Nearly half of national nursing associations (48.4%) report a significant increase in nurses’ migration or exodus from the profession altogether since 2021 – against stagnant salaries, poor health system performance, and growing violence directed at nurses along with a continually increasing workload.

These are among the key findings in a new report by the International Council of Nurses (ICN), warning of a deepening crisis in the global nursing workforce.

The report is backed by surveys showing that around 72.1% of National Nursing Associations (NNAs) reported little or no increase in nursing salaries since 2021, including in more affluent OECD countries. When accounting for inflation, over one-third, or 36.4%, of NNAs indicated that nurses have effectively experienced a decrease in salary in real terms.

Increased violence against health care workers, poor pay, and exhaustion are driving many nurses to leave the profession altogether.

“A shocking 86.2% of nurses’ associations reported experiences of violence from patients or the public, yet a third of countries had no policies in place to protect nurses from workplace violence,” said ICN’s President Pamela Cipriano, in launching the new findings.

Growing demands on nurses’ time

These findings come against a background of growing demands on nurses in their day-to-day duties since the height of the pandemic in 2021 – as reported by some 61.7% of nursing associations.

The report, Our Nurses. Our Future. Caring for Nurses Strengthens Economies, is complemented by a survey of 68 NNAs between 2021–2024. The ICN is a federation of over 130 national nurses’ associations representing millions of nurses worldwide.

“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,” said Cipriano.

Some 38% of national nursing associations rate their country’s capacity to meet current healthcare needs as “poor” or “very poor”, the survey of NNAs also found – partly as a result of the cumulative pressures on the nursing workforce and their exodus.

Threats to safety and low pay are major threats

Along with low pay, various threats to safety while at work are among the key issues nurses face, she added.

“The survey results also underscore a failure to protect nurses’ safety,” Cipriano said.

“Our report highlights how direct attacks on nurses and healthcare workers in conflict settings have also dramatically increased.”

Outside of conflict settings, however, violence directed against nurses is often a result of the frustration patients and their caregivers have towards the health systems, as many nurses work in resource-poor settings. In India, for instance, violence against healthcare professionals is a huge issue, often linked to the over-extended public healthcare system.

Report’s recommendations

The report flags a range of solutions for policymakers and governments. Investment in the right resources and equipment, safe and decent working conditions, and training support are among the top three “asks.”

It also suggests improving work culture so that nurses can thrive in a supportive environment.

Another one is to improve access to healthcare for healthcare professionals themselves.

Poor health among health care workers accounts for approximately 2% of national health care expenditure on average, draining valuable resources, according to the findings.

“Remove barriers to health care access for nurses by streamlining pathways to ensure easy, timely access to preventive care, treatment and support services. Ensure these services are readily available and designed to meet nurses’ unique needs,” it states.

And finally, there is a need to pay nurses fair and competitive compensation.

Investing in nurses’ well-being would boost health sector productivity by 20%

Despite mounting evidence of the nursing workforce crisis, many leaders and decision makers continue to prioritize short-term solutions over the sustainable investments that are needed to address the root causes of the health workforce emergency, ICN’s CEO, Howard Catton noted. Fundamental to that is the growing nurses shortage.

The report makes an economic case for investing in more nurses, as well as increasing their well-being. “For nurses, improving their health and resource allocation could boost health workforce productivity by as much as 20%, which directly translates into cost savings and improved health care delivery,” it states.

“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 is estimated at $100-300 billion based on capturing lost workforce productivity alone,” Catton said. He said the estimates are based on the World Economic Forum & McKinsey’s 2025 Thriving Workplaces report, which estimated that investing in workers’ health, more broadly, could unlock some $11.7 trillion in global economic returns.

“Extrapolating those figures to the proportional size of the nursing workforce, we get a possible opportunity value of $100-$300 billion, in increased economic returns,” Catton said, framing those as reduced sick leave and attrition, absenteeism, etc.

Savings obtained from investments outweigh the costs

“There is no concrete number put on the amount of investment required to bring about these benefits, however we do know that there is a strong return on investment on investing in nursing and in health: studies show that every dollar invested in health systems can generate a $2-$4 return (McKinsey Global Health Institute/Remes et al., 2020),” Catton added.

ICN has said that it will continue to push for increased protections for nurses at the upcoming World Health Assembly, 19-27 May, where WHA member states will consider the extension of a global strategy on Nursing and Midwifery, currently scheduled to expire this year.

“ICN is strongly advocating for this to be extended and prioritized, amidst grave risks to global health funding and a historic and chronic lack of investment in the health and care workforce,” said Richard Elliott, ICN spokesperson.

“The WHA has to decide to extend the current global nursing strategy,” Catton added.  “We obviously want a positive decision and are lobbying hard for that. However we are concerned that health workforce budgets at WHO and in countries are at risk and could be seen as a soft target for cuts. WHO in our view, has for a long time not invested proportionately in the health workforce – and given that it is so central to delivering so much, we are therefore very alert to risks of cuts.”

WHA will also include discussions on the Global Strategy on Human Resources for Health: Workforce 2030 and the most recent results of country compliance with the WHO Global Code of Practice on the International Recruitment of Health Personnel, which was released and reviewed at the WHO Executive Board in February.

“A strong, well-supported nursing workforce is more critical than ever to address global health challenges and support healthy, productive populations. It is now time for action to move nurses from being invisible to invaluable across all regions,” Cipriano said.

Image Credits: Unsplash, International Council of Nurses , International Council of Nurses, 2025, Studioregard.ch.