“As the largest group of health professionals, who are the closest and often the only available health workers to the population, nurses have a great responsibility to improve the health of the population…” (Judith Shamian, President of the International Council of Nurses 2014).
We, the Chief Nurses of the United Kingdom and the Republic of Ireland are very privileged to lead our profession at this time of huge challenge and opportunity. We fully support the theme of International Nurses Day (Monday 12th May 2014) and together we must be that theme - “A Force for Change and A Vital Resource for Health. “
Nursing has come a long way since the days of caps, capes, cuffs and cycles when nurses worked mainly in the local community or hospital and were seen as the doctor’s handmaiden. Although many things within our profession have changed and will continue to change, there are common values and principles to good nursing practice that remain unchanged. They are care, compassion, dignity, and respect for the people we work with and care for everyday.
Advances in science and technology and the changing health needs of our populations have seen nursing roles changing dramatically over time. Nursing today is a very broad church (some might say a cathedral), made up of over 635,000 registrants in the United Kingdom and the Republic of Ireland alone, from many different social and cultural backgrounds. Nurses work with people across their lifespan in a variety of care settings and in roles that cover the whole spectrum of health and illness. Our challenge is to build on the values of our long history of service and care and to develop nursing for the rest of the 21st century and beyond.
Nurses are clinicians and carers and also, and increasingly, educators, counsellors, advocates, researchers and improvers, system navigators, care coordinators or case managers for an individual’s family, groups, communities and populations. As you might expect a rich professional landscape like this brings tremendous career opportunities. We expect to see increasing numbers of nurses choosing to work 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.
Think of the health visitor, public health nurse, and school nurse who take children through infancy to young adulthood; the specialist Children’s Mental Health Learning/ Intellectual Disabilities nurse who supports those with additional health and care needs to live normal lives; the practice nurse who everyday provides day to day primary care; the community nurse who helps those with one or more long term conditions manage in their own homes; and the occupational health nurse who supports us back to work.
There will always be the need for nurses who care for people following trauma, illness or in life threatening situations. Increasingly there will be technical and technology enabled roles both inside and outside hospitals in ambulance services, community health centres or with the armed forces.
The demographic profile of our countries means that the vast majority of our nurses will work with older people helping them to live longer, more fulfilling lives in their homes or in a homely setting, providing high quality care when hospital is needed, and providing dignified compassionate end of life care in all settings.
We should not forget those nurses who may not practice ‘hands on care’ but who are still committed nurses in professional leadership and government roles, in professional or employee associations, in service leadership and management, and in research and teaching.
In order to meet the demands of contemporary practice, the levels of knowledge and skills required by nurses in all of these roles have been expanded to include some that were previously the domain of medicine. These include prescribing of medication; providing psychological therapies; management of minor or specialist illnesses; and providing chemotherapy and other advanced interventions independently. This is why nurses today have a higher level of education, as well as care and compassion in order to protect the public. Nurses are now on a par with comparable professions such as physiotherapists, teachers and social workers.
There is more change on the way for the nursing profession. The financial crisis has brought into sharp focus the imbalance between the population’s demand on health care and the resources available. The changing demographic profile means that we can no longer operate in the same way. More nurses will start their careers in community, primary care or public health roles. They will work in the voluntary or independent sector, and in integrated teams with social care workers, educators and others. They will spend more time preventing, supporting, and facilitating people to self-care and avoiding ill health as well treating it. The nurse patient relationship will be an equal and active partnership that focuses on strengths, self-care and support.