tag:blogger.com,1999:blog-2191081168194753372024-03-18T21:56:30.806-07:00The Lancet Commission on UK NursingRoger Watsonhttp://www.blogger.com/profile/07408659363029289322noreply@blogger.comBlogger6125tag:blogger.com,1999:blog-219108116819475337.post-73308787199355614552015-10-24T03:25:00.000-07:002015-10-24T03:25:52.943-07:00The reaction to the Lancet Commission in the Nursing Standard<div class="separator" style="clear: both; text-align: center;">
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<br />Roger Watsonhttp://www.blogger.com/profile/07408659363029289322noreply@blogger.com5tag:blogger.com,1999:blog-219108116819475337.post-47216645075580243322015-02-02T01:31:00.001-08:002015-02-02T01:31:28.208-08:00Text of editorial on Lancet Commission in British Journal of Nurisng<div class="MsoNormalCxSpFirst" style="line-height: 200%; text-align: justify; text-justify: inter-ideograph;">
<b><span style="font-family: "Arial","sans-serif";">The Lancet Commission on Nursing<o:p></o:p></span></b></div>
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<b><span style="font-family: "Arial","sans-serif";">Ian Peate <o:p></o:p></span></b></div>
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<span style="font-family: "Arial","sans-serif";">The terms of
reference for the Lancet Commission on Nursing were published in May 2014 and
stated that the purpose of the Commission was </span><span lang="EN-US" style="color: #262626; font-family: "Arial","sans-serif"; mso-ansi-language: EN-US;">in
the public’s interest and that the Commission was charged (by the Lancet
presumably) to consider the nursing contribution to</span><span lang="EN-US" style="font-family: "Arial","sans-serif";"> </span><span lang="EN-US" style="color: #262626; font-family: "Arial","sans-serif"; mso-ansi-language: EN-US;">improve
UK health care outcomes.</span><span lang="EN-US" style="font-family: "Arial","sans-serif";">
</span><span style="font-family: "Arial","sans-serif";"> The Commission is driven by the poor
perception of nursing in the UK (Dean, 2014) this is a pity. It is undeniable
that nursing has and is receiving bad press (and I am as distressed as are most
nurses about these atrocities) but nurses are still leading the way in many
areas, they are stellar in their dedication to the people they serve but the
Commission tells us it is driven by the poor perception of nursing. It could be
suggested that had the Commission focused on the outstanding and competent work
that nurses do then the often featured negative stories that appear in the
media would be put into much needed context.
<o:p></o:p></span></div>
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<span lang="EN-US" style="color: #262626; font-family: "Arial","sans-serif"; mso-ansi-language: EN-US; mso-bidi-font-weight: bold;">There are
sixteen Committee members made up predominantly of nurses, national and
international. The membership has impressive CVs with nearly all of the nurses
being affiliated to a university, what would appear to be missing are practicing
nurses. </span><span lang="EN-US" style="color: #262626; font-family: "Arial","sans-serif"; mso-ansi-language: EN-US;">The terms of reference allow for
additional members to be invited as necessary to either attend meetings or to
review the work of the committee and I suspect that the review of the work of
the committee will be handed down to the practicing nurse. The committee
will hold hearings periodically with the intention of gathering further opinion
about UK nursing, again the committee will no doubt draw heavily on the
practicing nurse in this respect. </span><span lang="EN-US" style="font-family: "Arial","sans-serif"; mso-ansi-language: EN-US;">The Chair of the Commission is
keen to make it clear that they are not out to fix any immediate problems; this
is about a vision and an agenda for nursing in 10-20 years time. <span style="color: #262626;"><o:p></o:p></span></span></div>
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<span lang="EN-US" style="color: #262626; font-family: "Arial","sans-serif"; mso-ansi-language: EN-US;">Two full day meetings were destined to be held in
2014, with three planned for 2015 and communication was to be maintained online
and via Google Drive. Yet, (according to
my knowledge) there has not been any communication regarding any progress.<o:p></o:p></span></div>
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<br /></div>
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<span lang="EN-US" style="color: #262626; font-family: "Arial","sans-serif"; mso-ansi-language: EN-US;">The Commission will review and report on UK nursing
education, review and report on the UK nursing workforce, review and report on
UK nursing practice and review and report on the public image of UK nursing. On
completion of all this a report will be produced in 2016 concerning the
Commission’s deliberations and proposals, the most patronising thing about all
of this is that the report is to be published, not in a nursing journal but, in
the Lancet. The Lancet is a journal for doctors and medical scientists,
regardless of the fact that the Lancet regularly holds commissions on health
issues, how many commissions has it held on other health and care professions.
Despite protestations by the Commission’s Chair that this is not going to be
punitive, it smacks of retribution – ‘naughty nursing can’t be managed by the
nurses’ so the doctors have to take it over. In 1932 The Lancet published its
report on nursing, The Nursing Commission’s Report (Lancet, 1932), it was
unacceptable then that a medical body professed over nursing matters and it is
such the case today, regardless of the fact that the Commission is Chaired by a
nurse under the auspices of the Lancet,, who is pulling the strings? In 2011
Delamothe in the British Medical Journal penned the editorial “We need to talk
about nursing” – the audacity of a medical journal again attempting to
patronize our profession, Delamothe (2011) is cited as saying “The problem is
not just heartless nurses or “resources,” although they’re a part of it” – a clear
case of tarring all nurses with the same brush, when the truth is that the
majority of nurses do an outstanding job under terms and conditions that leave
much to be desired. We do indeed need to be talking about nursing but it needs
to be done in a constructive way.<o:p></o:p></span></div>
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<span lang="EN-US" style="color: #262626; font-family: "Arial","sans-serif"; mso-ansi-language: EN-US;">I find it inconceivable that the Commission is making
a comparison with the nurse in the UK to that of the nurse in the United States
(Dean, 2014) this is akin to comparing apples with pears. There are so many
independent and dependent variables at play here that it ridicules comparison. <o:p></o:p></span></div>
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<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; line-height: 200%;">In 2010, the Commission on
the Future of Nursing and Midwifery in England published its findings decreeing
that the public image of nursing was out of date. This was a Prime Minister’s
Commission; the first overarching review of nursing and midwifery in England
since the Committee on Nursing chaired by Asa Briggs in 1972, this was not a
general medical and scientific journal commission.<o:p></o:p></span></div>
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<div style="line-height: 200%; margin-bottom: .0001pt; margin: 0cm; mso-add-space: auto; text-align: justify; text-justify: inter-ideograph;">
<span lang="EN-US" style="color: #262626; font-family: "Arial","sans-serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-US;">The Royal College of Nursing (RCN),
whose job it is to represent t</span><span lang="EN-US" style="color: #093446; font-family: "Arial","sans-serif"; font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-US;">he interests of nurses and nursing locally, nationally and
internationally, has encouraged the Commission</span><span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; line-height: 200%;"> to set forth and understand
why the image of nursing in the UK is poor (Dean 2014). The RCN is in collusion
here and this is tantamount to admitting that the image of nursing – lock stock
and barrel – is poor. The RCN should and must take a look at those nurses who
are making a difference, who are having a positive impact on the health and
well being of the nation and then tell me that their image is ‘poor’.<o:p></o:p></span></div>
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<br /></div>
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<span lang="EN-US" style="color: #262626; font-family: "Arial","sans-serif"; mso-ansi-language: EN-US;">Nurse bashing has to stop and the Commission would be
wise to think about its role in perpetuating the negative image of nursing and
nurses, of course there is always room for improvement but let us take time out
to publicise the good things that nurses do. Imagine what else nurses could do
if they were given the right support and encouragement and if their terms and
conditions were commensurate with their outputs.<o:p></o:p></span></div>
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<br /></div>
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<span lang="EN-US" style="color: #262626; font-family: "Arial","sans-serif"; mso-ansi-language: EN-US;">The Commission’s Terms of Reference make provision for
these to be kept under review. It might be an idea to invoke this provision and
invite shop floor nurses to sit as members of the Committee; these are the
people who live the job day in and day out and can give first hand accounts of
nursing as they see it.<o:p></o:p></span></div>
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<b><span style="font-family: "Arial","sans-serif";">References<o:p></o:p></span></b></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 200%; text-align: justify; text-justify: inter-ideograph;">
<span style="font-family: "Arial","sans-serif";">Dean, E.
