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Nurses, midwives and behaviour change

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.

Jane Cummings

Professor Jane Cummings is the Chief Nursing Officer for England and Executive Director at NHS England.

Before progressing into general management, Jane specialised in Emergency Care. She has held a wide variety of clinical and managerial roles including Director of Commissioning, Director of Nursing and Deputy Chief Executive.

In February 2004, she became the National Lead for emergency care agreeing and implementing the 98% operational standard. She has also worked as the nursing advisor for emergency care. In January 2005, she was appointed as the National Implementation Director for ‘Choice’ and ‘Choose and Book’.

Jane moved to NHS North West in November 2007 where she held executive responsibility for the professional leadership of nursing, quality, performance as well as QIPP, commissioning and for a time Deputy Chief Executive Officer. In October 2011, she was appointed to the role of Chief Nurse for the North of England SHA Cluster.

She was appointed as Chief Nursing Officer for England in March 2012 and started full time in June 2012. Jane is the professional lead for all nurses and midwives in England (with the exception of public health) and published the ‘6Cs’ and ‘Compassion in Practice’ in December 2012, followed by publishing the ‘Leading Change, Adding Value’ framework in May 2016.

Jane has executive oversight of maternity, patient experience, learning disability and, in January 2016, became executive lead for Patient and Public Participation.

She was awarded Doctorates by Edge Hill University and by Bucks New University, and she is a visiting professor at Kingston University and St George’s University, London.

She is also Director and trustee for Macmillan Cancer Support and a clinical Ambassador for the Over the Wall Children’s Charity where she volunteers as a nurse providing care for children affected by serious illnesses.

Follow Jane on Twitter: @JaneMCummings.

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