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Is it time we accepted that nursing care without leadership is not enough?

  • 1 Comment

Student affairs editor, Alan, questions whether the nursing profession is evolving into the leadership role that the health service needs.

The word “nurse” has somewhat lost its meaning to me. Hours of lectures surrounding professional identity have yet to alter my opinion, because the nurses I see rarely give it a thought. Not knowing how to define their profession beyond their day to day tasks does not affect their work. They look after the patients in front of them and that is enough.

We are entering a workforce that appears less and less sure what it wants to be.

The now familiar six Cs have been in place since the end of 2012 and this year the nursing strategy has expanded to incorporate the ”10 commitments”. In our lifetimes we could see further expansion, perhaps the “20 positions of nursing” or the “30 nursing standards”.

My point is, with an increasingly long job description, and a professional body advocating so many more areas of responsibility, how do we say what we are and what we do?

”How do we say what we are and what we do?”

How do we identify?

Assistant practitioners and the new nursing associates are increasingly tasked with roles traditionally performed by registered nurses. Our degree dictates that we should be able to bring a level of knowledge and understanding to our practice that will enhance patient care. But are we now nurses because our degree says so?

Are we to differentiate ourselves from our often equally skilled colleagues simply because of our responsibility and the fact that we hold a degree?

Florence Nightingale, arguably our most famous nurse, made the greatest impact by collecting statistics, which allowed her to demonstrate how the environment of care had a direct affect on mortality. Yet we rarely consider nurses to be statisticians.

”I feel I am not alone in being confused and even disillusioned”

I feel I am not alone in being confused and even disillusioned by a lack of understanding of what a nurse is. At its core, the main commonality among nurses would appear to be care of patients. But to identify ourselves in this way would still not clarify what a nurse is, due to the number of other caring professionals that can also stake this claim.

My concern would be that if we continue to operate as lone individuals without a sense of larger purpose, our power as the largest group of patient advocates could be lost.

”Those professions with strong professional identity promote a strong often immutable will”

By operating in this way we ignore our responsibility of ensuring that healthcare is not weakened by those who would seek to make short term savings on our long term health. We can see this in the response of our representative bodies in discussions involving the future of healthcare. Those professions with strong professional identity promote a strong often immutable will.

Ours, so far, has not.

I  suggest that the education of nurses needs to go a step further. New students should expect to become strategic leaders and orators as well as carers on the front line of healthcare.

I want to see my peers making important decisions that improve the care we give to patients. And I do not believe working in this way diminishes our levels of care or our concern for our patients.

We have already begun a transition from frontline staff members to leaders in healthcare, now we just have to figure out how to progress without losing our core commonality. Our need to care for patients.

  • 1 Comment

Readers' comments (1)

  • Anthony Johnson

    I agree in some sense that we need to be leaders but not if it's at the cost of our patients which is what happens when you introduce Nurse Associates and HCAs in higher numbers.

    The evidence is in, graduate nurses save lives. Every 10% of HCAs on a ward increase the risk of UTIs by 1% and pneumonia by 2%. In America, their LPNs, which is what our Nursing Associates will be, increase the risk of pressure ulcers and medicines misadministration.

    This isn't me saying they're not good HCAs or Nurse Associates as well as bad Nurses. This is me saying that the data shows the difference in training affects patient outcomes.

    If graduate nurses save lives we should invest in training our HCAs and Nurse Associates to degree level. As members of the profession, we should exercise our leadership to say that it is not only good for patient safety but probably cheaper for the NHS by reducing the length and therefore cost of acute admissions.

    The simple fact is our evidence base and our advocacy are what set us apart. We should use both to be leaders in healthcare.

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