(2014) “Lancet Commission to Tackle the Poor Perception of UK Nursing” Nursing
Standard Vol 28 No 21 pp10 <o:p></o:p></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 200%; text-align: justify; text-justify: inter-ideograph;">
<br /></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 200%; text-align: justify; text-justify: inter-ideograph;">
<span lang="EN-US" style="color: #262626; font-family: "Arial","sans-serif"; mso-ansi-language: EN-US;">Delamothe, T. (2011) “We Need to Talk
About Nursing” BMJ
2011;342:d3416 http://www.bmj.com/content/342/bmj.d3416 last accessed January
2015<o:p></o:p></span></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 200%; text-align: justify; text-justify: inter-ideograph;">
<br /></div>
<div class="MsoNormalCxSpMiddle" style="line-height: 200%; mso-layout-grid-align: none; mso-pagination: none; text-align: justify; text-autospace: none; text-justify: inter-ideograph;">
<span lang="EN-US" style="color: #262626; font-family: "Arial","sans-serif"; mso-ansi-language: EN-US;">Lancet (1932) “Nursing Commission’s Report” Lancet Vol
219 No 5660 pp 409<o:p></o:p></span></div>
<div class="MsoNormalCxSpLast" style="line-height: 200%; text-align: justify; text-justify: inter-ideograph;">
<br /></div>
<div style="line-height: 200%; margin-bottom: .0001pt; margin: 0cm; mso-add-space: auto; text-align: justify; text-justify: inter-ideograph;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; line-height: 200%;">Prime Minister’s Commission
on the Future of Nursing and Midwifery in England (2010) “Front Line Care: the
Future of Nursing and Midwifery in England. Report of the Prime Minister’s
Commission on the Future of Nursing and Midwifery in England 2010”.<o:p></o:p></span></div>
<div style="line-height: 200%; margin-bottom: .0001pt; margin: 0cm; mso-add-space: auto; text-align: justify; text-justify: inter-ideograph;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; line-height: 200%;">http://www.rcn.org.uk/__data/assets/pdf_file/0011/304301/Report_by_the_Prime_Ministers_Commission_on_the_Future_of_Nursing_and_Midwifery_in_England,_2010.pdf
last accessed January 2015<o:p></o:p></span></div>
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Roger Watsonhttp://www.blogger.com/profile/07408659363029289322noreply@blogger.com3tag:blogger.com,1999:blog-219108116819475337.post-10740709456177756382014-05-20T00:35:00.000-07:002014-12-19T06:57:52.493-08:00Terms of Reference<div align="right" class="MsoNormal" style="text-align: right;">
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<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">The
Lancet Commission on UK Nursing: Terms of Reference<o:p></o:p></span></b></div>
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<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">1. Purpose</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;"><o:p></o:p></span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">In
the public’s interest, the commission will consider the nursing contribution to<o:p></o:p></span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">improved
UK health care outcomes.<o:p></o:p></span></div>
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<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">2. Membership</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;"><o:p></o:p></span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">2.1 The members of the Commission are:<o:p></o:p></span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-bidi-font-weight: bold;">Professor Linda Aiken<o:p></o:p></span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-bidi-font-weight: bold;">Dr Parveen Azam Ali
(Secretary)</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-bidi-font-weight: bold;">Dr. David Benton<o:p></o:p></span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-bidi-font-weight: bold;">Professor. James Buchan<o:p></o:p></span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-bidi-font-weight: bold;">Professor Seamus Cowman<o:p></o:p></span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-bidi-font-weight: bold;">Professor Tonks Fawcett <o:p></o:p></span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-bidi-font-weight: bold;">Colonel Alan Finnegan<o:p></o:p></span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-bidi-font-weight: bold;">June Girvin<o:p></o:p></span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-bidi-font-weight: bold;">Professor Mark Hayter<o:p></o:p></span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-bidi-font-weight: bold;">Iain McIntosh<o:p></o:p></span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-bidi-font-weight: bold;">Professor Dame Jill Macleod
Clark<o:p></o:p></span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-bidi-font-weight: bold;">Professor Martin McKee<o:p></o:p></span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-bidi-font-weight: bold;">Professor Hugh McKenna<o:p></o:p></span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-bidi-font-weight: bold;">Professor Anne Marie
Rafferty<o:p></o:p></span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-bidi-font-weight: bold;">Professor Gary Rolfe<o:p></o:p></span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-bidi-font-weight: bold;">Professor Roger Watson
(Chair) <o:p></o:p></span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">2.2 Additional members will be invited as
necessary either to attend meetings or to review the work of the committee. Hearings will be held periodically to gather further
opinion about UK nursing.<o:p></o:p></span></div>
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<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">3. Meetings</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;"><o:p></o:p></span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">3.1 Frequency: Two meeting in 2014; three
meetings in 2015<o:p></o:p></span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">3.2
