I doubt many jobs in nursing can be called easy but there has probably never been a more difficult time to be a director of nursing.
That’s the point I made at the Nursing Times’ Directors’ Congress last week. Chief nurses there agreed with me, saying the job is getting harder. Agency caps, a shortage of trained nurses, a significant churn in those coming from overseas and pressure from executive boards to hit cost-reduction targets – without compromising quality – seem to make this an almost impossible job. A couple of delegates revealed to me that their staff tell them they would not do their director of nursing role for love nor money.
And these nurse leaders are not just in the firing line from board colleagues, managers and staff. I heard some saying they are often targets in the press; local newspapers have revealed their salaries and published damning – sometimes inaccurate, out of context – front-page reports about the care provided by their organisation. And the finger of blame more often than not points at the director of nursing. So what drives people to want to be a chief nurse? “It’s the best job in the world,” one delegate told me. “You have the ability to really change care and make a difference,” said another.
These directors’ stoical belief that their job is fantastic is echoed by nurses working in hospital, community and other care settings. Many are overworked, under-resourced and stressed – but still believe nursing is the best profession because of the impact it can have. This was demonstrated at the event by Judith Morris, chief nurse at Stockport Foundation Trust, who revealed what it’s like to live in the media spotlight and with constant police presence. Her experience happened after two patients died and many others were harmed when insulin was injected into saline bags and ampoules – a crime for which nurse Victorino Chua was convicted.
This was a terrible time for victims, other patients, families – and staff. It needed a strong leader to support everyone and reassure the public about safety at the hospital. Judith was that leader. If people ever question the importance of a chief nurse, they should look to her. She kept the hospital providing care against all the odds – staff off sick with long-term stress, nurses needing to be backfilled when called as witnesses and the media trying to break into the hospital. Judith exhibited integrity, compassion and honesty throughout. These are the values that make a leader, the values at the core of nursing.