When I was a student we used to ask patients to do the milky drinks rounds in the evenings.
Those were the days - when patients stayed in hospital until their stitches came out and we worked in predictable peaks and troughs with the occasional crisis. Life was less complicated 30 years ago. Patients trusted their nurses and there was never an expectation that anyone would complain.
The challenges faced by nurses today are so much more complex. Even if you had a patient well enough to do the hot drinks, they would probably not be allowed to help for health and safety reasons. The pace of change is rapid and it feels as if nursing has failed to keep up and engage the implications of this change.
We need to have that tricky conversation about what nursing is, what is driving its development and whether a direction is right for patients’ care. An example might be 12-hour shifts. They save money and might be good for staff arranging child care or social lives, but are they good for patient safety?
Marie Manthey, the advocate of primary nursing, gave some great advice that I always used when considering any change in practice: “Patients matter most but staff matter too.”
The new CNO of England, Jane Cummings, has laid out her vision for nursing and underpinned it with values: care, compassion, courage, commitment and communication. It is easy to be cynical but I think she has captured, in those five words, what nursing is.
She has started a dialogue about what nursing is and it is up to the profession, at all levels, to engage and take up the debate. This appears to be a real opportunity to talk about what nursing really means and define a philosophy for the future.
Imagine every nursing team across England sitting down for an hour and using the ‘five Cs’ to carve out their philosophy of care. An hour to write down what nursing means to them on their ward, unit or department and how they can achieve their goals. There is power in being able to articulate why your work is important, why it should be valued and to celebrate what you do well. It also helps to clarify when concerns should be raised and where change needs to happen.
Nursing has to change at grass roots level - anything else is merely cosmetic. So let’s stop talking audit and dashboards for a minute and think about what nursing should be. What is the value of empathy, compassion and care? How can nurses provide the best care all day, every day? What are the limits of nurses’ roles? What do patients actually need and want from nurses? When do nurses make a difference?
Being clear about what drives and motivates you and feeding this into the national debate is vital for patient care. With clear vision we can recapture public respect, but more importantly, their confidence in what we do.