Duration: 1000-1600<o:p></o:p></span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">3.3 Communication will be maintained online
and via Google Drive<o:p></o:p></span></div>
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<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">4. Functions</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;"><o:p></o:p></span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">4.1
Review and report on UK nursing
education<o:p></o:p></span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">4.2 Review and
report on the UK nursing workforce<o:p></o:p></span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">4.3 Review and
report on UK nursing practice<o:p></o:p></span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">4.4 Review and
report on the public image of UK nursing<o:p></o:p></span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 115%;">4.5
Taking international comparators
into account, the Commission will produce a report on its deliberations and proposals
which will be published in <i>The Lancet</i>
and as a separate booklet.<o:p></o:p></span></div>
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<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">5. Quorum</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;"><o:p></o:p></span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">The
nature of the work of the Commission will not require meetings to be quorate.<o:p></o:p></span></div>
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<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">6. Terms of
reference</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;"><o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">The
terms of reference will be kept under review.<o:p></o:p></span></div>
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<div align="right" class="MsoNormal" style="text-align: right;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">RW/PA/TL
23 May 2014</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;"><o:p></o:p></span></div>
</div>
Roger Watsonhttp://www.blogger.com/profile/07408659363029289322noreply@blogger.com0tag:blogger.com,1999:blog-219108116819475337.post-7234628493292681352014-01-26T07:20:00.000-08:002014-05-29T05:01:30.102-07:00The Lancet Commission Background reading<div class="MsoNormal">
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<div class="MsoNormal" style="margin: 0cm 0cm 6pt 14.2pt; text-indent: -14.2pt;">
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<div class="MsoNormal" style="margin: 0cm 0cm 6pt 14.2pt; text-indent: -14.2pt;">
<div class="MsoNormal" style="margin: 0cm 0cm 6pt 14.2pt; text-align: left; text-indent: -14.2pt;">
<div class="MsoNormal" style="margin: 0cm 0cm 0.0001pt 14.2pt; text-indent: -14.2pt;">
<span style="font-family: inherit;"><span style="text-indent: -14.2pt;">Aiken LH (2010)
Nurses for the future </span><i style="text-indent: -14.2pt;">The New England
Journal of Medicine</i><span style="text-indent: -14.2pt;"> 364, 196-198</span></span></div>
<div class="MsoNormal" style="margin: 0cm 0cm 0.0001pt 14.2pt; text-indent: -14.2pt;">
<span style="font-family: inherit;">Aiken LH, Clarke
SP, Cheung RB, Sloane DM, Silber JH (2003) Education levels of hospital nurses
and patient mortality <i>JAMA</i> 290,
1617-1623</span></div>
<div class="MsoNormal" style="margin: 0cm 0cm 0.0001pt 14.2pt; text-indent: -14.2pt;">
<span style="font-family: inherit;"><span style="text-indent: -14.2pt;">Aiken LH, Sloane
DM, Bruyneel L, Van den Heede K, Gri</span><span style="text-indent: -14.2pt;">ffi</span><span style="text-indent: -14.2pt;">ths P, Busse R,
Diomidous M, Kinnunen J, Kózka M, Lesa</span><span style="text-indent: -14.2pt;">ff</span><span style="text-indent: -14.2pt;">re
E, McHugh MD, Moreno-Casbas MT, Ra</span><span style="text-indent: -14.2pt;">ff</span><span style="text-indent: -14.2pt;">erty AM,
Schwendimann R, Scott PA, Tishelman C, van Achterberg T, Sermeus W, for the
RN4CAST consortium (2014) Nurse sta</span><span style="text-indent: -14.2pt;">ffi</span><span style="text-indent: -14.2pt;">ng and education
and hospital mortality in nine European countries: a retrospective
observational study <i>The Lancet</i> 383,
1824-1830</span></span></div>
<div class="MsoNormal" style="margin: 0cm 0cm 0.0001pt 14.2pt; text-indent: -14.2pt;">
<span style="font-family: inherit;"><a href="https://www.blogger.com/null" name="_GoBack"></a>Aiken
LH, Rafferty AM, Sermeus W (2014) Caring nurses hit by a quality storm <i>Nursing Standard</i> 28:35, 22-15<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0cm 0cm 0.0001pt 14.2pt; text-indent: -14.2pt;">
<span style="font-family: inherit;">Anonymous (1998)
Nursing nursing back to health <i>The Lancet</i>
352, 249<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0cm 0cm 0.0001pt 14.2pt; text-indent: -14.2pt;">
<span style="font-family: inherit;">Bishop V (2014)
Nursing and the NHS: Casino chip care <i>Journal
of Research in Nursing</i> 19, 171-175<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0cm 0cm 0.0001pt 14.2pt; text-indent: -14.2pt;">
<span style="font-family: inherit;">Briggs A (1979) <i>Report of the Committee on Nursing </i>The
Stationery Office, London<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0cm 0cm 0.0001pt 14.2pt; text-indent: -14.2pt;">
<span style="font-family: inherit;">Buchan J, Calman
L (2006) <i>The global nursing shortage:
priority areas for intervention</i> International Council of Nurses, Geneva<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0cm 0cm 0.0001pt 14.2pt; text-indent: -14.2pt;">
<span style="font-family: inherit;">Buchan J,
Seccombe I (2012) <i>Safe staffing levels –
a national imperative. The UK nursing labour market review</i> Royal College of
Nursing, London<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0cm 0cm 0.0001pt 14.2pt; text-indent: -14.2pt;">
<span style="font-family: inherit;">Buchan J,
Seccombe I, O’May F (2013) <i>Over-stretched.
