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'Providing expert care is what unites all nurses'

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Allotments are the new black. We have one, which makes us fashionable - at least until allotments are replaced on the cultural catwalk by solar-powered bicycles.

We supplied courgettes for a street full of people last summer. And strawberries. Carrots are a struggle and if this were Gardeners’ Monthly I’d hope for some advice. But it’s not so I’ll move on.

Sad as it may seem to those of you with more exciting hobbies, the best thing that has happened to me this year isbuilding a fruit cage out of wood I cut from our tree. It made me feel like Grizzly Adams, only without the flowing beard or big brown bear.

Anyway, I mention this because last week I was reading an article about ‘allotment wars’ and the new breed of allotment keepers who try to outdo each other by spending lots of money on pergolas and hiring labourers to do the work for them. One person even went and bought vegetables that they could put on to the allotment so they could invite people over to pick them.

We have constructed an odd relationship with our labour and an even odder notion of mastery. But perhaps it makes some kind of sense, after all you can be a Master of Business Administration before you ever work in business and a Master of Occupational Therapy before you have assessed 50 people’s daily living skills.

One allotment keeper even went and bought vegetables that they could put on the allotment so
they could invite people over to pick them

And what of nursing? We chose to develop an ‘expert nurse’ who gained their expertise through their capacity to make decisions or to lead, which was - when we designed it - a new type of expertise. Meanwhile we knowingly gave the labour of care to the support workers. We hired in the help.

In doing that we asserted that the labour of giving care was somehow easier to do than the other stuff - like an allotment keeper asserting that digging was less important than choosing the tools or sitting in the shed - and so caring became devalued. Being able to ‘care’ well was not considered masterful.

Of course there was some awareness of this among concerned nurses. The Essence of Care benchmarks were an attempt to institutionalise patient-centred expertise, as were roles such as the modern matron and the nurse consultant. But have they done that? Is there a clear sense that caring with great skill is the heart of nurses’ working day? Or rather are nurses the managers of care, the standard keepers, the problem solvers the people who make sense of policy and managerial demand?

Arguably nursing has struggled for a sense of clear identity in recent years. In such a large and disparate profession with so many different jobs, it is difficult to say what unites nurses. In part it has something to do with uncertainty and lack of confidence in the profession’s own strengths. But surely the only thing that unites the practice nurse, the community psychiatric nurse, the theatre nurse and the nurse in the care home is the capacity and responsibility to give care expertly. It is around that quality that nurse identity needs to be constructed.

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