Nurses were once seen as bedside helpers – now, they perform a complex variety of medical roles vital to the NHS
Today’s nurses run their own clinics, diagnose patients and prescribe drugs and can be found leading cutting-edge medical research. Others are in high-level management roles, and it’s not unusual to find nurse academics training junior doctors alongside student nurses in university medical schools.
The responsibilities they carry, and the contribution they make to every part of the NHS – spanning the whole cycle of life from pre-conception to death – could never have been imagined by their predecessors 70 years ago.
“They were originally the handmaidens to the medics, but those boundaries have moved and their responsibilities have risen exponentially,” says Toni Schwarz, head of the department for nursing and midwifery at Sheffield Hallam University, one of the largest nurse-training universities in England. “We have lifted the ceiling on where student nurses should see themselves today – it’s not just about being at the patient bedside.”
That view is confirmed by student nurse and career changer Clare Manley, who gave up her job as a £49,000-a-year highschool business manager to train as a nurse. Forty-two-year old Manley originally began nurse training 20 years ago, but was forced to give it up when she was diagnosed with epilepsy. But the desire to nurse – something she describes as “an itch which needed to be scratched” – stayed with her. She is now in her second year at Sheffield Hallam and plans to become a nurse consultant, probably in mental health.
“That for me is where I want to go. There are four parts to the job – practice and patients, research, training and education, and some policy development,” she says.
Today’s student nurses are ambitious. “They want to feel they are always being developed,” says Prof Lisa Bayliss-Pratt director of nursing at Health Education England, the government agency responsible for NHS workforce education and training.
It is advances in medicine and science, and the way that the burden of disease has changed over 70 years, that have influenced nurse development. Back in 1948 their priorities would have been infection control, improving sanitation and people’s diet in post-war Britain. “It was doctors who gave the first antibiotics, doctors who measured blood pressure,” says Prof Donna Kinnair, director of nursing, policy and practice at the Royal College of Nursing. “I think if you were to compare the knowledge of a doctor in 1948, with a qualified nurse today, there wouldn’t be much difference.”
An increasing older population, living longer with more complex and often multiple needs, and the growing number of people with long-term conditions such as type 2 diabetes, are perhaps the biggest issues influencing the future direction of nursing.
New nursing roles, such as nurse associate, are being developed to take on tasks traditionally performed by registered nurses, who are then free to adopt more complex work.
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In the next 10 to 15 years the community nursing workforce is expected to grow, supporting people living in their own homes or in intermediate care. They will work in an integrated health and care system – between hospital and community – and have broader, and more advanced, clinical skills, offering complex care including pain relief and intravenous fluids.
Hospitals will become centres for patients who are acutely ill, requiring a nursing workforce who are “highly technically competent,” says Schwarz. Summing up the future, Bayliss-Pratt says: “Our advance nurse practitioners of today should be the community practitioners of tomorrow.”
By Debbie Andalo | The Guardian
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