There appears to be a conspiracy of silence around the enormous changes happening in nursing right now, with few of its most senior leaders having any opinions on crucial issues facing the profession.
Spend a short teabreak on Twitter and you’ll find people debating short staffing, the nursing associate role, scrapping of the bursary, closure of the Department of Health’s nursing and midwifery policy advisory unit, and comments from NHS Improvement’s chief executive Jim Mackey that nurse to staff ratios above 1:8 are “unaffordable”.
Royal College of Nursing chief executive Janet Davies has made her voice heard, most notably at last month’s RCN Congress. But who else is standing up and saying what these changes will mean for the profession and how it will survive their aftermath?
Every time a big nursing issue arises, I expect a rousing response from a senior figure, galvanising the profession and explaining the impact of that change, but instead we get silence.
Nurses could be forgiven for being unaware of these issues, as so little is being said at the top of the profession. And I think that’s what the government is relying on – a wall of silence, no campaign and for everyone to sit back, shut up and do nothing. Move along, there’s nothing to see here.
But there is something to see. These are big changes and whatever the profession may feel, it looks like they will happen – the scrapping of the bursary was confirmed last week. The government will get what it wants, because no one is putting up a strong resistance. So if the rest of these changes are also to happen, surely we need someone to lead us through this sea of uncertainty?
Where will the workforce come from if EU nurses feel unwelcome? What will happen if the removal of the bursary does deter people from entering nurse training? The health service can’t even fill rosters now so how will it cope when these things take effect? Will we be filling empty nursing posts with nursing associates? And what will that look like? Will the public be confused? Will the nursing profession be threatened? Will it no longer mean as much to be a registered nurse? Or will it mean more?
I ask these questions, and I expect a deafening silence. Because everyone who should be speaking out is keeping silent.
Everyone, that is, except the House of Lords. Yesterday, its latest nurse representative Baroness Mary Watkins got the issue of how nursing will cope post-Brexit on to the agenda.
In her speech, she raised many of the above issues, and I felt like shouting “at last”. Because someone needs to stand up and say that enough is enough. That the axe has been wielded over nursing too many times, and the government cannot keep taking swings at the profession, without nurses and their patients sustaining some serious wounds.
This was the point made by fellow Baroness Audrey Emerton, also a nurse by background. She raised concerns about the nursing associate name, which she thought would confuse the public, and said that if the government could not afford enough registered nurses to provide safe care, it was time to consider changing its services – and even charging for them.
Baroness Emerton warned that another care scandal could be imminent, Baroness Watkins said that the future generation of nurses could be deterred by the removal of the bursary and wished a pilot had been tried first to gauge the effect. She also asked the government to consider protected training to preserve specialist careers in the service, and to reconsider closing the DH nursing and midwifery policy advisory unit. All wise words. Thank goodness Baroness Watkins and Baroness Emerton are asking the questions and raising concerns with ministers. Because very few others are.