In last month's RCN International Nurses' Day film, we said that we stand with nurses everywhere. At the RCN Institute of Excellence, and particularly within the International Academy, we take that quite literally.

'Everywhere' includes places many people never think about. Places absent from reports, disconnected from higher education institutions, geographically isolated, professionally overlooked. Places where a small number of expert nurses hold health care together.

The nurses working in the UK’s Overseas Territories (UKOTs) fit exactly into this description.

The UKOTs are territories constitutionally linked to the UK. The King remains their head of state, but they are not part of the UK itself. They usually have their own governments, laws, and local administrations, while the UK continues to provide technical support to their health systems; this is where the RCN fits in.

As part of the support offered by the UK Health Security Agency to the UKOTs, the RCN was invited to contribute specialist nursing expertise, working across time zones and oceans to support nurses in the UKOTs.

What began as support from the RCN's Professional Lead for Forensics and Prison Nursing for prison nurses in St Helena, Montserrat, Anguilla and the British Virgin Islands quickly revealed a much wider set of nursing needs.

Across these territories, and despite working oceans apart, nurses described similar realities: profound professional isolation, limited access to education and development, fragile workforce structures, and the emotional weight of being expected to hold nursing together with very limited support and even less recognition.

In some examples, nursing has been treated as an afterthought rather than a core part of health system planning.

There is no meaningful data about nursing in many of these territories within the WHO and ICN's State of the World's Nursing report. In many of the UKOTs, higher education institutions are educating future nurses, and access to professional development can depend entirely on external support and unstructured opportunities.

Even geography is against them: to reach St Helena, for example, travel often requires flying via South Africa or Namibia. Flights can be infrequent for weeks at a time. Recently, a problem with the airport's fire engines left the island effectively cut off for two weeks. That level of isolation changes what nurses have to do and reframes resilience across the health sector.

During a virtual meeting with the British Virgin Islands team, the RCN team of specialists was given a point-of-view tour of the emergency department via a mobile phone camera. This was an extraordinary reminder of how technology can collapse distances – we were taken to the other side of the world. We followed a patient's pathway through the ED, discussed strengths and opportunities, and co-created improvement plans.

In another meeting, with cameras turned off, one nurse quietly said after a period of silence, which I didn't know was about poor internet or reflection time: "No one cares about nurses, but we are the ones doing everything. We are the ones always there, and no one cares."

That sentence has stayed with me for a while. We've all felt that – we've all finished a shift where we gave our all, and at the end, there is this sense of fulfilled duty without recognition, and we take it because it's our duty, and what matters is the patient and keeping things together.

Then there comes a time when we have been through enough to think, ‘Hold on a minute. How much longer am I holding it together quietly? How much longer am I going to be 'resilient' and get my team through hardship without resources, education, praise, or a raise?’ We've all been here. Most experienced nurses have felt this at some point – remember the clapping?

However, behind our common challenges sits an inalienable truth: some of the most resourceful, adaptive and committed nursing practice in the world exists in places the wider profession rarely sees. And perhaps the most important lesson from this work is this: we are not "teaching" these colleagues how to be nurses, we are working collaboratively toward shared solutions.

These nurses work in environments where specialist backup may not exist, where transfer pathways are uncertain, where resources are stretched beyond imagination, and where the nurse is often the constant thread holding services together.

In many larger health care systems, conversations about nursing leadership and professional recognition can become abstract. In the Overseas Territories, they are immediate and deeply human.

Who advocates for nurses when there is no infrastructure around them?

Who supports professional development when there are no universities nearby?

Who notices burnout when teams are tiny, and everyone is indispensable?

And who records these experiences if global reports fail to capture them? Or captures them under the term 'health care' when, actually, ‘health care’ often means ‘nurses’. Without them, it ceases to exist.

This work started as professional support.

It has become something much more important: a reminder that nursing cannot be understood solely through large systems, major institutions, or metropolitan centres.

Some of the most important lessons about the future of nursing are emerging from places the world barely notices.

As global nurses, we should listen carefully to the voices from everywhere and pay attention.