Barbara M. Dossey, PhD, RN, AHN-BC, FAAN discusses the Nightingale Initiative for Global Health.

by Barbara M. Dossey, PhD, RN, AHN-BC, FAAN

“We must create a public opinion, which must drive the government instead of the government having to drive us….an enlightened public opinion, wise in principle, wise in detail.” Florence Nightingale, 18921

What a thrilling and challenging time to be a nurse—local to global. Nurses are expanding their understanding related to the legacy of Florence Nightingale (1820-1910) and their important role as 21st century Nightingales and global citizens.2,3,4  Nurses’ knowledge, expertise, and skills are crucial to creating a healthy world by 2020. Nightingale, recognized throughout the world as the philosophical founder of modern secular nursing, is clearly an epic example of global nursing. Actively engaged in one geographic area, she was simultaneously gathering and analyzing data from other areas of world conflict and always envisioned what a healthy world might be.

The Nightingale Initiative for Global Health (NIGH)5 is a nurse-led, grassroots global initiative that reflects the growing commitment of nurses and concerned citizens of all nations—to call for the commitment of all governments—to place the health of the people as a first priority of policy and action. In 2007 my Nightingale Initiative for Global Health (NIGH) colleagues (* See Acknowledgements) and I launched the Nightingale Declaration, the first global nursing Internet signature campaign. We seek to achieve the improved health of persons, locally and globally—as the first concern of citizens everywhere. Nurses and other health workers in communities worldwide presently carry an unequal and impossible burden of this essential and fundamental human goal.

Please go to By clicking on the box on the right side of the screen and signing the Nightingale Declaration for Our Healthy World by 2020 that is seen below, you will join over 17,500 citizens from 86 countries that includes over 1,000 organizations representing millions of their constituents worldwide, who have answered this call.


“We, the nurses and concerned citizens of the global community, hereby dedicate ourselves to achieve a healthy world by 2020.

We declare our willingness to unite in a program of action, to share information and solutions and to improve health conditions for all humanity—locally, nationally and globally.

We further resolve to adopt personal practices and to implement public policies in our

communities and nations—making this goal achievable and inevitable by the year 2020,

beginning today in our own lives, in the life of our nations and in the world at large.”


Source: Used with permission of the Nightingale Initiative for Global Health, 2007. Available at

To that end, the Nightingale Initiative for Global Health (NIGH) is engaging in transdisciplinary dialogues for partnership. We are collaborating with nurses, midwives, related professionals and allied healthcare providers and other concerned citizens throughout the world. With focus on connection rather than specialization, NIGH is building a diverse and committed global network for addressing this challenge and implementing our objectives for education, empowerment and support during the upcoming decade. 

Why this Nightingale Declaration? Signatures representing all 193 Member States of the United Nations will lay the foundation for accomplishing the adoption of two United Nations Resolutions that will be presented to the 2008 UN General Assembly declaring 2010: International Year of the Nurse and 2011-2020: United Nations Decade for a Healthy World.  The year 2010 will be the Centennial of Nightingale’s death, and 2020 will be the Bicentennial of Nightingale’s birth.

With these proposed UN Resolutions bringing visibility, recognition and value to nurses and healthcare providers, this action not only empowers them, but raises public awareness as to the crucial connection between empowered nurses and professional and allied healthcare workers and the health of people everywhere.

In 1880 Nightingale began to write that it would take 100-150 years before with educated and experienced nurses would emerge to change healthcare. Nurses today are that generation of 21st-Century Nightingales who have arrived to collaborate with others to transform healthcare.

Nightingale’s work was social action that demonstrated and clearly articulated the science and art of an integral worldview for nursing, healthcare and humankind. Her social action was also sacred activism,6 the fusion of the deepest spiritual knowledge with radical action in the world.

When we feel overwhelmed in our work and life, we can reflect on what Nightingale did without so many bright, innovative colleagues, professional nursing organizations, and the information superhighway.  If  she achieved what she did with her handwritten letters, publications, and networking men in power, can you imagine Nightingale with a laptop computer, cell phone, fax, messenger recorder,  E-mail, Medline, Internet, CD ROM, and the information superhighway!

