President’s Message
Dear EFN Members and Colleagues,
Since July 1st 2025, Denmark has taken the rotating chair of the Presidency of the Council of the EU, to be followed by the Cyprus Presidency and the Irish EU Presidency. In preparing these presidencies from an EFN perspective, the EFN lobby work in Brussels with MEPs, the Commission and the Permanent Representation is key. Therefore, these are exciting policy times in Brussels and in the Member States, with plenty of policy window opportunities for EFN and its members to positively influence key EU policies and legislation for the benefit of all EU and European nurses! For many years now, EFN is leading impactful change where needed, but also stability, especially when it comes to the Directive on Mutual Recognition of Professional Qualifications: EFN members agree that it is crucial to maintain the high level of nursing education.
Furthermore, building on the EFN data collected on Cybersecurity, at the April 2025 GA in Brussels, EFN has now more evidence from the EFN members on making the EU Action Plan for the Cybersecurity of Hospitals and Healthcare Providers a realistic and deployable tool! Cybersecurity is one of the key lobby priorities for the EFN as nurses frontline work will be affected when a cyberattack takes place. Nurses need an alternative plan in order to continue working safely. EFN members input to the Commission consultation was therefore key.
We have now also more evidence from the European Semester. EFN lobby in DG SANTE to get nurses data in and making sure the Directive 2013/55/EU sets the scene for this EU data collection, gives EFN members the power to negotiate their priorities at National level, mainly within the Recovery and Resilience Facility! EFN members appreciated this detailed feedback.
In addition, the Danish Presidency of the Council of the EU is working towards the implementation of the European Health Data Space (EHDS) Directive, and the review and implementation of the European Pillar of Social Rights Action Plan, both key policy files which the EFN has been lobbying on for years now, contributing to its success, especially when it comes to EFN priorities: access to healthcare, education and LTC. EFN priorities are clear: investing in the domestic EU nursing workforce is the only way to ensure the Safe-Staffing Levels which are key to patients’ safety and the resiliency of the European Health systems. Without highly qualified Bachelor nurses, in compliance with the Directive 2013/55/EU, we cannot be ready to face future health crises in the EU and Europe. Finally, EFN’s priority till March 2026 is the European Parliament SANT Committee Own-Initiative (INI) Report on the healthcare workforce shortages in the EU. EFN, together with the Standing Committee of European Doctors (CPME) and the Pharmaceutical Group of the European Union (PGEU), and the European Federation of Public Service Unions (EPSU) as key leader in Social Dialogue, is pushing all political parties to sign up to the joint-statement focusing on the three Rs. To get concrete outcomes, we need to focus down our lobby activities and push for Safe Staffing Levels, including APN. These developments are crucial to the co-design of EU legislation and to establish a bottom-up approach to EU health policy development.
With my warmest regards,
Aristides Chorattas
EFN President
News from EFN
EFN Autumn General Assembly
The EFN Members met in Dublin (Ireland) for the 121st EFN General Assembly, where key EU policy topics, having a huge impact on nurses and the nursing profession were discussed, as: the EMPL-SANT Joint INI Report on the Health Workforce; the European Semester 2025; the 2025 Danish Presidency of the Council of the EU and the upcoming Cypriot Presidency; EFN Advanced Practice Nurse developments; and the European Commission priorities impacting on the nursing workforce. The EFN members discussed and approved EFN Policy Statements on ‘the Union of Skills’, ‘Nurse Educators’, ‘Key Role of Nurses for Preparedness’, ‘Long-Term Care Workforce Challenges’, ‘The next EU Multiannual Financial Framework’, ‘The Data Union Strategy’. Investing in EU domestic nursing workforce capacity building and development is key for EU preparedness to any crisis. But you cannot tackle the shortage of nurses without investing in the development of qualified nurse educators. Next to that, with an ageing population, Long-Term care plays an increasingly crucial role. However, there is currently a shortage of registered nurses in the long-term care workforce, and this puts into question its sustainability, quality, and safety. The discussions and Policy Statements endorsed by the EFN Members are therefore key to achieve the EFN policy objectives and developments, as outlined in the EFN SOLP 2021-2027, to impact the EU policy process.
