We must be explicit about the contribution of nursing to public health and wellbeing, says Viv Bennett
Our new nursing and midwifery “vision and narrative” must address public concerns about care now and seize the opportunity to create a future-focused plan for improvement in care and health.
This must be one where the breadth of nursing and midwifery roles are visible and understood, one where the professions’ huge contribution to good health outcomes and care is valued, and one that sets a course for their contribution to meeting the public’s future health needs.
Healthcare is changing and will continue to do so, and part of this change will be driven by the “engaged and informed citizen” and the “active patient”. Nurses will increasingly be called to advise people on how to look after their physical and mental health, support people who are experts in their own care (for example to prevent complications of long-term conditions) and to lead early interventions that improve outcomes and promote wellbeing. Increasingly, nurses and midwives will provide care to people in new places, in groups and communities as well as individually, and to use technology and social media as well as face to face interactions.
Many nurses and midwives have specific responsibilities for leading public health programmes; for example, health visitors and school nurses lead the Healthy Child Programme. Many more have responsibilities for caseloads or populations that combine individual treatment with population prevention and protection, such as sexual health and tuberculosis nurses.
In my first few months as director of nursing at the Department of Health, I have been privileged to see how nurses and midwives are making a difference to the public’s health. They include health inclusion teams who bring healthcare to people unable to access traditional services, occupational health and dental nurses providing preventive healthcare on a construction site, and health visitors and school nurses ensuring children are ready for school and beyond, to name a few.
I have talked to many nurses in general practice about caring for individuals and groups and to nurses in mental health and learning disability services about how they are working with service users and providers to narrow health inequalities.
But, very often, this fantastic work gets little recognition. We need to make sure that our narrative is explicit about the contribution of nursing and midwifery to public health and wellbeing. We need to use this to build public confidence that nurses are skilled professionals in prevention and early intervention, as well as in caring for ill people, and to attract nurses and midwives into prevention and public health careers. That is why, in the new vision, the chief nursing officer and I have “improving health, wellbeing and outcomes” as one of the six areas for action.
This summer, chief nursing officer Jane Cummings introduced the “C’s” of the vision. Many of you have commented and we now have a suggested 6Cs for excellence in nursing and midwifery: care, compassion, competence, communication, courage and commitment. People have the right to expect high-quality care in prevention as well as in treatment and that it is provided with compassion from understanding personal situations.
A high level of competence is required to deliver support and advice that effects lifestyle changes. It takes real courage and skilled communication to raise difficult health topics with people, and it certainly needs real commitment to provide care where the results may not be fully realised for several years but ultimately improve health outcomes for all.
Viv Bennett is director of nursing at the Department of Health and principal adviser on public health nursing