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Focusing on the positive aspects of change in nursing

Depending on your point of view, change is either a nuisance or a positive way to look at the future. Helen Lewis discusses the ways in which the nursing profession must embrace change and see it as a necessary part of moving forward ...

In this current economic downturn, my mind was drawn to change. Change is happening all the time, from season to season (although I will admit that it has been difficult to spot the change from winter to summer this year!).

Women regularly change their hair colour, length and style, and this can be an uplifting thing, boosting our confidence and giving us a new perspective on the world around us (at least until we have to wash and style it ourselves the day after going "radical" at the hairdresser).

As far as our economy is concerned, the majority of households are looking to change the way we shop and pay for our goods and household bills. Change, we must. How we are all going to do that as individuals will ultimately depend on our socioeconomic status.

What about change in our work? For many years, nurses have discussed patients, outcomes and the best way to go about things. Today, that is called clinical governance, and is more structured in its approach; however, the fundamental ethos remains the same. Change should happen upon a continuum, with all the team members getting involved to swap ideas and arrive at the best solution for all.

Practice nursing is continuing to change and evolve all the time; we all have to be evidence-based practitioners not only for our own development but also for the development of our profession. Yet, in some quarters, change is difficult or bordering on the impossible, depending on who is implementing it in the first place.

Change can be resisted, and in the long run, this may be detrimental to the team as a whole if the resisting is being done by a team member who believes in the "we have always done it this way" approach.

This takes me back to my days as a first-year student nurse on a medical ward. The Sister in charge resisted change to the limit. She remained "back in the day", and saw nothing wrong with treating pressure sores with egg white and oxygen. Despite being given up-to-date evidence for the treatment of pressure sores, she continued to practise just the way she had done. Now, this could be seen as deliberately doing harm to the patient, because she refused to be an evidence-based practitioner, or that she was simply too set in her ways to accept change regardless of what evidence was placed in front of her.

Health care assistants (HCAs) are currently taking on more clinical roles within the nursing team in primary care. With the changes already taking effect from secondary to primary care it is vital that HCAs are given training and support to fulfil their role and to become initiated fully into the nursing team. Many HCAs are completing their NVQs, and who is to say that they will not want to go on and become qualified nurses in their own right in the future?      

Change should be embraced and welcomed; it should not be implemented using a "top down" approach, but based on a continuum. That way, we ensure that clinicians are practising right at the top of their game, instead of having one foot in the past - which will be the downfall of the profession striving so hard for change in practice and ethos.