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‘The two current reviews offer us a real opportunity to shape the future of nursing’

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Embracing nurse education in its broadest sense is the key to transforming the patient experience and developing leadership potential, says Karen Cox.

It’s not often that something stops me in my tracks but as I read Ken Jarrold’s column in the Health Service Journal recently (15 November), that is exactly what happened. In a short but insightful response to Lord Darzi’s report Our NHS, Our Future, he presents a clear analysis of the thrust of the report – transforming the patient experience and developing management and leadership potential.
Jarrold notes that if we really are to achieve these two key aims we must focus on the potential of team leaders and their ability to transform the patient experience. He points out that patients’ experiences of healthcare depend primarily on frontline staff and the team leaders who influence them – the ward leaders and their equivalents.
Every NHS organisation, he notes, should enable these leaders to focus on caring for both patients and staff – and this should be accompanied by a focus on improving NHS processes, which in the main is nursing. These are all sentiments that I have to agree with.
There are hundreds of thousands of nurses working in the NHS at different levels and in different roles. Almost all patients and families who access NHS care will spend the majority of their contact time with nurses. However, it was his next statement that really struck a chord. He reminds us of the need for nursing to be part of the boardroom but boldly states that we need ‘world-class nursing’ much more than we need ‘world-class commissioning’ if we are going to transform patient experience. He finishes by stating that ‘a crusade for nursing, care processes and a focus on team leaders are the things that will make a difference’.
Today, nursing is more fundamental to patient experience than ever. In a healthcare system expected to provide more effective and efficient services despite finite resources there is a resultant need to humanise the system for those who use it. It is this dual challenge that I believe nurses are well-placed to deal with.
Two major consultations are now under way, the outcomes of which will shape nursing and therefore patient care for at least the next generation. The first is tackling the thorny issue of nurse education: preparing nurses for practice, how to do it, at what level and what to include. The second: what does a ‘modern’ career for nurses look like and how do we provide continuing education to support career progression?
Through these reviews we have a real opportunity to shape the future of nursing. For me, one of the key things is to acknowledge that we are dealing with a profession that engages in a broad range of activities, some of which involve different levels and kinds of skills and knowledge.
This means we need a nursing team made up of a diverse range of individuals but led by skilled, registered, accountable practitioners. I would like to see a more general education in the early years
with a focus on specialisation later, a greater emphasis on inter-professional learning and team-working, community health and pathways of care rather than disease orientation.
In the post-qualifying years I want clearly articulated career routes for those who wish to progress and a greater emphasis on supporting and stimulating those who wish to develop within their current roles. This is crucial for recruitment, retention and motivation. I want nursing and nurses to embrace education in its broadest, most liberal sense. This will broaden horizons, encourage intellectual creativity, a capacity for lateral thought and argument and a deep knowledge of and enthusiasm for your subject. It gives you the tools to question the system and encourages debate. I believe it is a combination of all the above that will help us achieve world-class nursing and the ability to deliver and influence patient care effectively for the better, whether at the bedside, in the boardroom or in the classroom.

Karen Cox is professor in cancer and palliative care, University of Nottingham

Join in the consultations on nurse education and nursing careers at and by clicking on consultations

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