Recently, I visited a trust where, on her first day at work, an enthusiastic young graduate had knocked on the chief nurse’s door and asked how she could get her job one day.
That newly qualified nurse was a high achiever - a Student Nursing Times Awards winner in fact - and the source of her ambition was a desire to have an influence on care provided throughout the hospital, not just the care she was responsible for delivering.
But nurses with such drive aren’t commonplace. In an exclusive investigation by our reporter Nicola Merrifield (see page 2), we found one in eight trusts of those that provided data had a vacant permenant director of nursing position. And 15% of those that replied had directors of nursing who had been in post for a year or less.
Chief nurse roles are becoming increasingly challenging, and when trusts are in special measures or struggling to cope with financial or quality difficulties, the finger of blame is often pointed at their nursing directors.
These nurses are responsible for the largest workforce and have the greatest influence over quality issues, but often tell me they are not treated with the same level of respect as the rest of the executive board - either by other colleagues or their fellow board members. When it comes to nursing, it seems everyone is an expert, even if they’ve never nursed a patient.
When you couple their almost unachievable responsibilities with a lack of support, throw in a few other roles too - many nursing directors are safety or quality leads, some are deputy chief executives - you can see why this is not an attractive proposition.
These are challenging jobs, with little gratitude shown to the nurses prepared to take them on. If the trend shown by our research continues, the experienced few will soon retire to be replaced by less confident successors.
If an organisation’s nursing team wants to improve its standing with other professions and its ability to offer high-quality care, it needs a strong, experienced leader who is prepared to argue the case for the resources and staffing it needs.
Without those leaders, the profession will continue to be the scapegoat, instead of the champion, of great quality care.
Jenni Middleton, editor
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