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Are managers ignoring a valuable resource?

I am at work in the midst of what can only be called a "marking frenzy".

It is nearly the end of the academic year and final dissertations are being submitted and futures determined by the degree classification awarded. Listening to Five Live on Sunday there was speculation about the benefits of higher education.

Is it worth it? Well it is for females! The employment possibilities and job mobility is much higher for those who go to university than those who don't - however, the debts accrued now put a blot on the future landscape.

All of this made me think of the public health agenda and the complexity of health and wellbeing. Much of our work and government policy is seen through the lens of need and burden.

However, so much of our health and wellbeing is determined early on in life and by our social standing. When we see patients/clients/service users in the clinic/walk-in centre/primary care centre (whatever it might be called these days) there are so many factors impacting on their choices and decision making.

Providing advice and guidance to people about appropriate behaviour for their wellbeing can be reduced to simple instructions and colourful leaflets, but how much can we and do we take into account what goes on in the privacy of their home or their aspirations. What social issues do you think impact most on your success or otherwise within your work?

On another note (call that a hobby horse) I have just been back to Central Wales for the first time in 30 years, and while I was there I realised that the last time I was there was just after my O levels and was when I decided to be a nurse. I am very hazy about a lot of events in my teenage years but that one I do remember.

Despite my Headmistress thinking it was a mistake I went off to do my training and have spent many of those subsequent years wrestling with the contradictions inherent in nursing. For me these are about demand, dependency, power and caring.

None of you need to be told about how we are the largest workforce and yet we are ironically often overlooked and taken for granted in the decision-making in organisations.

Having recently had conversations in local primary care organisations about the future of district nursing I realised that neither practice nursing nor district nursing is really understood by managers, and that they are devising "core service" contracts without intimate knowledge or understanding of the complexity and intricacies within nurse-patient/carer relationships and the interactions within GP practices.
It is at this point that I wonder where the leadership is for community nursing and how can we get our voices heard? I guess the answer to that may well be staring me in the face. Here at Nursing in Practice we can provide a forum for this discussion, and with Marilyn at the helm we have a leader who in her editorials and blogs can raise issues that we can respond to. So go on, tell us what is going on out there!