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The future of the nursing profession depends upon us!

Tina Donnelly
TD MSc(Econ) BSc(Hons) RN
Director, RCN Wales

Nursing has become the most diverse professional group of carers within the UK healthcare sector, due to a huge variation of roles played out by nurses and support workers. Amazingly, many people outside of the nursing profession have an opinion as to what nurses should do, strongly articulating that nurses must "readily respond to new challenges"; be "more flexible", "more adaptable", "take on more responsibility", and "demonstrate clear accountability". For the profession to survive, it is vital that nurses are the instigators, developers and controllers of all things nursing! Nurses must lead nurses and nursing …

While I strongly believe nursing is the natural expression of our human desire to care, nurture and protect, we, as custodians of our professional practice, must ensure that the underlying philosophy of nursing – historically focused upon fulfilling patient needs and delivering quality care and support – remains constant, regardless of the setting or specialism, or yet another governmental shift in focus of care. We as nurses must be good ancestors for the future of the profession.

Government policy within each of the four countries that make up the UK has determined a cultural shift in nursing, with the requirement to deliver services from the institutional setting; and, as a consequence, provide more complex care in the community arena. I often worry about patients trying to access health services and having to navigate complex systems before reaching their desired destination. It is confusing for those of us who work within the system, and this move from acute (secondary) care to predominantly primary/community care is an important one. The impact of such provision of service really does need to be closely monitored.

To enable nurses to deliver suitable patient-centred care, they need to have received appropriate training, especially if they are migrating from a hospital setting to the community, to enable them to adapt accordingly. The shift to primary/community care requires nurses to be readily equipped to deal with wider issues while working in the "virtual" ward.

The demand for nursing to be delivered in the community is not restricted to generic nursing; numbers of care workers must also reflect the balance of professional skills needed to provide nursing care set against those skills needed also to give personal care. In particular, qualified district nurses, practice nurses, nurse practitioners and health visitors are greatly required. It is important that training courses reflect the specialisms within the nursing family. For these issues to be reconciled, workforce planning needs to provide a more accurate measure of the level of demand of our patients' needs so that it is possible to effectively map out where nurses and health support workers are needed. This will help to close the gap that exists and ease the extra pressure upon nurses especially as patients with more complex needs are discharged earlier into the community.

So, the tremendous diversity of nursing roles across a wide range of fields is vital to deliver care that will make a real difference to patients, the health service and the nursing profession. To continue to provide appropriate care to patients, nurses need to be adequately supported to develop their expertise and knowledge.