at full scope, are driving this crisis, which affects not only nurses but the health of entire populations.”
Pamela Cipriano
Dr Cipriano said the survey of NNA presidents was “a litmus test for the lived experiences of the world’s nurses”.
She added: “We must take urgent and decisive action to put nurse wellbeing at the centre of health systems and enable nurses to provide essential care, support thriving populations and economies, and advance universal health coverage and the sustainable development goals.”
Meanwhile, ICN chief executive, Howard Catton, argued that many leaders continued to make the wrong choices by prioritising short-term solutions over the sustainable investments needed to address the root causes of the health workforce emergency.
He said: “We are used to nurses safeguarding society from catastrophic health outcomes when disaster strikes, just as airbags deploy to protect us in a collision.
“But without immediate action to invest in and care for our nursing workforce, we risk a dangerous future where no airbag will inflate, where we won’t have nurses to come to the rescue when we need them most.”
Mr Catton called on the world’s leaders to “hold firm in their commitment to health priorities and deliver meaningful action by urgently investing in nurses and in health”.
He added: “We have clear evidence that supporting and caring for nurses is not a cost: it is a smart and strategic investment in the health and prosperity of all people, with the total potential value of initiatives to improve nurses’ wellbeing estimated at $100-300bn based on capturing lost workforce productivity alone.”