Under-resourced. The UK nursing labour market review 2012</i> Royal College of
Nursing, London<o:p></o:p></span></div>
<div class="Default" style="margin-left: 14.2pt; text-indent: -14.2pt;">
<span style="font-family: inherit;">Cavendish C (2013) <i>The
Cavendish Review. An Independent Review into Healthcare Assistants and
Support Workers in the NHS and social care settings</i> UK Government, London<o:p></o:p></span></div>
<div class="Default" style="margin-left: 14.2pt; text-indent: -14.2pt;">
<span style="font-family: inherit;">Centre for Workforce Intelligence
(2014) <i>Horizon 2035: International
responses to big picture challenges</i> CfWI, London<o:p></o:p></span></div>
<div class="Default" style="margin-left: 14.2pt; text-indent: -14.2pt;">
<span style="font-family: inherit;">Commission on Nursing (1998) <i>A blueprint for the future: the report of
the Commission on Nursing</i> The Stationery Office, Dublin<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0cm 0cm 0.0001pt 14.2pt; text-indent: -14.2pt;">
<span style="font-family: inherit;">Council of Deans
and Heads of UK Universities for Faculties of Nursing, Midwifery and Health
Visiting (undated) <i>Breaking the
boundaries</i> Council of Deans and Heads of UK Universities for Faculties of
Nursing, Midwifery and Health Visiting, London<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0cm 0cm 0.0001pt 14.2pt; text-indent: -14.2pt;">
<span style="font-family: inherit;">Council of Deans
of Health (2013) <i>Healthcare assistant
experience for pre-registration nursing students in England </i>Council of
Deans of Health, London<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0cm 0cm 0.0001pt 14.2pt; text-indent: -14.2pt;">
<span style="font-family: inherit;">Darzi A (2008) <i>High quality care for all</i> Department of
Health, London<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0cm 0cm 0.0001pt 14.2pt; text-indent: -14.2pt;">
<span style="font-family: inherit;">Darzi A, Keen A,
Nicholson D (2008) <i>A high quality
workforce</i> Department of Health, London<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0cm 0cm 0.0001pt 14.2pt; text-indent: -14.2pt;">
<span style="font-family: inherit;">Department of
Health (1994) <i>The challenges for nursing
and midwifery in the 21<sup>st</sup> century (The Heathrow Debate) </i>Department
of Health, London<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0cm 0cm 0.0001pt 14.2pt; text-indent: -14.2pt;">
<span style="font-family: inherit;">Department of
Health (1999) <i>Making a difference</i>
Department of Health, London<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0cm 0cm 0.0001pt 14.2pt; text-indent: -14.2pt;">
<span style="font-family: inherit;">Department of
Health (2013) <i>Patients first and
foremost: the initial response to the report of the Mid Staffordshire NHS Foundation
Trust Public Inquiry</i> The Stationery Office, London<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0cm 0cm 0.0001pt 14.2pt; text-indent: -14.2pt;">
<span style="font-family: inherit;">Francis R (2013)
<i>Report of the Mid-Staffordshire NHS
Public Inquiry</i> The Stationery Office, London<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0cm 0cm 0.0001pt 14.2pt; text-indent: -14.2pt;">
<span style="font-family: inherit;">Frenk J, Chen L,
Bhutta ZA, Cohen J, Crisp N, Evans T, FinbergH, Garcia P, Ke Y, Kelley P,
Kistnasamy B, Meleis A, Naylor D, Pablos-Mendez A, Reddy S, Scrimshaw S,
Sepulveda J, Serwadfda D (2010) Health professionals for a new century:
transforming education to strengthen health systems in an independent world <i>The Lancet</i> 376, 1923-1958<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0cm 0cm 0.0001pt 14.2pt; text-indent: -14.2pt;">
<span style="font-family: inherit;">Institute of
Medicine of the National Academies (2010) <i>The
future of nursing: leading change, advancing health</i> Institute of Medicine
of the National Academies, Washington DC<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0cm 0cm 0.0001pt 14.2pt; text-indent: -14.2pt;">
<span style="font-family: inherit;">The Lancet
(1932) The Lancet Commission on Nursing <i>The
Lancet</i> 219, 532-534<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0cm 0cm 0.0001pt 14.2pt; text-indent: -14.2pt;">
<span style="font-family: inherit;">Nursing and
Midwifery Council (2008) <i>Confirmation of
a new framework for pre-registration nursing education </i>Nursing and
Midwifery Council, London<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0cm 0cm 0.0001pt 14.2pt; text-indent: -14.2pt;">
<span style="font-family: inherit;">Nursing and
Midwifery Council (2013) <i>NMC response to
the Francis Report:</i> <i>the response of
the Nursing and Midwifery Council to the Mid Staffordshire NHS Foundation Trust
Public Inquiry Report </i>Nursing and Midwifery Council, London<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0cm 0cm 0.0001pt 14.2pt; text-indent: -14.2pt;">
<span style="font-family: inherit;">Prime Minister’s
Commission on the future of nursing in England 2010 (2010) <i>Front line care </i>Prime Minister’s Commission on the future of
nursing in England 2010, London<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0cm 0cm 0.0001pt 14.2pt; text-indent: -14.2pt;">
<span style="font-family: inherit;">Royal College of
Nursing (2003) <i>Defining Nursing</i> Royal
College of Nursing, London<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0cm 0cm 0.0001pt 14.2pt; text-indent: -14.2pt;">
<span style="font-family: inherit;">Royal College of
Nursing (2013) <i>Quality with compassion:
the future of nursing education (The report of the Willis Commission 2012)</i>
Royal College of Nursing, London<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0cm 0cm 0.0001pt 14.2pt; text-indent: -14.2pt;">
<span style="font-family: inherit;"><span lang="EN-US">Thorlby R,Smith J, Williams S, Dayan D (2014) <i>The Francis Report:
one year on</i> Nuffield Foundation, London</span><o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0cm 0cm 0.0001pt 14.2pt; text-indent: -14.2pt;">
<span style="font-family: inherit;">United Kingdom
Central Council for Nursing, Midwifery and Health Visiting (1999) <i>Fitness for practice (the Peach report) </i>United
Kingdom Central Council for Nursing, Midwifery and Health Visiting, London<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0cm 0cm 0.0001pt 14.2pt; text-indent: -14.2pt;">
<span style="font-family: inherit;">United Kingdom
Central Council for Nursing, Midwifery and Health Visiting (1986) <i>Project 2000: a new preparation for practice
</i>United Kingdom Central Council for Nursing, Midwifery and Health Visiting,
London<o:p></o:p></span></div>
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<div class="MsoNormal" style="margin: 0cm 0cm 0.0001pt 14.2pt; text-indent: -14.2pt;">
<span style="font-family: inherit;"><span style="font-size: small;">Watson R,
Manthorpe J, Andrews J (2003) </span><i>Nurses over 50: options, decision and
outcomes</i> The Policy Press, Bristol</span><span style="font-family: 'Times New Roman', serif; font-size: small;"><o:p></o:p></span></div>
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Roger Watsonhttp://www.blogger.com/profile/07408659363029289322noreply@blogger.com0tag:blogger.com,1999:blog-219108116819475337.post-81356398906274458972014-01-19T09:14:00.001-08:002015-11-03T08:22:50.230-08:00The Lancet Commission on UK Nursing Commissioners<div class="MsoNormal">
