Every nurse in the world is touched by the International Council of Nurses, whether they know it or not. ICN wrote the international Code of Ethics for Nurses, sets the theme for International Nurses Day each year, sits in official relations with the World Health Organization, and represents nurses in global debates about pay, safety, migration and the future of health care. Yet many nurses could not name a single ICN leader or explain how their own national association connects to it.
This explainer covers ICN’s history, how it is governed, who leads it today, how its board represents different regions, what it actually does, and how individual nurses can get involved.
Imagine you are a nurse in Accra, Manila or Madrid. Your national nursing association has spent years arguing that nurses should be represented in government health planning. At an international meeting, your association’s president stands alongside colleagues from more than 130 countries, backed by a federation that speaks for millions of nurses. A statement agreed there is quoted by health ministers at the World Health Assembly a month later. Your voice, through your association, has travelled from your ward to the global stage. That is what the International Council of Nurses is for.
What is the International Council of Nurses?
The International Council of Nurses (ICN) is a federation of national nurses associations (NNAs). It was founded in 1899, making it the world’s first and widest-reaching international organisation for health professionals. ICN is based in Geneva, Switzerland, and today represents more than 130 national nurses associations, which together speak for more than 28 million nurses worldwide.
ICN describes its mission as representing nursing worldwide, advancing the nursing profession, promoting the wellbeing of nurses and advocating for health in all policies.
A brief history
- 1899: ICN is founded in London, led by Ethel Gordon Fenwick of Britain, with nurses from the United States, Germany and other countries. Its early campaigns focus on professional registration for nurses, which many countries did not yet have.
- Early 20th century: ICN grows as national nurses associations are formed in more countries.
- 1953: ICN adopts the first International Code of Ethics for Nurses.
- 1965 and 1974: ICN begins marking International Nurses Day in 1965, and in 1974 fixes it on 12 May, the anniversary of Florence Nightingale’s birth.
- 1966: ICN moves its headquarters to Geneva, close to the World Health Organization and other UN agencies.
- 2020: during the International Year of the Nurse and the Midwife and the COVID-19 pandemic, ICN tracks and highlights the deaths of nurses and calls for protection and investment.
- 2025: ICN Congress in Helsinki, Finland, attended by around 7,000 nurses from about 130 countries, elects a new board for 2025–2029 and launches updated definitions of nursing.
How membership works
ICN’s members are national nurses associations, not individual nurses. Generally, each country has one member association, usually the main professional body for nurses in that country. Examples include the American Nurses Association (United States), the Canadian Nurses Association, the Royal College of Nursing (United Kingdom), the Australian Nursing and Midwifery Federation, the General Council of Nursing of Spain, the Japanese Nursing Association, the Ghana Registered Nurses and Midwives Association, and the Nigeria-based National Association of Nigeria Nurses and Midwives, among many others.
As a nurse, you are connected to ICN through membership of your national association. Your association pays membership dues to ICN, sends delegates to the Council of National Representatives (ICN’s governing body), and takes part in ICN’s networks and campaigns.
ICN also has other categories of affiliation, such as specialist affiliates. For example, the Sigma Theta Tau International Honor Society of Nursing is listed as a specialist affiliate.
How ICN is governed
Council of National Representatives (CNR)
The CNR is ICN’s governing body. It brings together the presidents or representatives of member associations, usually every two years. The CNR elects the President and the Board, sets policy direction, approves membership and adopts position statements.
The Board of Directors
The Board is elected for a four-year term and governs ICN between CNR meetings. It is made up of the President and members elected to represent different geographical areas of the world, ensuring that nurses from every region have a voice. From among its members, the Board elects three Vice Presidents.
The chief executive and staff
Day-to-day operations are run by a professional staff team in Geneva, led by a Chief Executive Officer. Howard Catton, a nurse from the United Kingdom, has served as ICN’s CEO since 2019 and has been a prominent voice on nurse wellbeing, the global shortage and ethical recruitment.
Who leads ICN now: the 2025–2029 Board
At the 2025 Congress in Helsinki, member associations elected a new board. The President is José Luis Cobos Serrano of the General Council of Nursing of Spain. He succeeded Dr Pamela Cipriano of the United States, who served as President from 2021 to 2025.
