Helen Lewis looks at the changes the nursing profession has undergone over the last 10 years, and where we are all heading
As regular Soapbox readers will know I have been ensconced in a degree, which is now heading to its conclusion. When I entered this profession called nursing, I was told about a lifelong commitment to learning, and I remember thinking towards the end of my degree that I would rather stick pins in my eyes than do another course. A decade later, here I am studying and fulfilling the legacy of continual learning.
More recently it has struck me how far the profession has come, and how much each and every one of us has grown. If you think about what nurses are doing now compared to what they were doing five, 10, or 20 years ago, the profession has grown and developed. To some extent we have come out of the shadow of our medical colleagues. There is no doubt that we are off the first rung of the ladder and, at the risk of rattling off a group of platitudes, we are no longer infants in healthcare; rather, we have moved up to the dizzy heights of a difficult teenager.
However, while the nursing profession appears to be taking big strides forward, some in the medical world are determined to hold us back, believing us to be the 'handmaidens' of the NHS and not a professional, forward-thinking, pro-active group.
There are two schools of thought here that I would like to put forward:
1. Nurses have lifted the lid on learning and are prepared, in some cases, to fund themselves to progress both professionally and personally within their own career pathway.
2. Medics are anxious, if not a little paranoid, about letting go.
To have knowledge is to have power – think of it like this. Imagine a man is driving his car in a strange city and momentarily gets lost. A woman would stop the car and ask a total stranger for directions. Why? Because she is lost and needs to gain an understanding of her surroundings so that she can arrive at her destination. In contrast, the male driver won't stop the car for fear that if he asks another man for directions this will somehow show a weakness. Of course the man who does stop and ask for directions also runs the risk of speaking to another man who does not want to share the power of his knowledge and sends him on a wild goose chase. Ultimately, the car runs out of fuel, and he goes nowhere!
In years gone by it would have been unheard of for a nurse to take blood from a patient because that was a doctor's job. What would the doctor of the 1950s have thought about this unruly teenager not only taking blood but now prescribing medication and completing minor surgery?
The reality is that that is exactly what is happening in the world today. Nurses are doing jobs that traditionally were done by medics, while, in some cases, healthcare assistants are doing what nurses have always done. It all comes down to education, education, education – and the more we learn, the hungrier we become for knowledge.
Here are some questions for you. How many practice nurses fit coils and contraceptive implants compared to our medical colleagues? Is there any rationale for a qualified nurse to be 'attending' with a medic during such a procedure, or is it a total waste of time and resources? Should nurses be doubling up as admin staff?
Nurses have moved on immeasurably, but we must continue to push the boundaries both professionally and politically if we want to take on our already politically savvy medical colleagues. As the saying goes, if a job is worth doing, isn't it worth doing well?
Your comments (terms and conditions apply):
"I agree in part – it is true that nurses have indeed taken on more diverse and advanced roles which undoubtedly contribute to improved patient care. But my observation over a 40-year nursing career is that these changes are often driven by other factors such as the directive to reduce junior doctors’ hours to reasonable levels. I agree that our nursing profession needs to push professional and political boundaries – what better way to
do this than to utilize the evidence gathered for the Prime Minister’s Commission on the Future of Nursing and Midwifery in England, 2010. Entitled Front Line Care, the recommendations in this report have the potential to revitalize our profession to take control if its own future. Our leaders should be shouting this from the rooftops" - Catherine Gleeson, West Yorkshire
"Nursing has changed over the years - and I am not tarnishing all nurses with the same brush but yes nursing is now a profession within its own right but I do think that we have lost sight of the basics behind nursing in striving for this recognition. Demands by our medical colleagues are of
our own doing as we have pushed to develop our roles and skills in what was once done by medics - like Pauline I have experienced first hand the lack of nurses' interest in the basic care of my late mother when she was in hospital and I don't think we can blame healthcare assistants as they no longer have role models of nurses to follow. With all due respect to
the nurses that qualify with degrees, nurse education is important and we don't need to stand in the shadows but not being afraid to 'get your hands dirty' is or should be a part of what nursing is still about and as for 'attending' medics, this is surely an opportunity to maintain good standards of procedures which sometimes our fellow medics seem to lack.
As for being the 'infants of the health service' - we don't do the intensive, longer training that medics do before attaining their doctor qualification. Sadly it worries me to think how, as we get older will we be cared for if needing medical care" - Sue Brown, East Midlands
"Thank you Pauline for your comments. I agree that we should never lose sight of what nursing means – to do that would be a disservice to our profession and to the patients we care for both in the community and within our hospitals. Patients should be cared for 100% with no excuses being tabled for poor nursing care; but it could be argued that staff shortages and the demands on nurses by our medical colleagues the
service is being stretched to the limit and beyond. Nursing is a
profession in its own right and we should not be standing in the shadows of doctors any longer, but to lose sight of our nursing ethos would be far worse and I don't think any nurse, in either secondary or community based care, would want or encourage that" - Helen Lewis
"I agree in part. I qualified at the end of the 1960s and yes it has changed but I do not think patients are really nursed any more! When visiting friends on wards, etc, where are the nurses? Nowhere to be seen. The patients looking lost and alone with no visitors, no nurse to sit and talk to – they have to watch everyone else have visitors and them not – just
to cite one instance. The urinals standing amid the orange juice and water bottles on top of the locker! I think that too much knowledge can dim the task of actually nursing the patient, giving them the best nursing care where they are. Yes I have gone on to specialise in respiratory medicine in all fields but at the end of the day I am a nurse, not a 'mini' doctor or super-qualified nurse and I trust I will never lose sight of that" - Pauline Filby, Chelmsford
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