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To concur is nursing, but to disagree is divine

  • Nurses need to learn how to challenge each other to improve practice and their profession
  • It’s perfectly acceptable to disagree with another professional, as long as you are respectful and constructive in your challenge
  • We should be comfortable at asking even our senior leaders who, what, where, when, how and why
  • Don’t argue for argument’s sake
  • Stand up for nursing, as you are the only ones who will


It is OK to say you don’t agree. I think sometimes nurses in particular shy away from challenging each other or debating topics. And I am not sure why.

This week at the Queen’s Nursing Institute’s annual conference, which was superb by the way, a Queen’s Nurse came to me in one of the breaks to ask me why nurses aren’t good at putting forward their argument in an articulate way.

I have witnessed nurses getting quite prickly about disagreeing with each other – both in the conference room and in practice. But the route to better practice and improved outcomes and experience for patients is to share, challenge and debate what’s best for the patient and the profession. All nurses should be more confident at doing that.

”People have raised eyebrows at my challenges in recent months”

People have raised eyebrows at my challenges in recent months to the senior nursing leaders about speaking out over the key issues that are pummelling the profession at the moment – the nursing associate, the removal of the bursary, the cuts to CPD registration, the closure of the nursing and midwifery policy advisory unit at the Department of Health. Many of these have happened without a word from some senior nursing leaders, and I’ve asked - why is that?

Isn’t it right that we question what the impacts of these changes will be on nursing and those who receive care from nurses? Is it really that impolite or impudent of me just to ask a question? To ask: “What do you think? What’s your plan B? Have you thought about the risks? And what’s being done to make sure this goes well?”

”Is it really that impolite or impudent of me just to ask a question?”

Aren’t we all right to question each other openly and request opinions, thoughts and contingency plans – particularly from those who are our professional leads?

To my mind, we should all be a bit more comfortable at asking why, saying “I don’t agree” and putting forward an opposing view.

”I’ve seen some people who hang out on Twitter, waiting to be offended”

Of course, there is a fine line. I’ve seen some people who hang out on Twitter, waiting to be offended who are keen just to do some 140-character sparring just for sparring’s sake. That doesn’t help anyone either.

Challenge, put forward ideas and don’t just knock others’ suggestions down without having an idea of how to improve it, or why it won’t work.

Challenge must be professional, responsible and respectful.

Nursing is changing beyond recognition, and unless nurses themselves get a lot more articulate and a lot better at influencing the agenda, they will lose control over the things that matter most to them.

Sometimes we are all guilty of arguing about the wrong things or losing sight of the bigger picture. It’s easy to do. We are human – and busy, stressed humans at that. But if nurses want nursing to make a difference, they must stand up and be proud, challenge the changes coming their way, shape them to improve them (or in some cases minimise their damage) and understand how to make a case for their contribution and value.

If nurses don’t, then who else will?



Readers' comments (2)

  • I have over 40 years experience in nursing and have seen many changes. I have a wealth of experience working as HCA and as a RGN in NHS and Non NHS areas and also recognise the daily challenges we meet requires a willingness to continue to learn and develop and part of that is being prepared to listen to the opinions and challenges of our colleagues, junior and senior. Being afraid to voice an opinion or to challenge others can be dangerous and lead to the problems a number of NHS Trusts, Charities and Private Sector Organisations have encountered over recent years. I have seen nurses who have expressed differing opinions to senior colleagues labelled as disrespectful or confrontational, being told they don't fit in with the team or perhaps this is not the right area of nursing for them. These same nurses having a wealth of experience and I have witnessed providing high quality care. We must surely have moved on from the attitude Matron or Sister knows best! I retired from nursing after many years working as a Ward Sister and after a number of years returned to work as a HCA something I have never regretted. I work with some wonderful people both qualified and non qualified who every day strive to provide the highest of care and succeed sometimes in very difficult situations. I am proud to work with them but have occasionally found a small number of them have their confidence and ability undermined because their expressing opinions is misunderstood or some might feel threatened by being challenged and become defensive. I know it's not easy but we must all feel comfortable in expressing concerns and offering opinions and just as importantly feel comfortable in how we respond to these.

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  • I also attended the QNI conference and yes it was excellent,
    so many excellent sessions, speakers,and delegates,
    strong clinical leaders, essential for the NHS to operate,
    The advice led by Jenni in this edition is accurate and essential,
    Please stand up for all you know is right, if you feel nervous even worse afraid, just think clinically, you have the knowledge the registration and duty to do so.
    We should and i believe will stand together.

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