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Nursing leaders need to ensure the benefits of policies are clear to nurses

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How content should we be about the readiness of nursing to face the challenges of the second decade of the 21st century?

This week's Nursing Times brings together a range of stories which suggest the cup can be viewed as half full or half empty.

On the plus side we report that nearly four in five nurses are confident enough in their practice to welcome quality measures - and that two-thirds believe they will improve patient care. Chief nursing officer for England Dame Christine Beasley will also be pleased that close to 80% understand the vision of nurses becoming 'practitioners, partners and leaders'.

This confidence is reflected in the number of nurses taking the lead in delivering services. Our 10-step guide to developing
a nurse-led clinic
is based on a growing body of evidence highlighting their contribution to the health service.

Nursing care - in parts of the country - is also being delivered in a more responsive way. The West Midlands should be congratulated for increasing its primary care nursing workforce.

However, elsewhere the picture is less encouraging. Although nursing numbers are up across England, there is little sign of major movement of treatment into primary care. That two strategic health authorities have actually reduced their primary care nursing workforce is alarming.

The shift to caring for patients in the community is not just a policy mantra. Our articles on the impact of the recession and emerging disease threats provide myriad examples of situations in which preventative care or early intervention will reap benefits. Work must redouble to develop primary care nursing - and to tackle the poor morale and deskilling which recent reorganisations have brought.

On a wider front, our findings that a third of nurses have never heard of Lord Darzi's Next Stage Review, that 40% believe quality measures will reduce nursing morale and that half believe the review will have no impact on their work suggest
a disconnection from emerging policy.

Nurses are probably more engaged in improving - rather than just delivering - care than at any time. However, if they want nurses to engage with the policies that shape their practice, nursing leaders at all levels must try even harder to demonstrate to nurses how these policies could benefit both their patients and themselves.

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