Furthermore, as the international community prepares for the rebuilding of Gaza, the EFN members found it important to have an EFN statement on “Rebuilding Gaza – A call for nurse-led recovery and sustainable health systems”, showing the European nursing community solidarity with the nursing colleagues and all healthcare professionals who have served with courage, compassion, and humanity under unimaginable conditions. The EFN statement urges that nurses in Gaza are fully supported and recognised as key partners in the reconstruction process. Their participation must be ensured at every level — from policy planning to implementation.
Finally, the EFN members welcomed a new EFN Executive Committee and two new EFN Members (from Moldova & Poland).
The next EFN General Assembly will take place in Cyprus, on 16-17 April 2026, during the Cyprus EU Presidency.
European Semester 2025 Spring Package
The 2025 Spring Package is part of the European Semester, the EU’s tool for coordinating and monitoring economic and social policies. Its country reports analyse economic, employment, and social developments in each Member State, identifying obstacles to national competitiveness and prosperity. The 2025 Spring Package calls on Member States to enhance the resilience of their health systems through greater investment in prevention and primary care. It also advocates for stronger social protection measures to support the achievement of the EU’s 2030 poverty reduction targets.
After years of effective EFN lobbying, the European Commission and Eurostat are now referring in the European Semester Country Reports specifically to practising nurses, who are compliant with the education and qualification standards set in the EU Directive 2013/55/EU. Now, let’s hope the ILO will follow! Stats: Despite the variations in density, all Member States, including Finland, have reported shortages of nurses! On average between 25-30% of the nursing workforce is 55 years old or more, with peaks in Poland (66%), Bulgaria (40%), Lithuania (35%), Latvia (34,4%).
EMPL-SANT Joint INI Report on the Health Workforce
The EFN Brussels Office has been lobbying the co-rapporteurs shadow rapporteurs of the EMPL and SANT Committees to get the EFN professional priorities into the INI Report. The EFN is closely working with CPME and PGEU, the sectorial professionals in the Directive 2013/55/EU, as well as with EPSU and EBN. However, it will be difficult to find compromises between S&D, RENEW, ECR and the Patriots for Europe with probably the EPP somewhere in between. If the INI report fails, healthcare systems will fail! So, we need to keep on pushing and pushing, and limit our priorities: it is better to have one bird in the hand than ten in the sky!
The EFN Brussels Office met all MEPs writing up the INI report, lobbying based on the EFN Position Statements agreed by the EFN members, especially those on Safe Staffing Levels, on Recruitment, on Directive 2013/55/EU.
EFN involvement in EU Projects
> BEWELL – BeWell project, of which the EFN is a partner of, bringing the nurses’ views in the ongoing developments, has just launched a shorter version of the Open Public Consultation, to make it easier for healthcare professionals to engage considering their heavy workload. This which will be key for the development ofthe second version of the BeWell Skills Strategy (Version 1 – available in 9 languages).The piloting of the BeWell Learning Platform – which provides training programs/courses (MOOCs) on digital & green skills, including the 2 EFN Courses on Digital Skills and on Green Skills, is nearing the end. The EFN MOOCs have received the greatest interest by the participants testing the system. The feedback has been very positive, underlining the quality and utility of the content for the daily work of frontline healthcare professionals.
> KEEPCARING – The KeepCaring project is aiming at (re-) building wellbeing and resilience of healthcare workforce in EU hospitals by co-creating a multi-faceted non-digital, digital and AI-supported solution package to prevent burnout among healthcare professionals on the individual, team, and organisational level. Among different interventions, KeepCaring is testing whether deep relaxation using Virtual Reality before working is an effective and cost-effective intervention to mitigate stress and help promote resilience. Furthermore, KeepCaring will: study stress and stressors experienced by (aspiring) health care providers in their specific setting; evaluate digital and non-digital solutions to reduce stress at an individual and team level; study job crafting among (aspiring) health professionals as a way to reduce stress, and finally; develop a change management platform that, using explainable AI, helps hospital managers as well as surgical caregivers to choose the solutions that match their context.
