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Senior nurses say leaving global nursing body would be 'nuclear option' for RCN

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A decision by the Royal College of Nursing to leave the International Council of Nurses could have “profound effects” on the profession worldwide, a group of senior nurses have warned.

In a letter to Nursing Times, they argue that leaving the ICN should be viewed as the “nuclear option” once all other attempts have been tried to find a way forward for the two organisations.   

It is signed by eight senior nursing figures, including former RCN past president Maura Buchanan and former RCN general secretary Christine Hancock.

Anne Marie Rafferty, professor of nursing policy at King’s College London, and Jane Salvage, independent nursing consultant and former editor of Nursing Times are also signees.

The letter is the latest twist in the continuing debate on whether the RCN should leave the ICN over the size of its membership fee, which the college says is “unsustainable”.

As the second largest member, the RCN’s fees contribute 16% of the ICN’s subscription income and in 2012 cost it around £600,000 – equivalent to £1.80 per member.

College members voted by a large majority (92%) to allow the RCN council to withdraw from the ICN during an extraordinary general meeting held at the college’s annual congress in Liverpool in April.

The RCN council called the meeting after seeing “little progress” in nearly six years of discussions with the ICN. It has already been suspended over its refusal to pay its 2013 subscription.

But the letter states that the ICN plays a “unique role” in taking on challenges such as the spread of HIV/AIDS and in promoting nursing in countries where it has little influence.

“Its role in leadership development has been formidable and it is sometimes a lone force in capacity-building for low income countries,” the letter says.

Its authors argue that the RCN should “continue to work for change from inside” the ICN and that the two organisations seek “impartial mediation” to find an “amicable solution” to the fee issue.

In addition, they want the college to lead a “wide, informed debate” on what withdrawal from the ICN would mean and what could replace it as a “vehicle” for the college’s international engagement.  

“Issues we should think about with enormous care include the damage to the reputation of the UK and the RCN, and our loss of influence in the global arena. Fellow nurses in many countries will feel shocked and let down,” they write. “The RCN might be perceived as selfish and arrogant.

“Withdrawal from ICN is the last resort – the nuclear option – and we urge council to use its power wisely and cautiously,” they warn.

The ICN is due hold its next congress in just a few days’ time. The event, held once every four years, will take place in Melbourne from 18-23 May, where it members – excluding the suspended RCN – will vote on a new fee structure and choose a new president.   

The letter states: “Reform is in the air at ICN. Its forthcoming vote on a new fee structure could give RCN a 17% reduction in its dues. The election of a new president offers potential for fresh leadership.

“We can all see the difficulties of democracy in action in the international arena – but the responsible solution is to stay in the tent, continue to negotiate and shape the future together.” 

Responding to the letter, RCN council chair Professor Kath McCourt said: “This is a difficult issue which the RCN has reflected on for some time.

“The authors of this article ask some very pertinent questions, which council will want to consider before any decision is reached.”

However, she highlighted the large 92% majority that had voted in favour of authorising the council to decide to leave the ICN.

“Council will look at the latest position when it next meets, and any decision will, as always, be considered very carefully,” she added.


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