“I consider this the definitive comment on the current state of nursing. Well done Philip”
– Prof. Roger Watson
The response worldwide to my short article in Nursing Review “We need to do more than talk about Nursing” (read it here) continues to amaze me. I have had feedback and comments from beginning students and Deans in North America, professors in Australia, nurse managers in the UK, Allied Health managers in New Zealand, clinicians everywhere and even ‘former nurses’, with the word ‘former’ speaking volumes. To a man and woman, they are saying the same thing. Enough is enough. Enough of thuggery masquerading as ‘strong management’. Enough of hospitals run as Stalinist fear factories while we wonder why compassion and empathy do not thrive. Enough of mindless ‘auditing’ that equates quality with a box to be ticked and reduces nurses to little more than a pen with a warm body attached to it. Enough of documentation where the volume of such documentation becomes a hollow substitute for actual nursing care. Enough of pandering to the lowest common denominator of nursing behaviour and professionalism. Enough of mediocrity and low expectations that are regularly met. Enough of excuses made for nightmare nurses who couldn’t care less. Enough of being embarrassed and ashamed by poor nursing. Enough of being to afraid to discuss or confront same. Enough of clinical leaders being held responsible for an ‘excellence’ that they are powerless to demand or enforce. Enough of going home after every shift unable to remember why you came into nursing in the first place. Enough of a nursing position being a job for life regardless of ability. Enough of flitting from one transient organisational fad to another. Enough of being transfixed by the bright shiny objects of alleged progress and forgetting that we are fundamentally about human relationships. Enough of another reorganisation or restructuring being the answer. Enough of the schism between being proud to be a nurse yet afraid to allow our loved ones into hospital unless we can stand permanent guard beside their bed. Enough of the dehumanisation of patients by ‘the system’ in which we are all complicit. Enough of nursing leaders, managers and educators with no passion, vision or at times, integrity. Enough of ‘advanced practice’ and ‘extended roles’ for nurses if this means ‘mini-doctoring’ while skilled nursing withers on the vine. Enough of ‘employing a qualification’ rather than a person. Enough of being pigeonholed as EITHER caring OR intelligent. Enough of the ‘any nurse is better than no nurse’ mentality. Enough cant about ‘students being our future’ while their clinical education becomes a thing of the past. Enough of becoming a patient yourself and weeping at the ‘care’ your fellow human beings receive. Enough.
I’m putting this special call out to friends, colleagues and all nurses. Please add your voice and views to this discussion. Let me know your views and experiences regarding these issues from your perspective, in your role and in your country. Join colleagues who have already used this paper as a valuable catalyst: ask your undergraduate and postgraduate students to discuss this paper in class and e-mail me their ideas and suggestions, ask leadership and management students to consider their role in both the problem and the solutions, table the paper as a discussion item at your next hospital, health service, nursing association or school executive group and challenge anyone to say that these are “someplace else’s problems”.
I’ve created a special email address for responses: firstname.lastname@example.org
For my part, I’ll be keeping this conversation centre-stage in upcoming conference presentations, future papers and in my everyday dealings with health services, universities and health executives and will ‘keep you posted’ via my newsletter, blog and website.