Leaders in health for everyone

09 May 2019
Volume 28 · Issue 9

Abstract

The chief nursing officers for England, Northern Ireland, Scotland and Wales celebrate nurses' essential role in ensuring high-quality care for all

‘We are all #teamCNO. We are all one voice of nursing’

I am so proud to represent the nursing profession every day and I want to take the opportunity on International Nurses Day to thank all nurses working across England. The day is about recognising the contribution you make to the lives of patients and their families; your dedication, your commitment, your skill and care are the reasons that nursing is the most trusted profession in England.

During my first 100 days as chief nursing officer, I have had the opportunity to listen, to shape a vision for nursing in England and, with you, I have identified three main priorities.

We all know we need a workforce that is fit for the future. We have a pivotal role to play in delivering the NHS Long Term Plan—and we cannot do this without the right teams in place. We must recruit and retain people with the right skills and build a culture that is rewarding, positive and filled with opportunity. We need to develop our workforce as well as the quality of leadership at every level. I want nurses to feel supported and recognised and seen. We have a diverse workforce, and we therefore need to tackle inequality and break down the barriers that are preventing too many from reaching their potential.

We need to renew the reputation of our profession for the future. All of us add value, and we must highlight the importance of what we do and why. And we must tackle the embedded stereotypes about our role, and raise our profile to achieve our future goals. The breadth of our role as nurses in prescribing, medicines safety, research, technical and clinical care is not sufficiently understood. We are a highly skilled and educated profession, full of inspirational clinicians and leaders.

Finally, we need to make sure our collective voice is powerful and heard. Too often, our voices are missing from the conversations where decisions are made. We have to speak with confidence, knowing that our contribution is important. A collective voice enables collective leadership. We are all #teamCNO. We are all one voice of nursing.

‘We are a highly skilled and educated profession, full of inspirational clinicians and leaders’

International Nurses Day is a time to reflect on the impact of our profession and to celebrate the value we add to society as nurses. It's the opportunity to take time to thank those around you, to respect and reward colleagues who are working to deliver their very best for our patients. It is also a reminder that, whoever we are and wherever we are, all nurses have a contribution to make to demonstrating our worth across the globe.

‘Nurses and midwives are tenacious and strong’

The acid test of a civilised society is how it cares for its most vulnerable citizens and there has been welcome debate over how the health service needs to adapt to meet present and future challenges. Nurses and midwives are at the heart of that change.

That is why the Nursing Now initiative is so relevant to Northern Ireland. The three-year global campaign was launched in January 2019 and focuses on public health, the health of homeless people and valuing diversity locally.

The foundations of our profession are built on humanitarian values that stretch back to Florence Nightingale. We have a very proud history of providing and improving care in times of conflict, as well as securing advancements in science, sanitary environments and health equality.

Nursing has a strong grounding in promoting social justice and taking action to promote the human rights of people at birth, throughout life and in old age.

In the words of Sir Michael Marmot, professor of epidemiology and public health at University College London: ‘Nurses are the most trusted group of people. Rightly so. They treat individuals with compassion and care and have great potential to improve the health of communities through action on the social determinants of health.’

In 2015, the nations of the world signed up to the ambitious target of ensuring everyone in the world has access to healthcare and that no one is left behind.

Nursing Now champions that goal. It will raise the status and profile of nursing, and the vital role it plays in improving health, promoting gender equality and supporting economic growth.

While nurses and midwives undertake different roles in different circumstances, they share expert knowledge, proficient practical skills and live the values of care and compassion. They are at the point of care delivery across this world, helping people who are in need.

Here in Northern Ireland, we must prioritise work to improve the health inequalities that continue to divide our communities. In the least deprived areas, men live 7.1 years longer than those in the most deprived areas. For women, this difference is 4.5 years. Good health and life expectancy should not be predicated on where someone lives.

‘Nurses and midwives are at the point of care delivery across this world helping people in need’

Homeless people experience extreme health inequalities. We know a homeless person is 20 times more likely to die from substance use and 50 times more likely to have hepatitis. I have therefore made tackling this one of my key priorities for Nursing Now.

Mental ill-health is another huge challenge for our society. It is the single biggest cause of disability, with one in five people experiencing a mental health problem in their lifetime. The other four will know a friend or family member who will.

Statistics such as these should never be acceptable and we should act now to address these issues and to deliver a bright future for this region. An investment in nursing is an investment in our society, our economy and in our future generations to come.

The Department of Health has taken forward initiatives to ensure we will have enough nurses going forward and, since 2016, additional investment has been made in undergraduate nursing and midwifery places. In 2018, this was made possible through transformation funding and has enabled us to increase the number of students studying nursing and midwifery to the highest ever level.

This summer, we will see an increased number of registered nurses and midwives qualifying and taking up full-time, permanent posts. That is a direct result of the increased investment made in 2016. This newly qualified group will join the other 22 000 staff members who make up the nursing and midwifery family.

