The ever-evolving healthcare needs of a growing and ageing population have led to new challenges for staff working in frontline health services. Examples of these challenges include increasing obesity, diabetes and antibiotic resistance, to name but a few. Medical advances continue to improve patients' lives, enabling people to live well for longer. However, in turn, the cost of care increases each year, especially as medical technology advances. Closure of local services continues, owing to centralisation, and commercialisation of the health sector has led to an increase in the availability of privatised services. All this is against a backdrop of increasing patient and public expectations and increasing litigation costs. And the NHS has fewer trained front-line staff and increasing staff vacancies, influencing staff resilience and retention.
In addition, it remains to be seen what impact Brexit will have, and there are concerns about medicine and consumables shortages as a result of a threatened free trade agreement with Europe. The current situation with the new coronavirus and the lockdown of China and its reduced economic output may also contribute to medical supply chain shortages, depending on how quickly the outbreak is controlled.
It may seem easier to focus on the negatives. However, on a daily basis, I see inspiration and glimmers of brilliance. I see staff striving to do their best for patients in the face of adversity, all staff groups working collaboratively to put patient needs at the heart of what they do, which is provide care with compassion, dignity and respect. It is easy, in the face of adversity, to dwell on the negatives as opposed to celebrating the positive work achieved by the health service and each staff member every day. We should remember that the NHS is one of the greatest achievements in modern history.
‘There has never been a better time to be a nurse or midwife. Challenges abound, but opportunities are endless to have a rich, varied and rewarding career’
This year, 2020, has been officially named the International Year of the Nurse and Midwife by the World Health Organization (WHO) (2020). It seeks to celebrate the essence of what it is to be a nurse or midwife in today's world, while looking back at the professions' achievements and celebrating what it means to every registrant. Nationally and locally, there will also be events to commemorate the bicentennial year of Florence Nightingale. Could she have ever imagined that nursing would achieve so much? We now have registrants working in specialisms and advanced practice roles as well as the evolution of nursing associates.
This year also sees the introduction of new commissioning for quality and innovation targets, the first related to pressure ulcer risk assessment in community hospitals linked to care planning in relation to the risks identified. The second relates to the assessment and treatment of lower leg wounds, the appropriate use of compression and onward referral. These initiatives will lead to increased scrutiny and focus. This is welcome, but will be challenging for all wound care practitioners in England.
Many trusts will use quality improvement methodology, such as plan, do, study, act (PDSA) cycles, to achieve these targets and to achieve, sustain and embed changes in practice. Realistic medicine and a push to make every contact count has led to a focus on motivational interviewing, active listening and reciprocity to empower patients to make informed choices about their care, and technological developments have facilitated increased self-care.
Research in the field of tissue viability and nursing is ever growing, with the 70@70 programme seeing 70 nurses and allied health professionals championing an increase in nursing, midwifery and allied health research.
I would argue that there has never been a better time to be a nurse or midwife. Challenges abound, but opportunities are endless to have a rich, varied and rewarding career. Enjoy this year of recognition, enjoy being the sum of our parts, celebrate being one of the 22 million nurses and 2 million midwives worldwide (WHO, 2020)—each and every one of us deserve it!