• DOI:10.1111/j.1365-2702.2010.03309.x
• Corpus ID: 19279518

Editorial: the future of clinical nursing: meeting the needs of patients for compassionate and skilled nurses?

@article{Bradshaw2011EditorialTF,
  title={Editorial: the future of clinical nursing: meeting the needs of patients for compassionate and skilled nurses?},
  author={Ann Lane Bradshaw},
  journal={Journal of clinical nursing},
  year={2011},
  volume={20 13-14},
  pages={
          1797-800
        }
}

• A. Bradshaw
• Published 1 July 2011
• Medicine, Political Science
• Journal of clinical nursing

In 2009, the UK Prime Minister, Gordon Brown, established a Commission to consider the future of nursing and midwifery. One of its aims was to ‘help fulfil the public’s desire for compassionate, skilled care’ (Prime Minister’s Commission 2009). The Commission was established at the same time as the Healthcare Commission (2009) raised questions about hospital trusts in England. These questions related to the quality of nursing care regarding hygiene, provision of medication, nutrition and hydration, use of equipment, and compassion, empathy and communication. During this period, the Patients Association (2009) reported patient experiences of deficiencies in basic nursing care. The need for compassion in nursing had also been admitted by the Secretary of State for Health a year earlier (Johnson 2008). Similarly, the Welsh Assembly Government nursing officer stated that some of the most common complaints were about a lack of compassion (Santry 2010). In establishing the Commission, the Prime Minister made compassion, competence and the role of the ward sister, charge nurse or community team leader central. The term ‘compassionate care’ is reiterated and is the overarching theme in the report published in March 2010. But neither in its review nor in its recommendations did the Commission explain why it made these aspects central, or acknowledge problems identified by the Healthcare Commission, the Government and the Patients Association. The Royal College of Nursing (RCN) also failed to acknowledge shortcomings in the basics of care. It responded to the Patients Association report defensively by suggesting that examples in the report ‘should not be allowed to overshadow the vast majority of good quality healthcare...’ (Evans 2009, p. 5). The Prime Minister’s Commission report (2010, p. 2–9) recommended a central place for nursing, protection of titles, regulation of roles, improved status, pledges for quality and compassionate competent care. Notwithstanding the report’s lack of detail, with regard to evidence base, analysis and methods, it lamented what it said was the public misunderstanding of nursing, suggesting that the media for 25 years had been and still were responsible for belittling and stereotyping nurses. The Commission chair, a former nurse, reinforced this view in her letter to the Prime Minister at the opening of the report by commending the fundamental change to nursing brought in by the Briggs Report of 1972, which had led to a new nursing system, its nurse preparation, authority structures and values. Two apparent paradoxes emerge. First, UK nursing has achieved status by embracing new ‘maxi roles’, blurring boundaries between cure and care (Godlee 2005). However, this seems to have led to the paradox that the basic practices of nursing care are often found wanting. The second paradox concerns the past. It is arguable that, by emphasising compassion, competence and leadership the Prime Minister’s Commission is harking back to the system of nursing replaced 25 years ago, which it disowns but which it recognises to be still in the public memory. In a further irony, a health services researcher (Black 2005) also points to nursing history by suggesting that the current loss of public faith in the UK hospital system could be restored by nursing as had happened in the 19th century. It is arguable, therefore, that an historical analysis of this system of nursing may cast light on the paradoxes and offer a vision for the future of nursing.