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PRACTICE COMMENT

'We must invest in nursing to avoid damaging our workforce'

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Liz Charalambous believes nursing is on course for a brighter future, despite the fact that it may have lost something of value from its ‘good old days’

International Nurses’ Day in May prompted a lively discussion on Twitter about the old days of nursing. We swapped stories about ancient equipment and remembered the remedies that have now been proven ineffective. Despite all the self-deprecation, I wonder if we have lost something of value when we threw everything out with the arrival of evidence-based practice and productive ward?

After 30 years of nursing, I am young enough to embrace new ideas and strive to develop excellence in practice, but old enough to remember many things that have been forgotten. For instance, in the past, nurses’ physical health was taken account of with provision of free, regular meals and nurses were encouraged to have regular check-ups and their iron levels checked. There was a strong sense of community involvement in the life of the hospital. Student nurses “lived in”, serving to complete the strong bond of companionship that certainly helped get me through my nurse training. I’m not saying it was a golden age, but I wonder: did we lose some of the valuable elements of nursing when we threw away the sorbo ring and egg white and oxygen we used for pressure ulcers?

Recent media coverage has shocked society with the cruel and abusive nature of carers in institutions such as Winterbourne View, and poor leadership and breakdown of joined-up thinking at Mid Staffordshire. World Elder Abuse Awareness Day in June served to highlight and raise awareness. Have things improved, stayed the same or got worse? There has been recent media alarm at the lack of hospital beds for patients with mental health needs who are acutely ill as a result of the closure of many institutions. Society appears to have changed with less community involvement and an insidious yet stealthy political move towards individualism and capitalism.

There needs to be a sharpened focus on caring for staff so they can care for patients. It’s really that simple. Investment in education, adequate staffing levels and good leadership will serve to address the issue of staff disenfranchisement, disengagement and subsequent burnout. A recent discussion on Twitter posed the question: “What if we invest in staff and they leave?” To which the reply was: “What happens if we don’t and they stay?” Winterbourne and Mid Staffordshire have shown us in shocking detail the costs incurred and dire results of not investing in staff.

So are things better or worse? Does it even matter? It depends who you ask, but my view is that it is certainly different. I am optimistic that nursing is on course for a brighter future, with evidence that degree nurses can reduce mortality rates, and staffing cuts can adversely affect patient outcomes. The enthusiasm, passion and determination of students never fails to amaze me and serves to enthuse others. However, I fear that the pressures in the system are in danger of damaging this fragile beginning and we must protect future vanguards of our profession and work together, old and new, to ensure nurses are cared for and supported to provide excellent care.

Liz Charalambous is staff nurse, Queen’s Medical Centre, Nottingham University Hospitals Trust.

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