I commend the huge contribution that nurses and midwives make to care and society by always acting in the best interests of their patients, clients, families and citizens—sometimes at huge personal cost. Nurses and midwives regularly sacrifice their own home lives or personal time by selflessly agreeing to extra shifts at short notice and putting the patient at the heart of everything that they do.

It is a challenging and uncertain time, but nurses and midwives are tenacious and strong. Every nurse and midwife should be proud of what they do, the care they give and the outcomes they achieve. Nurses and midwives are the holders of hope, champions of change, the voice of the vulnerable and are doing amazing things every day. Thank you for all that you do.

‘Nurses are often the sole health practitioners in isolated areas’

For nurses up and down the country, 12 May could easily pass by in a blur—we're taking care of our families, then going off to work, looking after our patients and getting on with a 101 things.

Yet this day is set aside to celebrate the contribution nurses make to improving health and is an important one for us to reflect on all that is good about our profession. Nurses across Scotland are working tirelessly to improve our population's health and deliver high-quality care to people in our hospitals and their homes.

‘Nurses the most trusted profession and are highly valued across all fields of health care’

The international Nursing Now campaign has highlighted the importance of nursing's contribution to improving population health, access to universal health care and high-quality nursing care across the world.

What we take for granted in Scotland is not necessarily enjoyed by nurses in other countries. There is our commitment to graduate nursing education, increasing numbers of student nurses, raising the student nurse bursary to £10 000 per year in 2020 and boosting nurse numbers—including 250 additional school nurses and 500 more health visitors.

Then there is a commitment to enshrining nursing workload tools in law through the Health and Care Staffing Bill. These are all pieces of the jigsaw that are being put in place in Scotland to help create an environment where nurses can connect with what brought them into the profession in the first place.

We know from recent surveys that people find nurses the most trusted profession in the country and are highly valued across all fields of health care.

There are genuine opportunities for nurses across Scotland to build on their excellent work—across all areas of society— and further improve our contribution to improving health and healthcare and reducing inequalities.

Taking our place in multidisciplinary and multiagency teams to make a real difference to people's lives has never been more important. We have amazing stories of how neighbourhood care, led by nursing teams, is making a difference in improving outcomes for people who have previously been passed from pillar to post.

Similarly, we have areas of Scotland where nurses are the sole healthcare practitioners on islands or in geographically remote areas, maintaining a healthcare service for isolated and rural communities.

From university lecture theatres, to care homes, to communities and hospital wards, day in day out, nurses in Scotland are doing the most professional and highly regarded job.

I would like to put my sincere thanks on record to all nurses and support staff for all they do, readily going above and beyond the call of duty and making a genuine, material difference to people's lives.

‘Nurses can and must play a role in tackling health inequalities’

International Nurses Day is celebrated around the world on 12 May, the birth date of Florence Nightingale. It is an opportunity to pause and reflect on what the nursing profession is achieving and what challenges are yet to be overcome.

The International Council of Nurses has set the theme of this year's celebration as ‘Nurses: a voice to lead health for all’, acknowledging that in many parts of the world access to health care by all citizens remains a problem while recognising the increasing importance of nurses and midwives to the health and wellbeing of populations.

‘We must evolve our services to keep pace with people's needs or health inequalities will continue’

Although people living in the UK have access to the NHS, health inequalities remain. When you consider the life expectancy of people from different ends of the wealth spectrum, there is a marked difference. In addition to shortened lives, many people in our most deprived communities will live for many years with poor health, affecting their wellbeing.

We know good health depends on much more than the provision of good health services: the way a society is organised; the country's economic prosperity; early life chances; education and employment opportunities; community support and cohesion; the food we eat; and the homes we live in. The complex causes of health inequalities mean a combination of approaches is required and, in many of these nurses, midwives and specialist community public health nurses can and must play a role.

Getting the best start in life is essential and much of my work in the Welsh Government is directed towards this. Last year, we published a new school nursing framework for special schools that builds on the mainstream school nursing framework launched in 2017. This was designed with the support of frontline staff, there is an increasing role to support the health and emotional wellbeing of school-age children throughout the year, not just term time. There is now an Adverse Child Experience (ACE) Prevention and Support Hub, to increase our understanding of ACEs and developing an ACE-aware society. This year, we are launching a vision for maternity services and approaches to support Wales as a breastfeeding-friendly nation.

Last year, the Welsh Government published its 10-year plan for health and social care, A Healthier Wales. Much of our attention will be on developing services out of hospital to help keep people living in the community. We have invested in training more district nurses, increased support for advanced practice roles and are piloting different models of care. As our population ages, we must evolve our services to keep pace with their needs or health inequalities will continue.

I strongly believe that nurses and midwives have the potential to support this evolution in health and wellbeing approaches and, for this, we need to involve ourselves and use our collective voices.

Happy International Nurses Day to you all!