Whether in long skirts and veil headdresses or scrubs and Crocs, nurses have always faced challenges and risen to them, says Rosemary Cook
The word “new” is somewhat loaded in the health service. In their private lives, people may get excited about a new house, a new job or a new start in the new year. For nurses, working in a system in which change and “reform” are a constant feature, it is hard to get excited about anything just because it’s new. The new job, team, service or manager may well have come about because someone else has lost out. In the community in particular, it is sad to see each new organisation setting itself up with huge efforts to engage its staff who are transferred in, to embed its new name and logo, and to create a culture, only for it all to be torn down a couple of years later in favour of another new organisation.
So perhaps, rather than looking for “new opportunities” in the new year that we can get excited about, we should look for some old things, some enduring issues, that will form the bedrock of the year ahead. Like the fact that the great majority of patients in any survey you look at are happy with the quality of their nursing care. It doesn’t excuse the failures or mistakes, but it puts them into perspective.
“The great majority of patients in any survey you look at are happy with the quality of their nursing care”
By and large, the very difficult job of caring for people in mental or physical crisis or decline is done very well by nurses. We also have some enduring institutions in nursing that have survived the slings and arrows of policy and change and still stand - namely nurse registration (93 years old in 2012); the Royal College of Nursing (aged 96); the Queen’s Nursing Institute (formed 125 years ago); and the Florence Nightingale School of Nursing (still going strong after 152 years). And we have, across the country, an establishment of individual nurses, midwives and health visitors to match any profession in the world - wise old heads, curious researchers and challenging students; dedicated educators, campaigning public health leaders, and passionate family health nurses; acerbic commentators, committed Queen’s Nurses and brave entrepreneurs. There are nurses in journalism, in business, in policy making and in the media. We are - as we have been since the job was first professionalised around 150 years ago - an essential part of the fabric of society. And that is a good place to be when there is great strain on that fabric.
The external challenges ahead are well-known. Financial constraints are hitting services, skills and jobs in all sectors as well as in healthcare. Vulnerable groups are growing and becoming even more vulnerable. The health system is still changing around us. There is increasing demand for health and social care, which will continue to grow as the population ages and pursues its very human way of doing only some of the things that are good for it, and continuing with habits that may be bad but are pleasurable. And new technologies and discoveries are increasing the costs of healthcare even as they save lives, improve experience and speed up recovery.
The internal challenges are the more important ones: holding on to morale and building resilience; matching cleverness with compassion, and knowledge with nurturing; being brave and adventurous without being risky or reckless. These are the tasks that nursing has always undertaken, whether in long skirts and veil headdresses, in scrubs and Crocs, in war zones, on wards or in well-heeled suburbia. The bedrocks for the year ahead are our continuity, longevity, variety and adaptability. We are an evolutionary success - show us a niche or a new environment, and we fill it perfectly.
Nursing isn’t in crisis; nursing is bombproof. So let’s get with the programme, get out there and get on with it.
Rosemary Cook CBE is director of the Queen’s Nursing Institute