At its first meeting on 14 June 2025, the new Board elected three Vice Presidents:
- First Vice President: Sineva Maria Ribeiro (Sweden)
- Second Vice President: Megumi Yamaura-Teshima (Japan)
- Third Vice President: Perpetual Ofori-Ampofo (Ghana)
Board members representing ICN’s geographical areas
- Eastern Mediterranean: Myrna Abi Abdallah Doumit
- West and Central Europe: Emily McWhirter
- Southern Europe: Ricardo Correia de Matos
- North America and Caribbean: Sylvain Brousseau
- Central and South America: Nora E. Barahona De Peñate
- South East Asia: T. Dileep Kumar
- Asia: Ching Min Chen
- Pacific and Eastern Asia: Debra Thoms
ICN reported that the 2025–2029 Board has 12 members, eight of them women. The Vice Presidents also represent their regions, including Africa, Northern Europe and Asia.
What ICN does
1. Sets ethical and professional standards
The ICN Code of Ethics for Nurses, first adopted in 1953 and most recently revised in 2021, is used around the world as the foundation for national codes, education and practice. It sets out nurses’ responsibilities to patients and communities, to practice, to the profession and to global health, including respect for human rights, cultural values and dignity.
In 2025, ICN launched updated definitions of “nursing” and “a nurse”, the first major revision in decades, to reflect the modern scope of the profession, including its scientific basis, leadership and autonomy.
2. Advocates at the global level
ICN is in official relations with the World Health Organization and works with other UN agencies, the International Labour Organization, the World Bank and governments. It contributes to the World Health Assembly, influences global health workforce strategies, and has long argued for senior nursing leadership in governments and international agencies.
ICN has been vocal on:
- The global nursing shortage and the need for investment in nursing education and jobs
- Ethical international recruitment, warning against high-income countries draining nurses from countries with severe shortages
- Violence against nurses and attacks on health care in conflict zones
- Nurse wellbeing, burnout and mental health
- Pay equity and gender equality
- Advanced practice nursing and expanding nurses’ scope to improve access to care
- Universal health coverage and primary health care
- Climate change and health
3. Publishes reports and position statements
ICN publishes guidance and position statements on topics ranging from nurse staffing and patient safety to digital health, immunisation and nurse migration. Its annual International Nurses Day report provides evidence and resources for nurses to use in their own advocacy. ICN also partnered with WHO on the State of the World’s Nursing reports in 2020 and 2025.
4. Develops leaders
The Global Nursing Leadership Institute (GNLI) is ICN’s flagship leadership programme, bringing together senior nurses from around the world to build policy and leadership skills. ICN also runs leadership programmes for national associations and supports the development of early-career nurse leaders.
5. Runs networks for specialist nurses
ICN hosts networks that connect nurses working in specific areas, such as the Nurse Practitioner/Advanced Practice Nursing Network, which publishes international guidance on advanced practice roles, along with networks on areas such as disaster nursing and nursing regulation.
6. Supports nurses in crisis
ICN’s humanitarian funds have supported nurses affected by disasters and conflict, including in Ukraine, Türkiye and Syria after earthquakes, Lebanon, Sudan and elsewhere. It has repeatedly called for the protection of health workers under international humanitarian law.
7. Supports education for nurses’ children
Through the Florence Nightingale International Foundation (FNIF), ICN’s charitable arm, the Girl Child Education Fund has supported the primary and secondary education of daughters of deceased nurses in several low-income countries.
The ICN Congress
The ICN Congress is one of the largest international gatherings of nurses, now held every two years. It brings together thousands of nurses for scientific sessions, policy debates, networking and cultural exchange. Recent congresses were held in Montreal, Canada (2023) and Helsinki, Finland (2025). The Congress is an opportunity for nurses at every level, including students and early-career nurses, to present research and connect with colleagues worldwide.