> ICUData4EU – The project is aiming at addressing the challenges that Intensive Care Units (ICUs) are facing, such as aging society, combined with a shortage of specialised staff, with the possibility to also address crisis situations, such as future pandemics or wars. The EFN has supported the identification of key end users’ requirements for the ICUDATA platform. The platform must: Be Reliable, enabling Fast Access to Data in Crisis Situations; Support ICU Staff with Data-Driven Insights – it must reduce the administrative burden on frontline nurses; Enable Hospital-to-Hospital Data Exchange – International Classification for Nursing Practice (ICNP) must be integrated as common terminology; Allow easy Access to New and Relevant Information.
NURSING ACTION
- EFN Policy Brief on Safe Staffing Levels – In the context of the WHO Nursing Action, EFN developed a Policy Brief on Safe Staffing Levels by conducting a literature review and a mapping with the EFN Members. As a result, EFN developed the following key recommendations: Legislate safe nurse staffing levels to ensure the safety of patients and nurses; Define and enforce safe staffing levels to sustain high-quality patient care standards across the EU and Europe; Establishing effective and sustainable strategies to develop safe staffing levels in the EU and Europe is a priority; The emphasis on safe staffing frameworks, regulations, and professional judgment in addressing recruitment and retention challenges is vital; Safe nurse staffing is an incentive to attract nurses, aid recruitment and retention, and reduce reliance on unethical recruitment practices; The EU and Europe will need to reach a tipping point where safe staffing levels are the enforced standard rather than the exception.
- EFN Policy Brief on Mentorship – In the context of the WHO Nursing Action, EFN developed a Policy Brief on Mentorship by conducting a literature review and a mapping with the EFN Members. Mentorship is a cornerstone of professional development in nursing education, bridging the gap between theoretical knowledge and clinical practice. It provides nursing students with essential guidance, support, and opportunities to develop their skills in real-world settings. Beyond enhancing the educational experience, mentorship fosters professional growth, facilitates socialization in the nursing role, and contributes to improved patient care outcomes. However, despite its recognised importance, the practices and effectiveness of mentorship vary significantly, shaped by institutional structures, cultural contexts, and the dynamics between mentors and mentees. The barriers to mentorship developments include time constraints, heavy workloads, and a lack of experience and knowledge among mentors, making it difficult to effectively balance their responsibilities to both students and patients. Furthermore, a lack of support from professional networks and insufficient recognition of the dual roles the mentors play contribute to feelings of isolation and stress. To overcome these barriers and fully realize the potential of mentorship programs, it is essential to identify the obstacles and implement appropriate strategies to address them.
News from the EU
The Danish Presidency of the Council of the EU
The Danish Presidency of the Council of the EU, which began in July 2025, is supporting several ongoing initiatives, including the action plan for implementing the European Pillar of Social Rights, the Quality Jobs Roadmap, the EU Gender Equality Strategy, the EU LGBTIQ Equality Strategy, and the Directive on combating violence against women and domestic violence. Other initiative includes supporting the future of ageing and long-term care, and developing new strategies for quality, accessibility, and improved working conditions. In health, the Presidency aims to strengthen EU preparedness.
The European Commission DG SANTE launched a new EU Health Union Fellowship on 10 February 2025, with a ceremony in Bruges, under the motto ”Health Unites Us’’. This training program aims to unite public health experts from across the EU Member States to learn, exchange knowledge and collaborate on key health topics like digital health. Fellows, nominated by national authorities, will receive training from a team of highly experienced mentors and renowned experts. This first edition, named after RNA pioneer Katalin Karikó, runs until September 2025. It is key that EFN members influence the Ministry of Health to nominate a nurse to become fellow!
European Commission actions on Preparedness
The new EU Preparedness Union Strategy sets out 30 actions to better prevent and respond to crises, from pandemics to climate disasters and cyber threats. The Strategy promotes an “all-hazards” and “whole-of-society” approach, proposing measures such as strengthening essential societal functions, establishing an EU Crisis Hub, and improving foresight capabilities. The Commission’s review of the Health Emergency Preparedness and Response Authority (HERA) reaffirms its key role in strengthening EU-level coordination, stockpiling, and pandemic response. The report calls, amongst other things, for a deeper Member State engagement to reinforce Europe’s health security architecture.
