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Would you “pledge” to deliver quality nursing care?

Marilyn Eveleigh
Consultant Editor

With the general election looming, the future of the NHS seems uncertain. Marilyn Eveleigh looks at the issues raised by the publication of the government commissioned report, Front Line Care, and what its recommendations mean for nurses ...

The 2010 general election date is to be announced sometime soon. Already I sense election fever, and one of the symptoms is the uncertainty of where future healthcare policy will be going. This is breeding stagnation and discontent within many sections of the NHS, be it the freezing of posts or healthcare watchdogs and quangos uncertain of their future direction.

For nurses, there has been a very clear message about the future of the profession from the incumbent at No. 10, outlined in the Prime Minister's Commission on the Future of Nursing and Midwifery. Front Line Care sets out 20 recommendations that will restore the public's trust in nursing - and give the profession clear direction and expectations.1  

Some may consider this report a brave move at the present time when the profession is undergoing some internal disagreement over the move to a graduate profession, and experiencing external criticism of care standards and lack of appropriate reporting in the Mid Staffordshire Foundation Trust enquiry. Others may consider it electioneering. Whatever the press, professionals and public think, I suggest you take a look at it yourself. It makes interesting reading, with the recommendations ranging from the ethereal to the practical and objectively measured.  

What do you think about the recommendation that all nurses and midwives should make a pledge that declares their "commitment to society and service users to give high-quality care to all and tackle unacceptable variations in standards"? According to feedback in the nursing press and websites, this appears to have stimulated much irritation - what does the NMC code mean if not this very pledge?

The recommendation that the profession acts as a role model for healthy living does not specifically mention the words overweight, smoker and excessive alcohol user, but the message has been picked up by nurses and midwives. Tackling obesity and advising the overweight is a key role for healthcare
workers: we lose credibility and could be subject to ridicule if we do not "practice what we preach". With a significant number of staff challenged by shift work patterns, high stress levels and low morale, this suggestion has attracted derision, a lack of understanding and mutterings of hypocrisy. And if this is the case, all those in society who act as leaders and influencers should be good role models - including MPs.

One recommendation is that for public protection and safety, and to allay the current confusion with nursing roles, titles and responsibilities, the title of "nurse" is protected and it is used solely by those registered by the NMC. Other training that leads to a "nurse" award has considerably less autonomous decision-making compared to an NMC-registered nurse.
Dental, veterinary and nursery nurses are particularly concerned that a decision may strip them of their title. I predict status and semantics will tax the great and the good, and the ensuing debate on who provides "care" and who undertakes "nursing" will provide much insight into how the profession views itself.  

Other recommendations from the report are listed in Box 1. Many will have a profound impact on the way we work and want to work in the future. Like them or loathe them, there is something for everyone and their implementation will strengthen the profession. Lynn Young offers another perspective on page 6 in this issue of Nursing in Practice.

[[Box 1 ME]]

Wherever you decide to place your cross on the ballot paper in the coming election, Gordon Brown has set out his commitment to the nursing and midwifery professions in this report. Will it swing our commitment to Labour?

1. Prime Minister's Commission on the Future of Nursing and Midwifery in England. Front Line Care: the Future of Nursing and Midwifery in England. London: Central Office of Information; 2010.