The newly elected President of the International Council of Nurses (ICN), Dr Pamela Cipriano, has arrived in the role at a time when the demands placed on the global workforce have arguably never been higher.

Nevertheless, Dr Cipriano, the ICN’s 29th president and the ICN’s First Vice President from 2017-2021, is optimistic about what the organisation can achieve, despite the complex challenges that nurses and national nursing associations (NNAs) face worldwide on an individual and collective basis.

“One of the strengths of ICN is our solidarity – among NNAs and among individuals in a shared commitment to help one another to improve the profession and the health of the world,” Dr Cipriano, who is also currently the Dean of the University of Virginia School of Nursing, says.

“I believe we are more alike than we are different, and even though we recognise there are distinct conditions that enable or limit the work any one of our NNAs can do, it still helps us recognise that humanitarian issues are everyone’s issues and that together we must address health equity and universal health coverage for all.”

The ANMJ discusses with Dr Cipriano about her career in nursing, the ICN’s plans for 2022, and issues such as climate justice and the ongoing COVID-19 pandemic.

ANMJ: You have spent more than 40 years in nursing. What drew you to the profession initially and what sustains your passion for it now?

Dr Cipriano: I was always intrigued with science and had initially pursued a degree to become a medical technologist but soon realised I would not want to spend my days in a laboratory. Knowing I could combine my education in biology and chemistry with a people-oriented profession, nursing became the obvious choice.

Upon entering my basic nursing program, I became engaged in our local level student nurses’ association, where membership was mandatory. Volunteering came naturally, and I quickly learned that being part of an association was the best way to shape your destiny and the student experience.

My early patient care experiences, coupled with a desire to work to better the profession, fuel my passion to this day. I cherish the patient and family experiences that underscored nurses’ impact on people’s lives.

ANMJ: For those in Australia who are less familiar with your work, what have been your clinical and professional interests as a nurse, and how have those interests evolved throughout your career?

Dr Cipriano: Like many early career nurses, my first experience was in a hospital on an orthopaedic surgical hospital unit. After six months, I transferred to a Burn Intensive Care Unit and became hooked on ICU nursing, later working with open heart surgery and shock-trauma patients.

Upon completing my master’s degree, I became an adult ICU clinical nurse specialist (CNS) working with five different populations, helping nurses learn how to use new technologies to improve the accuracy of physiologic monitoring and care.

I appreciated the direct influence I could have as a CNS but wanted to have a greater impact on the administration of care which led me to pursue my first job in nursing management.

It seemed there were many accomplished clinicians, but too few effective administrators and I believed my association leadership skills had prepared me to take on progressive roles leading groups of nurses and whole organisations.

ANMJ: You commenced your term as ICN President late this year. What do you see as the ICN’s priorities throughout your term and how will your leadership further those objectives?

Dr Cipriano: It goes without saying that we continue to deal with a great amount of uncertainty in healthcare as the pandemic rages on. ICN will be vigilant to help track and detect changes occurring with the pandemic as well as respond to help our members address the challenges.

At the same time, ICN remains focused on our current strategic plan priorities: to increase global impact; enhance member empowerment; provide strategic leadership for the profession; and pursue innovative growth.

Those who know me know I do not shy away from difficult problems, so we will embrace challenges together and keep our eyes on a post-COVID world that recognises and values nurses as a growing force for health.

ANMJ: With climate change posing significant public health challenges in the decades to come, what level of responsibility does the nursing workforce have to remain engaged with such issues given the likelihood that they are and will be on the frontlines dealing with climate disaster?

Despite the overwhelming effects of the pandemic, nurses are rightly concerned about climate change because it is the biggest health threat facing humanity: in fact, its impacts will dwarf the effects of the pandemic.

ICN joined other health professional groups in writing to the COP26 meeting in Glasgow last year to express our alarm at how little is being done to combat climate change. Nurses are uniquely aware of the direct link between the threats posed by climate change to the health of populations, and many are already seeing its effects in their everyday work.

In the face of these problems, nurses are mobilising and speaking out to try to bring about positive change locally, nationally and globally.

ANMJ: It has been a tough two years for the profession, but one that has shown the strength of people who work within nursing. What has given you hope from the past two years, and how do we utilise that for the future?

Dr Cipriano: No one has escaped the pandemic, but nurses, more than most other groups, have suffered the emotional impact of caregiving.

Yet, for the most part, they have rallied – they’ve signed up for mental healthcare, they have used their creative ideas to redesign care, they’ve been the voice of wisdom and knowledge for their communities and they’ve continued to ‘show up’ regardless of their exhaustion.

We know that can’t go on forever, but I see many nurses also placing their hope and trust in their leaders, working together to get through sustained adversity. We share the responsibility to care for our caregivers. So when I see them holding on, it gives me renewed hope that we’ll retain our precious workforce.

Those of us in leadership positions need to take the lessons learned and ensure we do not forget the sacrifices of those we lost and those who are still suffering. We need to be relentless in assuring our governments and healthcare organisations will protect our workforce and ensure we have systems in place to detect and address future threats.