<b><span style="font-family: inherit; line-height: 107%;">Linda
Aiken</span></b><br />
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<b><span style="font-family: inherit; line-height: 107%;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEje9E77OYlsxEU4hQz4K8XrC1lqaq-UcIgNUufWCb_DZ4Gc4_lvuJB2kEQG04CBrcWre0MhmpKYLzv3w5BW9wBqK6nFZaQF5yTm_mnJUqGuXCcoXxort_baciCm-ubxSyfbvhM1gjvYd5JD/s1600/Aiken_Headshot_0607_copy_copy.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="188" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEje9E77OYlsxEU4hQz4K8XrC1lqaq-UcIgNUufWCb_DZ4Gc4_lvuJB2kEQG04CBrcWre0MhmpKYLzv3w5BW9wBqK6nFZaQF5yTm_mnJUqGuXCcoXxort_baciCm-ubxSyfbvhM1gjvYd5JD/s1600/Aiken_Headshot_0607_copy_copy.jpg" width="200" /></a></span></b></div>
<b><span style="font-family: inherit; line-height: 107%;"><span style="font-size: small;"><o:p></o:p></span></span></b></div>
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<span style="font-family: inherit; line-height: 107%;">Dr <a href="http://www.nursing.upenn.edu/faculty/profile.asp?pid=107">Linda H Aiken</a> PhD FAAN FRCN RN<o:p></o:p></span></div>
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<span style="font-family: inherit; line-height: 107%;">Claire M Fagin Leadership Professor in Nursing,
Professor of Sociology and Director of the Center for Health Outcomes and
Policy Researcc<o:p></o:p></span></div>
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<span style="font-family: inherit; line-height: 107%;">University of Pennsylvania School of Nursing<o:p></o:p></span></div>
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<span style="font-family: inherit; line-height: 107%;">Room 387 Fagin Hall<o:p></o:p></span></div>
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<span style="font-family: inherit; line-height: 107%;">418 Curie Boulevard<o:p></o:p></span></div>
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<span style="font-family: inherit; line-height: 107%;">Philadelphia, Pennsylvania 19104-4217, USA<o:p></o:p></span></div>
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<span style="font-family: inherit; line-height: 107%;">Tel: (215) 898 9795<o:p></o:p></span></div>
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<span style="font-family: inherit; line-height: 107%;">email: <a href="mailto:laiken@nursing.upenn.edu">laiken@nursing.upenn.edu</a><o:p></o:p></span></div>
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<b><span style="font-family: inherit; line-height: 107%;">David
Benton</span></b><br />
<b><span style="font-family: inherit; line-height: 107%;"></span></b><br />
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<b><span style="font-family: inherit; line-height: 107%;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg_Y18H8J2hwCxdSaZtJQ8vu9cOLvysEjJbTtokWjQvggn0hnwW48Dem0CI9cC2M3ZmNRke430mXLtZG21MTSmDEgPm_mJRRQigsqvTCZwRlvL2SVSV4utJBHqPxpWRFk4W0QgFciDZiEPe/s1600/download.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg_Y18H8J2hwCxdSaZtJQ8vu9cOLvysEjJbTtokWjQvggn0hnwW48Dem0CI9cC2M3ZmNRke430mXLtZG21MTSmDEgPm_mJRRQigsqvTCZwRlvL2SVSV4utJBHqPxpWRFk4W0QgFciDZiEPe/s1600/download.jpg" width="121" /></a></span></b></div>
<b><span style="font-family: inherit; line-height: 107%;"><o:p></o:p></span></b></div>
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<span style="font-family: inherit;"><br /></span></div>
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<span style="font-family: inherit; line-height: 107%;">Dr <a href="http://www.intrahealth.org/page/david-benton-ceo-of-the-international-council-of-nurses">David Benton</a> <o:p></o:p></span><span style="font-family: "times new roman" , serif; font-size: 12pt; line-height: 107%;">RN PhD FFNF FRCN</span></div>
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<span style="font-family: inherit; line-height: 107%;">Chief Executive Officer<o:p></o:p></span></div>
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<span style="font-family: inherit; line-height: 107%;">International Council of Nurses<o:p></o:p></span></div>
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<span style="font-family: inherit; line-height: 107%;">3 Place Jean-Marteau<o:p></o:p></span></div>
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<span style="font-family: inherit; line-height: 107%;">1201 Geneva, Switzerland<o:p></o:p></span></div>
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<span style="font-family: inherit; line-height: 107%;">Tel: +41 22 908 0100<o:p></o:p></span></div>
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<span style="font-family: inherit; line-height: 107%;">Email: <a href="mailto:benton@icn.ch">benton@icn.ch</a><o:p></o:p></span></div>
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<b><span style="font-family: inherit; line-height: 107%;">James
Buchan</span></b><br />
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<b><span style="font-family: inherit; line-height: 107%;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhPhuVe8WcgmpTg2lki8GNiYIKtMe6wI19nqJ7mT9cYvH70CKlBsU4emjhzS-JPWuNpdf4NwFHDRPaB2Rb3iw4_7Ox9KF9GA_4CJfvPZrDmNkc2RzpH_WGq3Gn0jqUJHqqu4L7AUha3uEp6/s1600/download+(1).jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="133" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhPhuVe8WcgmpTg2lki8GNiYIKtMe6wI19nqJ7mT9cYvH70CKlBsU4emjhzS-JPWuNpdf4NwFHDRPaB2Rb3iw4_7Ox9KF9GA_4CJfvPZrDmNkc2RzpH_WGq3Gn0jqUJHqqu4L7AUha3uEp6/s1600/download+(1).jpg" width="200" /></a></span></b></div>
<b><span style="font-family: inherit; line-height: 107%;"><o:p></o:p></span></b></div>
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<span style="font-family: inherit;"><br /></span></div>
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<span style="font-family: inherit; line-height: 107%;">Professor <a href="http://www.qmu.ac.uk/iihd/profiles/staff_profile_James_Buchan.htm">Jim Buchan</a> MA (Hons) PhD DPM<o:p></o:p></span></div>
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<span style="font-family: inherit; line-height: 107%;">School of Health</span></div>
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<span style="font-family: inherit; line-height: 107%;">Queen Margaret University, Edinburgh<o:p></o:p></span></div>
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<span style="font-family: inherit; line-height: 107%;">Edinburgh EH21 6UU <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: inherit; line-height: 107%;">Tel: +44131 4740000<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: inherit; line-height: 107%;">email: <a href="mailto:jbuchan@qmu.ac.uk">jbuchan@qmu.ac.uk</a><o:p></o:p></span></div>
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<span style="font-family: inherit;"><br /></span></div>
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<b><span style="font-family: inherit; line-height: 107%;">Seamus
Cowman</span></b><br />
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<b><span style="font-family: inherit; line-height: 107%;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi3E2EDDIoQ_StQlm1iFJyqUhTKHiI7YvDlXy5OLxMBjFjS3Q3XLnvMHxCZGI_RZzuV7SeKWiA8g6ApV20qmby2ZJJpKumt3hoCvOHbEi-TstbIaOUowYBToo1CFTt2fv49PK5ROalrCMrj/s1600/download+(2).jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi3E2EDDIoQ_StQlm1iFJyqUhTKHiI7YvDlXy5OLxMBjFjS3Q3XLnvMHxCZGI_RZzuV7SeKWiA8g6ApV20qmby2ZJJpKumt3hoCvOHbEi-TstbIaOUowYBToo1CFTt2fv49PK5ROalrCMrj/s1600/download+(2).jpg" width="130" /></a></span></b></div>
