Jane Cummings, Chief Nursing Officer for England, has today marked International Nurses Day by reflecting on the changing face of the profession.
She said: “Nursing has changed dramatically in the 150 years since Florence Nightingale founded the first nursing school in London – undoubtedly for the better.
“While compassionate care is still the guiding principle, advances in science and technology and changing health needs have seen nursing roles change dramatically.
“We now have specialist acute and community nurses, mental health and learning disability nurses and nurse consultants to name a few. Most nurses now either have a degree or are studying for one. They can specialise in a wide variety of roles including areas of practice such as promoting health and well-being, supporting patients manage their own conditions, prescribing medication, providing psychological therapies, treating minor injuries or illnesses or providing chemotherapy.
“This is testament to how nursing has evolved and advanced over the years. This will continue to evolve. Changing demographics mean that more nurses will start their careers in community, primary care or public health roles; they will work in voluntary or the independent sector and in integrated teams with social care, educators and others.
“We expect to see increasing numbers of nurses working in roles that focus on keeping people healthy and well by empowering people to manage their own health and lifestyle or on preventing people becoming ill through anticipatory care as well as during times of ill-health.
“The nurse patient relationship will be an equal and active partnership that focuses on strengths, self-care and support. Our challenge is to build on the values of our long history of service and care and develop nursing for the rest of the 21st century and beyond.”
“Last week I had the privilege to celebrate with qualified nurses, student nurses and military nurses from around the country at the Florence Nightingale Service in Westminster Abbey. It was a fabulous experience and truly recognised the significant role nurses play.
“I spend much of my time with nurses who care for patients day in day out and I see the pressure they face. I am consistently overwhelmed by their resolute determination to do the very best for their patients. I am as proud today to be a nurse as I was when I qualified over 30 years ago.”
The number of nurses has increased in recent years. At the same time, demand is greater than ever. In the decade since 2002/03, emergency admissions staggeringly rose by almost a third. Nurses are seeing more patients, with more complex and serious conditions than ever before.
She added: “The modern nursing challenge is to deliver consistent and improving high quality care despite this growing demand.
“In the face of these pressures, it is clear that we need to change and transform the service. We need to up the pace of radical change if we are to truly respond to the lessons of Mid Staffordshire, Winterbourne View and the needs of our increasingly older population.
“Key to this is widespread cultural change in our approach to healthcare. We need to think and do things differently right across the health and care sector – each of us and every organisation needs to step up to the plate and be accountable.
“The public debate around staffing levels quite rightly continues. This is a priority in the nursing and care strategy ‘Compassion in Practice’ and more recently, at the end of last year, I published guidance on nurse staffing with the National Quality Board. With the Department of Health, we have also commissioned NICE to look at the evidence available about adult hospital wards and make recommendations on determining nurse staffing. These recommendations will be published for consultation imminently.
“This is part of the sophisticated, evolving approach to staffing that we need. Each ward in each hospital around the country is different in size, number of patients, the type of patients and acuity of condition. Likewise, each community is different – rural Cumbria is very different from inner city Birmingham.
“We need a culture of using hard evidence and local professional judgement to determine the right team of staff with the right experience in each situation and a culture of support to speak out when something isn’t right. Evidence increasingly shows that this approach directly correlates with better care and a positive patient experience.
“Public accountability will intensify – more Trusts are publishing actual versus planned nurse staffing levels shift by shift and are being publicly held to account. Together with the Care Quality Commission we have asked all Trusts to ensure they are doing this by June.”
Our communities have also changed over time. Jane Cummings added, “Society is now more multi-layered and multicultural. Yet the NHS seriously lags behind in its BME representation, particularly in the most senior positions. We need an NHS that is truly representative of the communities it serves and Equality and Diversity week, this week reinforces that we must step up the pace on this.
“There is increasing evidence that diverse teams make better and safer decisions which leads to better patient outcomes and better staff experience, because they are more representative of the communities they serve when making decisions.
“We must continually challenge ourselves. We need a culture of reflection and learning and of respect and understanding. We need an NHS that truly embraces equality and diversity and represents all demographics.”