Monday, 30 June 2008

New vision for NHS

Yes, I know that I am on holiday but I am not jetting off until Thursday, so I have taken a look at the new vision for the NHS that the Department of health has released.

Now, I have read the beginning, and the forward is by the leader into the MMC fiasco. So, it is somewhat less alarming (I hope) to read of the effect of modernising Nursing careers. Now, visiting health professions and patients may be rubbing their hands with glee as another Nurse bashes the government. Well that will, and will not be happening.

The fundamental problem with Nursing care in the NHS is that too often, both in my own practice as a registered nurse, and from the reports made in media and by other staff nurses, ratios are unsafe. It is impossible for the nurse to always give every patient the same amount of attention. Clinical decision making is an important skill to posses as a nurse as this allows individual nurses to assess and attend/delegate patient care on a rationalised system. The theory postulates that care is given on a basis of need and priority under a guided framework utilising evidence based practice, not in an unco-ordinated and fragmented nature. Textbooks state that clinical decision making is the application of critical thinking. Critical thinking is accepted as being one of the skills that is possessed by people who are trained and taught within higher education, such as universities. The new vision for the NHS welcomes this idea of Evidence based practice, and that Nurses are the professionals that are most likely to shape the experiences that patients have while on wards. While the NMC are currently making a study on the effect of an all graduate profession, it is to a certain extent agreed that better patient outcomes and better quality of thought as a nurse will come from a graduate Nurse. This seems to be a common consensus between the government, the professional regulator and from the profession itself. While there are some very good points to be made by having an all graduate profession, there is one barrier to this.

The sad, and indeed true, problem with having an all graduate profession is the people that would train to be nurses. A degree nurse on the ward is not better then a nurse with a Diploma in nursing in doing their job per-say. This may not always reflect the problems that people may have while training, and the fact that like it or not, the average student nurse is female, aged 26, with one child. I admit, as a Male, 23, with no children, I am far from average (though this does not ergo mean that my perceptions are any less average opposed to the wider professional opinion). As a common factor, the Diploma with its bursary is a far more attractive option with the current rise in the cost of living. While the report may suggest better training, more career pathways for nurses, and a graduate training, there should be other considerations made to accommodate this within the wider pressures that society places upon individuals. A move that could lower the number of people graduating and entering the profession is not a move in a positive direction.

Only other thing is that the report seemed to be very vague:- they want to do things to improve the nursing profession, but the problem is the wording of the report was far too broad and vague in its meaning that it could be interpreted in a number of ways.

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