International Nurses Day
International Nurses Day is celebrated on 12 May each year. ICN chooses a theme and publishes a resource pack and report. Recent themes have highlighted the economic power of nursing and the importance of caring for nurses’ own health and wellbeing. Many hospitals, universities and national associations use the theme for events, awards and campaigns.
ICN and other nursing organisations
ICN is distinct from, but works alongside, other organisations:
- The World Health Organization has its own Chief Nursing Officer and nursing and midwifery team, which sets global health workforce policy
- Nursing regulators, such as national councils, register and discipline nurses; ICN is not a regulator but supports regulation through guidance
- Trade unions represent nurses in pay and employment negotiations; in some countries, the ICN member association is also a union, while in others they are separate
- Specialist and academic organisations, such as Sigma, the Council of International Neonatal Nurses, and regional federations, focus on particular areas
- Nursing Now Challenge and other campaigns focus on developing young nurse leaders
Criticisms and challenges
Like any global federation, ICN faces challenges and criticism:
- Distance from frontline nurses: many nurses feel ICN’s work is remote from their daily reality, and awareness among individual nurses is low
- Uneven representation: national associations vary greatly in size, resources and independence, and in some countries the member association may not represent all nurses
- Limited power: ICN can advocate and advise, but cannot force governments to act or to raise pay
- Tension on migration: ICN must balance the rights of individual nurses to migrate with the needs of countries losing nurses, and its member associations in source and destination countries may see the issue differently
- Funding: dues from associations in low-income countries are limited, and the federation relies heavily on larger members
How to get involved
- Join your national nurses association. This is your direct link to ICN and the most effective way to make your voice heard.
- Use ICN resources. International Nurses Day packs, position statements and reports are free to download and can support your teaching, advocacy and practice.
- Attend or present at an ICN Congress. Students and nurses at all levels can submit abstracts.
- Join a network through your association if you are in advanced practice or a specialist field.
- Apply for leadership programmes, such as GNLI, when you have gained senior experience.
- Get involved in your association’s international work, such as policy committees or delegations to the CNR.
Inside the ICN Code of Ethics
The Code of Ethics for Nurses is organised around four principal elements, each describing a set of responsibilities:
- Nurses and patients or other people requiring care: respecting human rights, values, customs and spiritual beliefs; ensuring informed consent; protecting confidentiality and privacy; and advocating for equity and social justice in access to care.
- Nurses and practice: carrying personal responsibility and accountability for ethical practice; maintaining competence through lifelong learning; looking after their own health and wellbeing; and using technology and evidence safely.
- Nurses and the profession: setting and implementing standards for clinical practice, management, research and education; contributing to a positive practice environment; and supporting colleagues.
- Nurses and global health: valuing health care as a human right; working to address social determinants of health; and contributing to environmental sustainability and global health.
Many national nursing regulators and associations base their own codes on this framework, so the principles you are taught in nursing school often trace back to ICN.
Recent ICN presidents
- Judith Shamian (Canada), 2013–2017
- Annette Kennedy (Ireland), 2017–2021, who led ICN through the start of the COVID-19 pandemic
- Dr Pamela Cipriano (United States), 2021–2025, who focused on recovery from the pandemic, nurse wellbeing and the workforce crisis
- José Luis Cobos Serrano (Spain), 2025–2029
ICN and the COVID-19 pandemic
During the pandemic, ICN became one of the loudest voices calling attention to the risks nurses faced. It collected data from national associations on nurse infections and deaths, pressed governments to provide personal protective equipment and vaccines to health workers, and warned of a “mass trauma” effect on the workforce that would drive nurses out of the profession. It also argued that nurse deaths from COVID-19 should be properly recorded and recognised as occupational. Many of the concerns ICN raised then, about burnout, staffing and retention, remain central to its work today.
ICN’s position on nurse migration
ICN supports the right of individual nurses to migrate and seek better opportunities, while warning against unethical recruitment practices. It has called on high-income countries to become more self-sufficient by training and retaining enough nurses of their own, to respect the WHO Global Code of Practice on the International Recruitment of Health Personnel, and to avoid actively recruiting from countries on the WHO safeguards list. ICN has also highlighted problems faced by migrant nurses, such as exploitative contracts, debt to recruitment agencies, underemployment and discrimination, and called for fair treatment and equal opportunities in destination countries.
