Anytime now the new 2016-2019 nursing and midwifery strategy for England is to be launched by our chief nurse, Jane Cummings. How does that make you feel? Does it excite you with the opportunities it will bring nursing – or make you groan with the reminders of what we have not got, not done and the need to aim for more? As well as revalidation!
Whatever your feelings, this strategy is a vision with goals for nursing that will focus professional and public expectations. It is intended to build upon the previous strategy, Compassion in Practice, that launched the famous 6Cs. You remember: care, compassion, competence, communication, courage and commitment – the values that every nurse should hold and deliver in every health and care episode. The 2012 strategy was launched when nursing was feeling bruised and tainted by a spate of national high-profile exposures indicating poor nursing care, appalling professional standards and a dire lack of compassion. The strategy became a timely reminder to nurses of what nursing should be – providing core values for nursing students, and giving the public a reassuring blueprint to trust the profession.
Not everyone liked the theme; it was criticised for stating the obvious, that nursing is compassionate. But the scandals identified nurses did not have the courage to stop poor practice, many were not competent in skills and knowledge, and we failed to listen to patients and carers. However, the subsequent inquiries into poor quality care and patient safety exposed the pressures that nurses were uniquely under at the coal face. They identified the importance of safe staffing levels, discovered that nursing posts were frozen or left unfilled to meet monetary targets, uncovered the need for reporting and whistleblowing pathways and brave nursing leadership at all levels in all organisations.
As a consequence, healthcare standards, expectations and attitudes have changed, but nursing has been severely exposed by the process. So do we really need another nursing strategy now? Could the energy, time and expense of a nursing strategy be better focused and more influential if linked to the Department of Health plan outlined in the Five Year Forward View launched in October 2015? Simon Stevens, the NHS chief executive and report author, depends heavily on nursing to deliver healthcare over the next five years. Jane Cummings is in his team, so my prediction is that her strategy will reflect his plans. I hope so because it needs to.
For the NHS to deliver safe services in the future it must address the scandalous shortages in the nursing workforce now! Our numbers are dwindling as the eligible mature rush to retire, and the disenchanted young find alternatives to the stress of staff shortages and frustrating levels of care. We need a strategy that shows we value nursing with improved working conditions that increase morale, reduce bureaucracy and retain the experienced. We require an increase in nursing training places with adequately resourced, practical placements that offer a satisfying career pathway, where nurses are not used, abused and exhausted. We must improve the movement of nurses and skills between hospital, community and residential care for the benefit of the patient and the profession. Nursing can then provide the quality of care patients deserve.