Together, nurses are collectively addressing human health—of individuals, of communities, of environments (interior and exterior) and the world as our first priority. Nurses are educated and prepared at the physical, emotional, social, mental, and spiritual levels to effectively accomplish the activities required—on the ground—to create a healthy world. Nurses are key in mobilizing new integral and holistic approaches in health education and healthcare delivery in all areas of healthcare.2,3,4 Solutions and evidence-base practice protocols can be shared and implemented around the world through dialogues, the Internet and publications.

Outside of nursing, there continues to be minimal understanding and recognition related to the depth of nurses’ knowledge, expertise, and critical-thinking capacities and skills for assisting others in achieving and maintaining health and well-being. We are faced with a changing picture of global health due to globalization that knows no natural or political boundaries. Increasing our understanding of global health through the exploration of health principles, new partnerships and relationships with other nurses globally, we better understand that health becomes an essential component and expression of global citizenship. Health is a basic human right and a global good that needs to be promoted and protected by the global community.

According to the International Council of Nurses (ICN), there are currently 13 million nurses and midwives engaged in nursing and healthcare  around the world.7 Severe health needs exist in almost every community and nation throughout the world. Thus, all nurses are involved in some aspect of global health and healing endeavors to assist individuals and nations to become healthier. To have a healthy world we must have healthy people and healthy environments. Nursing shortages are now critical and epidemic worldwide. The problem is serious, complex and is impacting health and well-being across the globe. Nurses are the heart and soul of healthcare and they need more support. Overcoming this nursing shortage crisis will require exceptional advocacy and leadership. Like Nightingale, the Nightingale Initiative for Global Health believe that partnerships are key to improving health around the globe. They can ensure that we transcend national borders, unify healthcare disciplines, and create healthy communities.       

Standing alongside Nightingale, each of us has an opportunity—right now—to use our power to make a difference. In 1893, Florence Nightingale wrote: “Health is not only to be well, but to use well every power we have.”8


* Portions of this article are reproduced with permission from the Nightingale Initiative for Global Health (NIGH). I honor my NIGH colleagues and NIGH Founding Board Members Deva-Marie Beck, PhD, RN, Cynda Rushton, PhD, RN, FAAN, Eleanor Kibrick, MS, Wayne Kines, William Rolph MLS, as we move forward with our vision to create a healthy world by 2020.


1. F. Nightingale, Letter to Sir Frederick Verney. 23 November 1892, Add. Mss. 68887 ff 102-105.

2. B. M. Dossey, L. C. Selanders, D. M. Beck, and A. Attewell, Florence Nightingale Today: Healing, Leadership, Global Action, (Washington, DC: NurseBooks.Org, 2005).

3. B. M. Dossey, D. M. Beck, C. H. Rushton,  “Nightingale’s Vision for Collaboration.” In S. Weinstein, A. M. Brooks, eds. Nursing Without Borders: Values, Wisdom and Success Markers, (Indianapolis, IN: Sigma Theta Tau, 2008), 13-29.

4. B. M. Dossey, & L. Keegan. Holistic Nursing: A Handbook for Practice (5th ed). Sudbury, MA: Jones and Bartlett, 2008.

5. Nightingale Initiative for Global Health. Nightingale Declaration. Accessed July 5, 2008, at

6. A. Harvey, Sacred Activism, Accessed July 18, 2000,

7. International Council of Nurses (ICN), The Global Shortage of Registered Nurses: An Overview of Issues and Action, (Geneva: International Council of Nurses 2004), Accessed April 1, 2007, at

8. F. Nightingale, 1893 Essay “Sick-Nursing and Health Nursing.”  In B. M. Dossey, L. C. Selanders, D. M. Beck, and A. Attewell, Florence Nightingale Today: Healing, Leadership, Global Action, (Washington, DC: NurseBooks.Org, 2005, pp. 288-303).