<b><span style="font-family: inherit; line-height: 107%;"><o:p></o:p></span></b></div>
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<span style="font-family: inherit;"><br /></span></div>
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<span style="font-family: inherit; line-height: 107%;">Professor <a href="http://www.rcsi.ie/index.jsp?p=142&n=226&a=887">Seamus Cowman</a> PhD FAAN FFNMRCSI<o:p></o:p></span></div>
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<span style="font-family: inherit; line-height: 107%;">PO Box 15503<o:p></o:p></span></div>
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<span style="font-family: inherit; line-height: 107%;">Adilya<o:p></o:p></span></div>
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<span style="font-family: inherit; line-height: 107%;">Bahrain<o:p></o:p></span></div>
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<span style="font-family: inherit; line-height: 107%;">Tel: +973 17351450 Ex 3425<o:p></o:p></span></div>
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<span style="font-family: inherit; line-height: 107%;">Email: <a href="mailto:scowman@rcsi.ie">scowman@rcsi-mub.com</a><o:p></o:p></span></div>
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<b><span style="font-family: inherit; line-height: 107%;">Tonks
(Josephine) Fawcett</span></b><br />
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<b><span style="font-family: inherit; line-height: 107%;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjBtxHS_zfCQTxVCGnLyQ8Yx2K2Kc4UPmV3qRDDReDDnV0PoPdpYOXmde_J2s0z4pk4tQwpXYZPAWZETZwrFHYB7-44vkcPZv8iha0PkhwMLsI06A3PWgoXGZwGoIn1Jka6-JG83hd7cANy/s1600/TonksFawcett150x198.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjBtxHS_zfCQTxVCGnLyQ8Yx2K2Kc4UPmV3qRDDReDDnV0PoPdpYOXmde_J2s0z4pk4tQwpXYZPAWZETZwrFHYB7-44vkcPZv8iha0PkhwMLsI06A3PWgoXGZwGoIn1Jka6-JG83hd7cANy/s1600/TonksFawcett150x198.jpg" width="151" /></a></span></b></div>
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<span style="font-family: inherit; line-height: 107%;">Professor <a href="http://www.ed.ac.uk/schools-departments/health/people/staff-profiles?person_id=36&cw_xml=profile.php">Tonks Fawcett</a> BSc (Hons) MSc RN RNT FHEA<o:p></o:p></span></div>
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<span style="font-family: inherit; line-height: 107%;">Professor of Student Learning (Nurse Education) <o:p></o:p></span></div>
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<span style="font-family: inherit; line-height: 107%;">Nursing Studies</span><br />
<span style="font-family: "times new roman" , serif; font-size: 12pt;">The School of Health in Social Science</span><br />
<span style="font-family: "times new roman" , serif; font-size: 12pt;">The Medical School, Teviot Place</span><br />
<span style="font-family: "times new roman" , serif; font-size: 12pt;">University of Edinburgh</span><br />
<span style="font-family: inherit; line-height: 107%;">Edinburgh EH8
9AG</span></div>
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<span style="font-family: inherit; line-height: 107%;">Tel: +441316503883<o:p></o:p></span></div>
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<span style="font-family: inherit; line-height: 107%;">email: <a href="mailto:t.fawcett@ed.ac.uk">t.fawcett@ed.ac.uk</a><o:p></o:p></span></div>
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<b><span style="font-family: inherit; line-height: 107%;">Alan
Finnegan</span></b><br />
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<b><span style="font-family: inherit; line-height: 107%;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjZFBWKe-6DeB-QxunkNu7jD2DBWUC_3dMQtJRxVnfBI5ZC_B60jzrimQYWyNQZRHd1TksXnbA0AMj8f0CXm2sw0JtDZ-ASAvlcn1joj6YrsrARM3bnQsE9_JAA8GqMrBRP1LIMEGtnQF75/s1600/download+(3).jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="166" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjZFBWKe-6DeB-QxunkNu7jD2DBWUC_3dMQtJRxVnfBI5ZC_B60jzrimQYWyNQZRHd1TksXnbA0AMj8f0CXm2sw0JtDZ-ASAvlcn1joj6YrsrARM3bnQsE9_JAA8GqMrBRP1LIMEGtnQF75/s1600/download+(3).jpg" width="200" /></a></span></b></div>
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<span style="font-family: inherit; line-height: 107%;">Colonel <a href="http://www.chester.ac.uk/cvw/personnel">Alan P Finnegan</a> PhD L/QARANC<o:p></o:p></span><br />
<span style="font-family: inherit; line-height: 107%;">Professor of Nursing & Head of he Academic Department of Military Nursing</span><br />
<span style="font-family: inherit; line-height: 107%;">ICT Building, Birmingham Research Park</span><br />
<span style="font-family: inherit; line-height: 107%;">Vincent Drive</span><br />
<span style="font-family: inherit; line-height: 107%;">Edgbaston</span><br />
<span style="font-family: inherit; line-height: 107%;">Birmingham B15 2SQ, UK</span><br />
<span style="font-family: inherit; line-height: 107%;">Tel: +44</span><span style="font-family: "times new roman" , serif; font-size: 12pt; line-height: 107%;">121 415 8863</span><br />
<span style="font-family: inherit;"><span style="line-height: 107%;">Email: </span><a href="mailto:alan.finnegan526@mod.uk" style="line-height: 107%;">alan.finnegan526@mod.uk</a></span><br />
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<b><span style="font-family: inherit; line-height: 107%;">June
Girvin</span></b></div>
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<span style="font-family: inherit; line-height: 107%;"><a href="http://www.hls.brookes.ac.uk/june-girvin">June Girvin</a> RN MSC PGDip Management Studies<o:p></o:p></span><br />
<span style="font-family: inherit; line-height: 107%;">Pro Vice-Chancellor/Dean of Faculty of Health and Life Sciences</span></div>
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<span style="font-family: inherit; line-height: 107%;">Oxford Brookes University</span></div>
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<span style="font-family: inherit; line-height: 107%;">Gipsy Lane<o:p></o:p></span></div>
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<span style="font-family: inherit; line-height: 107%;">Headington<o:p></o:p></span></div>
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<span style="font-family: inherit; line-height: 107%;">Oxford OX3 0BP<o:p></o:p></span></div>
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<span style="font-family: inherit; line-height: 107%;">Tel: +441865 482560<o:p></o:p></span></div>
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<span style="font-family: inherit; line-height: 107%;">Email: <a href="mailto:jgirvin@brookes.ac.uk">jgirvin@brookes.ac.uk</a><o:p></o:p></span></div>
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<b><span style="font-family: inherit; line-height: 107%;">Martin McKee</span></b><br />
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<b><span style="font-family: inherit; line-height: 107%;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjLr-x-_Y5WxtrlErIH6SDtuj6GlnJTVLZy9AcxmiPjnxinVwEPGmgy2W0aMJKT18QDbqu52AGxhQMnsThH_zSS1-mzt5E_B4YczPDB-Pt36G-ulaSvF_yJYn_EdQpvmHn3xZYYAaoHwQl7/s1600/McKee_Martin18_FINAL+.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjLr-x-_Y5WxtrlErIH6SDtuj6GlnJTVLZy9AcxmiPjnxinVwEPGmgy2W0aMJKT18QDbqu52AGxhQMnsThH_zSS1-mzt5E_B4YczPDB-Pt36G-ulaSvF_yJYn_EdQpvmHn3xZYYAaoHwQl7/s1600/McKee_Martin18_FINAL+.jpg" width="158" /></a></span></b></div>