A new Pandemic Agreement – WHO Member States concluded negotiations on a landmark pandemic agreement. The proposal includes commitments to equitable access to health countermeasures, technology transfer, a skilled global health workforce, and a coordinated financial mechanism.
Publications – EFN Articles
The European Parliament SANT Committee Own Initiative Report on EU Nursing Workforce Shortages – This Article identifies the key professional topics that should be part of the Own Initiative Report developed by the European Parliament SANT and EMPL Committees, which looks into the ongoing healthcare workforce crisis in the European Union and Europe. The emphasis on the three Rs Square (3R²) is a key input to the Own Initiative Report: “Recovery and Resilience Facility”, “Recruitment”, and “Retention”. A specific focus is on safe staffing levels, mentorship of nursing students, EU financing mechanisms, and zero tolerance for violence in addressing recruitment and retention challenges in all EU Member States. Furthermore, we must move from endless EU recommendations, Joint Actions and awareness-raising to concrete, implementable actions that provide more nurses at the bedside. We need more highly qualified and motivated nurses at the bedside, and we need them now. Therefore, it is key that nurses engage with policymakers and stakeholders to advocate for effective and sustainable solutions to the health workforce crisis, such as increasing investment in education, training, and retention of nurses and ensuring fair and ethical recruitment practices across countries.
Integrating Nurses into Cybersecurity Governance: Assessing Preparedness in European Healthcare Systems – Although nurses play a crucial role in cybersecurity within healthcare systems by acting as the first line of defense against cyber threats, the findings supports the assumption that the role of nursing staff within cybersecurity has not yet been fully recognised and potential synergy effects have not yet been fully exploited. Supporting the education and training of nursing staff in digital and cybersecurity skills is therefore key. Standardised, compulsory and regular cybersecurity training for nurses in their respective healthcare institutions/hospitals are needed based on an EU-level cyberattack contingency plan for the healthcare sector.
EFN Preparedness Article in Open Access Government – The way forward to be better prepared for upcoming crises – To ensure that the EU is better prepared for future health emergencies, EFN recommends continued investment in the nursing workforce. This includes improving working conditions, ensuring adequate staffing, expanding access to training, and integrating emergency preparedness into nursing curricula. Strengthening the role of nurses is essential not only for effective crisis response but also for building resilient health systems across Europe. Therefore, it is key that the European Commission does something concrete with the Policy Dialogues, and the European Parliament can push the Commission to take concrete actions. The EP Intergroup on ‘Resilience, Disaster Management and Civil Protection’ is therefore a key policy platform to engage with from a nurse’s perspective. This Intergroup can foster good practices for an enhanced model of civic engagement, to build a stronger resilience in the EU and Europe, and to develop a European civil defence industry, which is key for the EFN. EFN’s focus on disaster management and civil protection across the EU and Europe becomes, therefore, a political priority.
Strengthening Healthcare through Safe Staffing Levels: A European Policy Perspective on Safe Nurse-to-Patient Ratios and Workforce Sustainability – Safe staffing levels (SSL) are essential to ensuring patient safety, nurse well-being, and health system resilience. Although a strong evidence base links nurse staffing to care quality, legislative and policy approaches across Europe remain inconsistent and fragmented. The EFN Study results highlight major gaps between policy aspirations and implementation. While progress is evident, many European countries still lack robust legal and institutional frameworks to ensure safe staffing. Strengthening SSL governance requires harmonisation, enhanced data systems, and greater involvement of the nursing profession in shaping policy. Safe nurse staffing is not only a workforce issue but a public health imperative. Without binding legislation, transparent mechanisms, and the active involvement of nurses in shaping policies, European health systems will continue to face risks to care quality, nurse well-being, and patient safety. This study provides a data-driven and ethically grounded call to action: policymakers, healthcare leaders, and professional bodies must move from aspiration to action, ensuring that every patient receives care from an appropriately staffed and qualified nursing workforce.
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