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Nurses, midwives and behaviour change – Jane Cummings

Nurses and midwives have the privilege of working in close partnership with patients and their families, carers or clients.

In the community, primary care or hospitals they often have not only a continuity of relationship and accessibility, but also an understanding of the context of peoples’ lives that may not be shared by doctors or other health professionals.

Nurses and midwives work with families and within local communities. They have a good understanding of a person’s capabilities, strengths and support needs in relation to the behaviours that affect their health.

Nurses and midwives are leaders of quality, and an important aspect of quality is effectiveness. For the best outcomes in terms of treatment and care we need our patients to be working with us as full partners.

Nurses and midwives, through their credibility as authorities on health and care, are ideally placed to work with people and support them to improve their own and their family’s health. They can impact on whole families’ and communities’ health now and in the future.

Delivering on our responsibility to support people to improve their health is something we all agree with in principle. There are a number of reasons why we may not always put this in to practice. Nurses and midwives are often working under pressure. They are trained to give advice, but may then wonder if it is either welcome or heeded.

What is more effective and acceptable than simple advice-giving is to find out what motivates people and to work out with them what are the best steps they personally can take to improve their own health. Working with people to raise their awareness of how their own behaviour can help them get well, stay well or maintain their independence is an important step in working with them as full partners in care to reduce ill health and demand on services.

Health-related behaviours are complex and nurses and midwives need training in how to give effective support on behaviour change. This involves a radical change in the relationship between a nurse, midwife and patient – so that we learn to motivate, build confidence and maintain encouragement for change over time.

Organisational support is important: those of us in a position of leadership need to ensure that supporting patients in effective behaviour change is systematically integrated into all we do and into all clinical pathways and care plans. Staff need to be supported not only through their objective setting and personal development plans, but also in adopting healthier lifestyles themselves.

NHS England, through its Forward View, has highlighted the importance of supporting staff into making healthier choices. We recognise that staff may find it hard to give advice until they themselves start to make some changes in their own lifestyles.

There are many ways we can support them in making those choices, from ensuring that healthy food choices are available to making it easier for them to live an active life.

Organisations need to give opportunities to staff to talk about their health and issues they may have, and to understand how they can best support staff to live healthier lifestyles. The NHS has begun to show real leadership on this.

As leaders we must demonstrate through our own behaviour and lifestyles that we can work on our own health challenges. This includes a good work-life balance and understanding our motivations and what keeps us well.

We are nurses and midwives, and we are also members of families and communities. Improvements in our own health and lifestyle will influence the health of future generations.

Jane Cummings, Chief Nursing Officer England.

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