<br />
<span style="font-family: inherit;">Professor <a href="http://www.lshtm.ac.uk/aboutus/people/mckee.martin">Martin McKee</a> CBE MD FRCP FMedSci</span><br />
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<span style="font-family: inherit;">London School of Hygiene and Tropical Medicine</span></div>
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<span style="font-family: inherit;">London WC1H 9SH</span></div>
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<span style="font-family: inherit;">Tel: <span style="font-family: inherit;">+4420 7927 2229</span></span></div>
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<span style="font-family: inherit;">Email: <a href="mailto:martin.mckee@lshtm.ac.uk" style="line-height: 107%;">martin.mckee@lshtm.ac.uk</a></span></div>
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<b><span style="font-family: inherit; line-height: 107%;"><br /></span></b>
<b><span style="font-family: inherit; line-height: 107%;">Hugh
McKenna</span></b><br />
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<b><span style="font-family: inherit; line-height: 107%;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjOqjqcm3z9_5CEj3m7prhjhzz1cMURucsWeDoQmJ5gKPl-gX2F3wVXgc0nXphB4LQhupxBCFOswAqcQygixFtakkhbg2qOIJuC-CWlrsfD9rZwJ8pdkrricIXxiEBrp0KgkfV_TO9k8z9T/s1600/download+(5).jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjOqjqcm3z9_5CEj3m7prhjhzz1cMURucsWeDoQmJ5gKPl-gX2F3wVXgc0nXphB4LQhupxBCFOswAqcQygixFtakkhbg2qOIJuC-CWlrsfD9rZwJ8pdkrricIXxiEBrp0KgkfV_TO9k8z9T/s1600/download+(5).jpg" width="131" /></a></span></b></div>
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<span style="font-family: inherit; line-height: 107%;">Professor<a href="http://www.science.ulster.ac.uk/ihnr/profiles/h.mckenna.php"> Hugh McKenna</a> <o:p></o:p></span><span style="font-family: "times new roman" , serif; font-size: 12pt; line-height: 107%;">CBE PhD FRCN FAAN FEANS</span></div>
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<span style="font-family: inherit; line-height: 107%;">Pro-Vice Chancelloe (Research & Innovation)<o:p></o:p></span></div>
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<span style="font-family: inherit; line-height: 107%;">Room H235<o:p></o:p></span></div>
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<span style="font-family: inherit; line-height: 107%;">Coleraine Campus<o:p></o:p></span></div>
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<span style="font-family: inherit; line-height: 107%;">University of Ulster<o:p></o:p></span></div>
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<span style="font-family: inherit; line-height: 107%;">Coleraine<o:p></o:p></span></div>
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<span style="font-family: inherit; line-height: 107%;">Co Londonderry<o:p></o:p></span></div>
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<span style="font-family: inherit; line-height: 107%;">Northern Ireland BT52 1SA<o:p></o:p></span></div>
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<span style="font-family: inherit; line-height: 107%;">Tel: +4428 701 24343<o:p></o:p></span></div>
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<span style="font-family: inherit; line-height: 107%;">email: <a href="mailto:hp.mckenna@ulster.ac.uk">hp.mckenna@ulster.ac.uk</a></span></div>
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<b><span style="font-family: inherit; line-height: 107%;">Iain
McIntosh</span></b><br />
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<b><span style="font-family: inherit; line-height: 107%;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj-f-qJSV2vmQOZQdcgm0MbxJW-M2PlW7qAHqiWSlorJGdeNbd-b34j5RNspiaYEKzEiSnez4h8jY03s7-K09i0WL5Bldil8yq2uje2xhlE6ffp2yD2-TegFMTW-73Db3GvYdiQPMlnXqCO/s1600/download+(6).jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj-f-qJSV2vmQOZQdcgm0MbxJW-M2PlW7qAHqiWSlorJGdeNbd-b34j5RNspiaYEKzEiSnez4h8jY03s7-K09i0WL5Bldil8yq2uje2xhlE6ffp2yD2-TegFMTW-73Db3GvYdiQPMlnXqCO/s1600/download+(6).jpg" width="133" /></a></span></b></div>
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<span style="font-family: inherit; line-height: 107%;"><a href="http://www.napier.ac.uk/faculties/health-life-social-sciences/Pages/Staff.aspx?BioID=29235bc6-1053-4680-a441-c3649205400f&StaffName=Iain-McIntosh">Iain McIntosh</a> BA MSc RGN<o:p></o:p></span></div>
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<span style="font-family: inherit; line-height: 107%;">Dean<o:p></o:p></span></div>
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<span style="font-family: inherit; line-height: 107%;">Faculty of Health , Life & Social Scienecs<o:p></o:p></span></div>
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<span style="font-family: inherit; line-height: 107%;">Edinburgh Napier University<o:p></o:p></span></div>
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<span style="font-family: inherit; line-height: 107%;">Sighthill<o:p></o:p></span></div>
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<span style="font-family: inherit; line-height: 107%;">Edinburgh EH11 4BN, UK<o:p></o:p></span></div>
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<span style="font-family: inherit; line-height: 107%;">Tel: +44131 455 5687<o:p></o:p></span></div>
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<span style="font-family: inherit; line-height: 107%;">email: <a href="mailto:i.mcintosh@napier.ac.uk">i.mcintosh@napier.ac.uk</a><o:p></o:p></span></div>
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<b><span style="line-height: 107%;">Jill Macleod Clark</span></b></span><br />
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgsjrGZdO1ltkwu1Bl9S08Ub7wpjtMU9tPkONSljOcZLvECYHftbmkJOZq2QUD6J3WtvT-xpArGguczR1gYzu_1zplZ7surU0IJHxjlVavsxM5B6WhF1Uky0cni3a5pPmCCffido-9DkYHG/s1600/CNMR_01177_XL.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><span style="font-family: inherit;"></span></a><br />
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjxk_bht1NSktRC-2vOwxQEbG6CXGw7VMiTFaynPaYeN_ZCSGbSQslSORnmGBHuPPXASQr0fLQSv16S4xJzfR3zxpWdMZay4baf_NbBwOe8fsWTJD1s9zKwLj-vIuO9cGxedTyDL6ekqJo9/s1600/jmc+pic+4.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjxk_bht1NSktRC-2vOwxQEbG6CXGw7VMiTFaynPaYeN_ZCSGbSQslSORnmGBHuPPXASQr0fLQSv16S4xJzfR3zxpWdMZay4baf_NbBwOe8fsWTJD1s9zKwLj-vIuO9cGxedTyDL6ekqJo9/s1600/jmc+pic+4.jpg" width="132" /></a><span style="font-family: inherit; line-height: 107%;">Professor Dame <a href="http://www.southampton.ac.uk/mediacentre/guidetoexpertise/jill_macleod_clark.html">Jill Macleod Cl<span style="font-family: inherit;">ark</span></a><span style="font-family: inherit;"> </span></span><span style="font-family: inherit;">DBE Phd BSc Hons RGN FQNI FRCN</span><br />
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Professor of Nursing<br />
Faculty of Health Sciences<o:p></o:p></div>
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University of Southampton<o:p></o:p></div>
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University Road<o:p></o:p></div>
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Southampton SO17 1BJ, UK<o:p></o:p></div>
