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No-one knows what nurses do

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On The Pulse is a weekly round-up of what’s happening in nursing or an analysis of a key nursing issue, written by Nursing Times staff. This week: editor, Jenni Middleton

In the last 48 hours I have heard about leg ulcer clubs merged with flower arranging classes, art lessons teaching kids about their asthma, a celebration of diabetes to teach people with the condition to eat well, a GP educating the local Tesco to sell more food that would appeal to its local Bangladeshi residents, and even a race for people with their walking frames in the Netherlands.

The theme of the last two days at the Florence Nightingale Foundation annual conference has been that we should stop asking patients and the local community what is the matter with them and ask them what matters to them.

Nurses who want patients and service users to take responsibility for managing their own conditions or making lifestyle choices that keep them healthy will be more successful if they work alongside their communities and collaborate and co-produce health plans.

”Empowering nurses to make decisions to keep patients healthy could actually empower patients too”

Amazing presentations from Sir Sam Everington, a GP from Tower Hamlets, and Jos de Blok, the founder, director and CEO of Buurtzorg – a home care provider in the Netherlands, showed how empowering nurses to make decisions to keep patients healthy could actually empower patients too.

Mr De Blok works in a system where there are no managers – the senior nurses coach the junior nurses and organise themselves, doing away with large HR departments and management fees. And guess what – in 10 years of working in this way, there have been zero mistakes made by those nurses.

His organisation and that of Sir Sam’s have made it easy for nurses to do the right thing – the best thing for the patient.

If we want to do more with less, we have to reduce the demands on the healthcare service, and we can only do that by engaging people in their own health, helping them to understand what they should do to keep well.

Sir Sam told the audience that the hospital or GP surgery was not their hospital or surgery, it was the community’s. And members of the community have a right to use it how they wish.

”If we want to do more with less, we have to reduce the demands on the healthcare service”

Public health and prevention does need to be high on the agenda – and finding a new way to deliver care, and a new place to deliver it, will be vital.

The culture in the Netherlands and in other countries seems to be very different to that here. Nurses are appreciated and valued as intelligent health professionals.

At the conference, several nurses talked about how friends, family and careers advisors had tried to steer them away from nursing and into medicine because they were “too clever to nurse”. Several nurses took to the stage to say that medicine had been suggested to them as a preferred option if they were getting straight As.

Incredible isn’t it? Somehow nursing is still seen as having a lower status than medicine. That’s something the profession needs to change, because unless general attitudes to nursing change, it stands no chance of articulating its contribution to care, or getting its demands for safer staffing and better pay and career progression met.

If we are to redefine the way care is delivered, this is a new opportunity to define what nursing is and how it can influence its local community, and how the public will perceive value.

”Somehow nursing is still seen as having a lower status than medicine”

The two days were rounded out by Tony Kemp MBE, the nurse who looked after casualties on the scene at the A27 Shoreham plane crash. His presentation made us all think about what first response looks like after major incidents.

He described how he and other health professionals helped people who were injured by the crash, but also handled the emotional trauma of those who had witnessed the scene, those who trapped by the ensuing road closure who couldn’t get home to take medication on time, as well as wasp stings and the unavoidable trips and falls seen in a crowd in shock.

Mr Kemp was describing a very different situation to other speakers at the event, but one theme remained consistent – the misunderstanding of nursing and its value. Recounting how he was described as a “first aider” in the press, he commented: “that’s because no one understands what a nurse does, but they all understand what a first aider does”.

The power of nursing is phenomenal and its influence can be great – but only nurses will articulate that, and telling the stories of their achievements is the best way to accomplish this ambition. It’s time to abandon modesty or bashfulness and blow your own trumpets. The last two days have shown me that there is a lot for nursing to be proud of.

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