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Nurse contribution 'often invisible' in NHS policy, says academic

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Nurses are relying on stories of empathy and compassion to describe their role at the expense of explaining the skills and abilities required to carry out the job, a UK healthcare academic has claimed.

Focussing on the characteristics of people who hold nursing posts means the profession is excluding important elements of their work – such as clinical judgement – said professor Alison Leary, chair healthcare and workforce modelling at London Southbank University.

“That’s a real challenge… for nursing. I think their contribution isn’t always recognised”

Alison Leary

Speaking about the problems facing specialist nurses and the profession more widely, Professor Leary said that relying on this “virtue script” contributed to a lack of understanding about the complexity of the role.

“If you think about nursing, people think about the characteristics of the person doing that, which is a good thing,” she said at the Florence Nightingale Foundation annual conference.

“But it then excludes the things you also need to nurse, such as clinical judgement and things that lots of nurses do all the time – such as rescuing patients and using clinical judgments to do this, or maybe spotting that a prescription is wrong,” she told delegates on Thursday.

“Relying on the virtue script to tell our story – and only the virtue script – gives an impression in decision makers’ minds,” she added.

Professor Leary said specialist nurses in particular often experienced problems in explaining their worth to employers, which when faced with service budget cuts often focused cuts or redeployment on them to try and make savings.

She added that the specialist nursing part of the workforce, and nurses more generally were often “invisible” in government policy.

“Specialist nurses in advanced practice are invisible,” she stated. “They show up on a spreadsheet but don’t show up in policy.”

“Specialist nurses in advanced practice are invisible. They show up on a spreadsheet but don’t show up in policy”

Alison Leary

Professor Leary said she was “pushed” to think of a government policy – apart from one on cancer reform – in recent years that stated specialist nurses were an important part of the team.

“That’s a real challenge – not just for this group but for nursing,” she said. “I think their contribution isn’t always recognised.”

Professor Leary said a wide range of job titles relating to specialist nurses, a lack of developmental posts leading to the job, and difficulty in tracking and analysing the complex workload they dealt with, were also among the reasons that they failed to receive the recognition they deserved.

She emphasised specialist nurses were a “safety critical” workforce and should be treated as such rather than an “extra” role.

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Readers' comments (2)

  • There is an ongoing challenge to raising the profile of nursing staff, both male and female. Along with healthcare assistants they are the core of the NHS and the care it provides. Better pay, career development, support, mentoring and policy planning are crucial to enabling these people to make the full contribution that is needed in every clinical setting, and to give the pastoral care that is often left to individual friendships in nursing teams. Public perceptions of nursing are outdated and the NHS and politicians should do more to raise the profile of this valuable role in the healthcare team.

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  • Not to forget that many trusts used removing Band 7 posts as an easy hit for trimming budgets over the last few years, thus removing many more specialist or experienced nurses and also chopping off any career development for those at Band 6 with knock on effects for Band 5...

    That's how important we are.

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