Nursing power and technological empowerment for better health

Howard Catton Chief Executive Officer, International Council of Nurses

The accelerating pace of population aging, the rising burden of chronic and non-communicable diseases, the increasing frequency of public health emergencies, and the growing imbalance and structural shortage of global healthcare resources are intensifying challenges. In the field of nursing, in particular, the latest State of the World’s Nursing Report [1] highlights that, although the current global number of nurses is approximately 29.8 million, a severe shortage of 5.8 million remains, and many countries experienced no growth in their workforce from 2020 to 2023. It is estimated that by 2030, there may still be a shortage of 4.1 million, and reducing this shortage to a more manageable level would depend on urgently increasing the nursing workforce. This means that the global health system is entering a critical period characterized by rapidly growing demand, limited supply, and an urgent need for structural reform. To meet growing health needs, decisive investment in retaining, expanding, and supporting the nursing workforce is needed, which must include enabling and empowering nurses with digital technology. Technology-enabled nursing is becoming an essential embodiment of a country’s health governance capacity, healthcare system resilience, and quality of social development. Nurses cannot be seen as passive implementers in the care delivery chain: they are a core force driving healthcare system reform, improving service efficiency, and strengthening population health.

1. Growing global healthcare pressure makes system transformation imperative

Despite changes in disease patterns and population structure, most global healthcare systems remain hospital-centered and treatment-oriented, which makes them insufficient to meet the increasing needs for chronic disease management, long-term care, and holistic prevention. As disease complexity and patient care cycles increase, concentrating healthcare resources primarily on inpatient services and costly medical interventions can lead to increased medical expenditures and heightened workloads for healthcare professionals, thereby increasing the risk of burnout. As outlined in the International Council of Nurses (ICN)’s report on nursing and primary health care (PHC), a health system transformation towards PHC, with whole-of-society integrated health services accessible to all, is critical to achieving health goals [2]. Nurses are the largest health professional group with the broadest coverage and closest patient contact, and not only provide treatment, but also play critical roles in disease management, risk assessment, continuity of care, quality control, rehabilitation guidance, and health education. The quality and efficiency of healthcare systems largely depend on whether the nursing workforce can realize its full potential with adequate capacity, institutional support, and policy backing. Therefore, healthcare system reform should not be limited to infrastructure expansion and professional growth, but should also focus on the structural improvement of nursing practice in health systems, management, education, and the development and use of technology.

2. The digital wave is driving profound changes in nursing models

COVID-19 catalyzed the global adoption of digital healthcare. In some countries, telehealth use increased by 766 % within three months, while virtual education rapidly became mainstream. Electronic health records, smart devices, AI-assisted decision-making, and online continuing education have all been increasingly widely adopted. When designed and used appropriately, digital handover processes, electronic nursing documentation, and intelligent early warning systems can help improve the speed of information transfer and reduce repetitive manual work, allowing nurses to devote more time to patient care and clinical leadership. Remote monitoring, virtual follow-up, and digital education extend nursing beyond hospitals, supporting transitions from short-term inpatient treatment to long-term health management and improving patients’ self-management and adherence. When done right, nursing digitalization can support nurses as leaders and key contributors to clinical judgment, health management, and system-level support, marking an expansion of roles and an elevation of status for nursing within the healthcare system. Digital tools can never replace nursing, but they can enable the full expression of nursing's professional value.

3. Advanced practice nurses become a key force in technology-enabled nursing

In many countries, Advanced Practice Nurses (APNs) have become a vital human resource, supporting the transformation of healthcare service models. The State of the World’s Nursing report confirms that 62 % of countries now have established APN roles, with APNs especially prevalent in lower-income regions with limited medical resources. APNs can significantly improve service accessibility, enhance health outcomes, and increase the capacity of the health system [2]. APNs are a fast-growing professional group in digital and intelligent healthcare systems, providing clinical care, diagnosis, risk assessment, care decision-making, cross-team coordination, and telehealth services. However, many countries still face challenges, such as a limited scope of practice for APNs, insufficient compensation mechanisms, inadequate education systems, and a lack of policy support, all of which prevent nursing from fully contributing to health outcomes. In the era of technology-enabled nursing, we must ensure institutional and policy safeguards that expand the professional autonomy of advanced nurses. By positioning nursing at the core of community health, disease prevention, chronic disease management, and digital healthcare, working in collaboration with health care teams, the profession can become a key solution to the challenges of limited healthcare resources combined with rapidly growing healthcare demands.

4. Nursing education must embrace new demands for digital competency

Technology-enabled nursing requires an education system that can produce nursing professionals ready to respond to current and future healthcare needs. Global nursing education is shifting from skill-based training to comprehensive competency-based development in areas such as clinical reasoning, data literacy, digital competence, remote communication, and interprofessional collaboration. The Global Strategic Directions for Nursing and Midwifery [3], which were extended by WHO member states to 2030, explicitly state that nursing education must support the use of digital technologies as well as digital learning. Digital infrastructure construction, digital curriculum development, continuing education enhancement, and faculty capacity building, must cover initial nursing education, post-graduate training, and career advancement. In terms of educational philosophy, digital health should not be treated as an add-on technical course, but as a core component of nursing competency. In practice, teaching must align with digital clinical environments to avoid a disconnect between advanced classrooms and outdated clinical settings. Instructors must not only teach but also demonstrate, guiding students to apply digital tools in analyzing clinical problems and addressing real cases. Educational reform will determine the extent of nursing digital development, future professional competitiveness, and the depth and practicality of technological integration into nursing.

5. Case study: China’s digital nursing development path

China provides an example of demonstrated value in digital nursing for chronic disease management, community health, home-based care, and ongoing patient support. Through initiatives leveraging digital platforms such as WeChat, patients can record their blood pressure, blood glucose levels, changes in symptoms, and daily health behaviors at home. Meanwhile, nurses can perform assessments, follow up, provide education, issue risk alerts, and implement interventions through the platform, thereby significantly improving health system efficiency. Nurse-led digital management models can reduce emergency visits, lower the risk of readmission, and enhance treatment adherence and self-management, particularly benefiting long-term patients, individuals with limited mobility, or residents in areas with insufficient medical resources [2]. This example from China demonstrates a transition from hospital-based treatment to integrated hospital–community–home health management, offering valuable experience on expanding service coverage through the integration of nursing and technology under resource constraints.

6. Technology can enhance nursing, but cannot replace its human core

Although digitalization, artificial intelligence, and telemedicine are reshaping healthcare systems, the essence of nursing remains in care, trust, judgment, and effective communication. Technology can optimize processes, improve efficiency, and support prediction and early warning; however, it cannot replace nurses’ valuable perception of complex patient emotions, their understanding of family difficulties, or their ability to help patients transform “knowing” into “doing” through behavioral support. The future of healthcare is not about technology replacing the profession, but rather about integrating technology with nursing expertise. Digital care should not be used to substitute or reduce nursing, but instead enable nursing value to be more fully realized. As technology advances, nursing must maintain its human-centered core.

Technology-enabled nursing is not a technical engineering project, but can become concentrated expression of a country’s governance capability, healthcare system, and workforce maturity, as well as professional development level. Nursing is the core force connecting hospitals, communities, families, and individuals; technology is a key engine that can release this power and expand health outcomes.