26 March 2015

'I'm only a nurse'

HULL, United Kingdom—I was teaching a group of students last week who were finishing the return-to-practice course we offer at the University of Hull. All of the students in the class are registered nurses who have taken a career break and, as a result, not met the prescribed number of hours of practice as specified by the United Kingdom’s Nursing and Midwifery Council. My task was to tell them about recent developments, including various commissions and commission reports—such as the Francis Report—that have made recommendations relevant to nursing.

The class session could not have been better timed, as publication of the Shape of Caring report had just been announced. I had not seen the report, but I was aware, based on advance information and discussions with colleagues close to Lord Willis, chair of the Shape of Caring review, what was likely to be recommended.

I knew, for example, there would be proposals for widening access to the nursing register by making it easier for health care assistants to enter nursing education by receiving credit for previous experience and undertaking a shortened programme. I questioned the wisdom of this proposal, as I have discussed previously in “Nursing education,” another blog I write. Repeating what we often hear, one of the students in the class observed that the proposal to broaden access addresses the problem of prohibiting good, caring people who wish to look after patients from doing so. 

Time to drop the apologetic "I'm only a nurse."
Michael Jung/iStock/Thinkstock
I replied that—assuming they are given the right assignments—such people should not be excluded from working with patients, but if they wish to become registered nurses, I saw no reason why they should not meet the expected entry-level educational qualifications and undertake the full educational programme. After all, we are trying to produce accountable and responsible professionals. Many may wish to become physicians, but I hear no call from anyone for widened entry gates to medicine.

The student actually agreed with me—a first! I think the problem is, many of our all-you-need-to-be-a-nurse detractors who make statements about nursing are rarely challenged. As a result, their rhetoric sticks in the minds of the public and the profession.

Wanted: An end to ‘I’m only a nurse’
I have been asked, along with others, to address in May a UK Royal College of Nursing forum that focuses on some aspects of nurse education and attitudes toward nursing. In the five minutes I’m allotted, I intend to address the apologetic “I’m only a nurse” reply that many of us give when we are asked what we do—especially if a few “high fliers” have just introduced themselves at a conference dinner table. If I never hear those words again, I will retire happy.

Lancet Commission update
Earlier in the year, after considerable thought, I decided to relinquish the lead of the Lancet Commission on UK Nursing. A few things have changed personally and professionally, and I was beginning to lose sight of our aims and how we would get there. I am glad to say that leadership is now in the excellent hands of Anne Marie Rafferty, PhD, CBE, FAAN, professor of nursing policy at the Florence Nightingale School of Nursing and Midwifery, King’s College London, and I will continue to serve on the commission.

We still aim to report in early 2016 and, despite my negative reflections on the Shape of Caring report, there is much in it that the Lancet Commission may be able to build on. Vitriolic criticism of the commission—its composition, its purpose, and the fact that it was inspired by The Lancet—continues in the nursing press, additional evidence of just how narrow minded we can be in UK nursing.

The Far East and Middle East beckon
I am in the process of packing for a week in China where I will address a conference in Luzhou. After returning for a few days over Easter, I leave for 10 days in Saudi Arabia. You can bet you will hear all about those visits, and I will resume production of my “travelcast” podcasts.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International. Comments are moderated. Those that promote products or services will not be posted.