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Nurses must help to build the future

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VOL: 97, ISSUE: 48, PAGE NO: 31

Sally Gooch, MSc, BA, RGN, RHV

The NHS building programme is forcing many trusts to develop revolutionary new schemes. For the first time, buildings could offer technological solutions to problems. Every new hospital has modern technology and better facilities than the older ones.

The NHS building programme is forcing many trusts to develop revolutionary new schemes. For the first time, buildings could offer technological solutions to problems. Every new hospital has modern technology and better facilities than the older ones.

The possibilities being explored are beyond our ken, so ignorant are we of building and electronic design. NHS staff are more likely to be experts in Victorian architecture, 1940s utility ware and 1960s management practices.

Many new hospitals will be built without the involvement of nurses because the pace of developments makes it less possible for them to be involved, even with goodwill. Gone are the days when managers worked out optimal ward sizes, and asked sister what colour the walls should be.

There is consensus on the separation of emergency and elective care, so planned surgery doesn't stop during the winter bed crisis. New services always incorporate the principle that child patients should not be exposed (literally) to adult patients.

The elimination of mixed-sex wards means there is more chance of getting enough bathrooms on a ward. But are nurses adapting the way they work?

Several health professions, including nursing, have dived down the sub-specialisation path, but how will they adapt as advances in science and technology fudge some of the specialty divisions? It is all very well being a specialised gynaecology nurse caring for those really sick women with carcinomas, but what if your 24-bed gynaecology ward gets divided between serving as a day case unit, and caring for inpatients on a 42-bed floor that combines urology and various other pelvic diseases?

As practically all ear, nose and throat patients will go through diagnostic and treatment centres within 23 hours in future, how will the ENT nurse skilled in intensive postoperative treatment feel about throwing in her lot with the head-and-neck reconstructionists from the plastic surgery unit?

It is hard to argue against the logic of many changes that benefit patients. What is a worry is that almost no one in nursing is dealing with these conundrums.

Universities are still implementing Fitness for Practice and Purpose (UKCC, 1999), and blanch at the thought of producing another new product. New workforce development confederations are reeling at politicians' demands that there must be cardiac surgery factories that will need skilled workforces of several hundred new people within four years.

Why isn't there a clamour from nurses demanding to help shape ideas, designs and future staffing plans? Isn't modernising too mellow to miss?

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