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Developing the nurse role

As we look to a new government to set the direction regarding the future of the NHS at a particularly difficult economic time, I felt it was a good opportunity to reflect on the recent report commissioned by the ex-prime minister, Front line care.1

Following extensive consultation, the Commission has made a number of recommendations, including improving the quality of patient care, improved health and wellbeing for nurses and midwives, recognition of the nurse's role in caring for patients with long-term conditions, promoting innovation and leadership, and in the move to an all-graduate profession, the provision of a career framework to support nurses through clinical practice, education and research.

As always, the document lacks clarity regarding how this ambitious agenda will be achieved, and many nurses and midwives will feel they have heard it all before and have concerns about how such challenges can be achieved. With over 70% of nurses and midwives on the NMC register aged over 40, in addition to the move to a graduate profession, it is essential that workforce development is addressed if safe, high-quality care is to be provided in the community, hospital and other settings. Recruitment and retention strategies need to be developed to ensure the right people come into nursing and see it as a career they are proud of.

Alongside this, training, education and development strategies will ensure that nurses and midwives are supported in their roles and continue to embrace lifelong learning, to keep up-to-date and constantly develop the skills and knowledge required by professionals in today's healthcare environment. However, this will continue to be a challenge as financially strapped organisations cut budgets in training departments and I am certainly hearing this is happening already.

So, once again, we will need to be more creative about accessing learning opportunities other than attending a course or study days. In fact, we have been doing this for a number of years since the advent of the NMC PREP standards.2 Many nurses and healthcare professionals attend far more than the required minimum of five days over three years to maintain their competence and meet the standards. Shadowing, reading, clinical supervision, networking, action learning and accessing technology are all examples of rich learning opportunities that can be used to keep up-to-date and share best practice.

If, as is recommended in Front line care, nurses and midwives are "educated to care", we must not forget existing staff, many of whom are not yet educated to degree level. It is essential that this group of staff are not disadvantaged and prevented from developing their skills and knowledge. After all, they are the ones who will be expected to support the future workforce as new nurses come into the profession and they, too, need to feel valued.

1. Department of Health. Front line care. London: DH; 2010. Available from:
2. Nursing and Midwifery Council. PREP Handbook. London: NMC; 2010. Available from:

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"I agree with Donna, the nurse's role is the backbone of patient's prognosis; therefore, nurses and midwives need to be developed in their profession. The right people need to be recruited who are passionate with patients' care in order to improve on communication skills as well" - Grace Baguma, Africa