Why national associations matter
ICN’s strength rests on its members. Strong national associations can negotiate with governments, contribute evidence to policy, support nurses facing difficulties, and send capable delegates to ICN. Weak or underfunded associations struggle to do this. In many countries, low membership rates among nurses limit what associations can achieve. When nurses join and participate, they strengthen both their national voice and the global voice of nursing.
A glossary of ICN terms
- NNA (national nurses association): the national professional body that is a member of ICN
- CNR (Council of National Representatives): ICN’s governing body made up of representatives of member associations
- Board of Directors: elected leaders who govern ICN between CNR meetings, representing geographical areas
- Position statement: ICN’s agreed view on a policy issue, used by associations in their own advocacy
- GNLI (Global Nursing Leadership Institute): ICN’s senior leadership development programme
- FNIF (Florence Nightingale International Foundation): ICN’s charitable foundation
- IND (International Nurses Day): 12 May each year, with an ICN theme and resource pack
- APN (advanced practice nursing): roles such as nurse practitioners and clinical nurse specialists, supported by an ICN network
How ICN’s work reaches your ward
It can be hard to see how a federation in Geneva affects your shift. Here are some practical connections:
- The ethical principles in your national code of conduct often come from the ICN Code
- Evidence your union or association uses in pay and staffing negotiations may come from ICN or WHO reports
- Recognition of advanced practice roles in your country may draw on ICN guidance
- Rules on ethical international recruitment that affect agencies hiring nurses build on WHO’s Code of Practice, which ICN helped shape and promote
- Campaigns on violence against nurses and protecting health workers in conflict are amplified by ICN at the UN level
- International Nurses Day events in your hospital usually follow ICN’s annual theme
The future of ICN
Under its 2025–2029 Board, ICN’s priorities include addressing the nursing workforce crisis, securing investment in nursing as a driver of health and economic growth, protecting nurses in conflict and disaster zones, strengthening nursing leadership and regulation worldwide, and preparing nurses for climate change and digital transformation. With global health funding under pressure and shortages persisting in many countries, ICN’s ability to unite nurses across very different health systems will be tested. Its effectiveness will depend on whether it can turn global commitments into real change in countries, and whether nurses on the front line see it as speaking for them.
ICN in numbers
- 1899: the year ICN was founded
- 130+: national nurses associations in membership
- 28 million+: nurses represented through those associations
- 12: members of the 2025–2029 Board
- 4 years: the length of a Board term
- 2 years: the interval between ICN Congresses
Behind each of these numbers are nurses who volunteer their time, often after long shifts, to serve on committees, draft position statements and represent their colleagues. Their work keeps nursing visible where decisions about health are made.
Frequently asked questions
Can I join ICN as an individual nurse?
Generally no. ICN’s members are national nurses associations. You connect to ICN by joining your national association.
Who is the current ICN President?
José Luis Cobos Serrano of Spain, elected for 2025–2029.
Who is the ICN CEO?
Howard Catton has been ICN’s Chief Executive Officer since 2019.
Is ICN a regulatory body?
No. It does not register or discipline nurses. Regulation is done by national or state bodies.
When was the ICN Code of Ethics last updated?
The current version was published in 2021.
But does ICN really change anything for ordinary nurses?
Change at global level is slow and often invisible. But ICN’s work has helped put nursing on the agenda of health ministers, secure the creation of senior nursing posts in government and at WHO, shape ethical recruitment rules, and give nurses’ associations evidence and support to push for change at home. Its influence depends on its members, and its members’ strength depends on nurses joining and participating. The stronger your national association, the louder ICN’s voice, and yours.
Your next step: Find out whether your national nurses association is an ICN member, and download the ICN Code of Ethics for Nurses to share with your team.
Related: State of the World’s Nursing 2025 · Sigma Nursing’s leadership change
Sources: International Council of Nurses (organisation, Board elections 2025, Congress 2025, Code of Ethics for Nurses 2021, definitions of nursing 2025), World Health Organization, State of the World’s Nursing 2025.
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