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Winter work


Sometimes as nurses we have to rock the boat



The last thing we want is for nurses to be gung-ho, especially when it comes to clinical care but there is a lot to be said for having an appropriate level of confidence, not be afraid to speak up, act when needed and using our initiative to push the boundaries.

I have recently been reading about Cuckoo Lane surgery in west London, which is a nurse-led alternative provider of medical services. I am so impressed with how nurses such as Julie Belton and Carol Sears are showing nurses being so pro-active in the delivery of care.

Another example of an impressive community nurse-led service is Accelerate CIC in east London. Accelerate provide chronic wound and lymphoedema services and, like Cuckoo Lane Surgery, are making a real difference to the lives of their patients.

I find it fascinating that these nurses are demonstrating real creativity and clinical leadership showing that good healthcare can be delivered in a different way from the standard GP/hospital model.

I am also curious about what it is that has given these teams the confidence and determination to do things differently. The Cuckoo Lane nurses have rightly identified that nurses need to develop the necessary skills and competencies to become a nurse partner.  But lots of nurses have those skills and competencies and yet very few have gone on to lead such services.

The Cuckoo Lane nurses suggest that would-be nurse partners need the ability to think ‘outside the box and push traditional boundaries’ and I think they are right.

In my experience, too many nurses are risk averse. We worry too much about rocking the boat and getting things wrong. The last thing we want is for nurses to be gung-ho, especially when it comes to clinical care but there is a lot to be said for having an appropriate level of confidence, not be afraid to speak up, acting when needed and using our initiative to push the boundaries.

How do we encourage nurses to be more assertive and creative? I am trying to do this with the students I teach but a large proportion of their education and clinical practice takes place in the very hierarchial world of acute hospitals where student nurses are very low on the pecking order!  I like to think that community nursing offers more opportunities for creativity. The more student nurses we can support in their training through community practice placements, the more we can open their eyes to other ways of nursing.

I recently attended the Queens Nursing Institute conference. Dr Crystal Oldman gave an inspirational opening address and pointed out that if ‘you aren’t at the table, you are on the menu!’

We need to follow the example of Cuckoo Lane Surgery and Accelerate CIC and make sure nurses are determining the agenda for community nursing and providing wonderful role models for the next generation of nurses to emulate.