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<o:p></o:p></div>
<span style="font-family: inherit; line-height: 107%;">email: </span><a href="mailto:jmc@soton.ac.uk" style="font-family: inherit;">jmc@soton.ac.uk</a><br />
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<b><span style="font-family: inherit; line-height: 107%;"><br /></span></b>
<b><span style="font-family: inherit; line-height: 107%;">Anne
Marie Rafferty</span></b><br />
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<b><span style="font-family: inherit; line-height: 107%;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgXIw55ogITBoRKZ2JXhegV_HIqcvpo2N10ghzUr9xuk0QjzBZ7yfUqSEmnfFDir5IznKkU87K6eli0_ztRFSCcM_Zz3Yj4j7QRLnoTDhUNAl1vAa9wwbleXj3NRvq5K0uov98m9CIce9lv/s1600/1260188_Rafferty_Anne_Marie007.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgXIw55ogITBoRKZ2JXhegV_HIqcvpo2N10ghzUr9xuk0QjzBZ7yfUqSEmnfFDir5IznKkU87K6eli0_ztRFSCcM_Zz3Yj4j7QRLnoTDhUNAl1vAa9wwbleXj3NRvq5K0uov98m9CIce9lv/s1600/1260188_Rafferty_Anne_Marie007.jpg" width="155" /></a></span></b></div>
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<span style="font-family: inherit; line-height: 107%;">Professor <a href="https://kclpure.kcl.ac.uk/portal/anne_marie.rafferty.html">Anne Marie Rafferty</a> PhD FAAN<o:p></o:p></span></div>
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<span style="font-family: inherit; line-height: 107%;">Chair of Nursing Policy<o:p></o:p></span></div>
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<span style="font-family: inherit; line-height: 107%;">The Florence Nightingale School of Nursing &
Midwifery<o:p></o:p></span></div>
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<span style="font-family: inherit; line-height: 107%;">King’s College London<o:p></o:p></span></div>
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<span style="font-family: inherit; line-height: 107%;">James Clerk Maxwell Building<o:p></o:p></span></div>
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<span style="font-family: inherit; line-height: 107%;">57 Waterloo Road<o:p></o:p></span></div>
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<span style="font-family: inherit; line-height: 107%;">London SE1 8WA, UK<o:p></o:p></span></div>
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<span style="font-family: inherit; line-height: 107%;">Tel: +4420 7848 3608<o:p></o:p></span></div>
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<span style="font-family: inherit; line-height: 107%;">email: <a href="mailto:anne_marie.rafferty@kcl.ac.uk">anne_marie.rafferty@kcl.ac.uk</a></span></div>
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Roger Watsonhttp://www.blogger.com/profile/07408659363029289322noreply@blogger.com12tag:blogger.com,1999:blog-219108116819475337.post-87839836064353371462014-01-19T08:35:00.001-08:002014-01-19T08:35:14.432-08:00Proposal for a Lancet Commission on UK nursing<div class="MsoNormal" style="line-height: 24px;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12pt;">Background</span></b></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12pt;">Modern nursing developed in <st1:country-region w:st="on"><st1:place w:st="on">Britain</st1:place></st1:country-region> under the leadership of Florence Nightingale. The main achievement of Nightingale was to initiate training for women who aspired to be nurses, but this seminal achievement was preceded by fundamental changes to the way wounded soldiers were treated in the Crimea and followed by changes to the delivery of public health in <st1:country-region w:st="on"><st1:place w:st="on">Britain</st1:place></st1:country-region>. Nightingale was a consummate politician who used statistics to support her arguments. She reached the decision-makers of her day and was held in high regard by those she cared for and by those through whom she exerted her influence. <o:p></o:p></span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12pt;">Following Nightingale’s establishment of a training programme for nurses, Mrs Bedford Fenwick—assisted by her physician husband—established the first register for nurses whereby those listed were recognised as having undertaken a prescribed training course and achieved an agreed level of knowledge and skills. Thereafter, regulatory bodies for nurses were established in the counties of the United Kingdom (UK) and, notwithstanding changes to the precise details of what a registered nurse (RN) needed to achieve and the ways this needed to be demonstrated, the training and registration of nurses remained largely unchanged until the late 1980s.<o:p></o:p></span></div>
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<b><span style="font-family: "Times New Roman","serif"; font-size: 12pt;">From training to education<o:p></o:p></span></b></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12pt;">The main features of nurse training until the late 1980s was: schools of nursing located in hospitals and usually serving a group of hospitals; and two sets of examinations: one, the ‘hospital exam’ which identified the nurse with the specific hospital where training had been undertaken, and a ‘state exam’ which was administered by the nursing regulatory body—the General Nursing Council (GNC) and its immediate successor in the counties of the UK—and taken by every nurse being examined at that point on the same day and at the same time. Another feature of nurse training was a two-tier system of registration (leading to the status of State Registered Nurses (SRN)) and enrolment (leading to the status of Enrolled Nurse (EN)). Those undertaking training courses leading to SRN and EN were, respectively, referred to as ‘student nurses’ and ‘pupil nurses’. Student nurses undertook three years training and pupil nurses undertook two years training. Student nurses trained for entry to several branches of nursing: general; sick children and mental (psychiatric and mental subnormality). All of these qualifications were available post-registration as was midwifery, for general trained nurses. Pupil nurse training was generic and could be undertaken in general and mental hospital settings. Students (called pupil midwives) could enter midwifery directly and for general trained nurses and midwives, post-registration training as a health visitor was also available. In addition, there was a plethora of post-registration specialist certificates available and further registration as a nurse teacher.<o:p></o:p></span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12pt;">Until the early 1980s the training and registration—which included the ability to remove nurses from the register—rested with the GNC. However, in the early 1980s the training and regulatory functions were separated and the United Kingdom Central Council for Nursing, Midwifery and Health Visiting (UKCC) was established. The training functions were devolved to bodies in each of the four countries of the UK; for example, in England, the English National Board for Nursing, Midwifery and Health Visiting was established.<o:p></o:p></span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12pt;">The UKCC oversaw the first major change in the way nurses were prepared in the late 1980s when the proposals for Project 2000 (P2000) were finalised. The main features of P2000 were a greater emphasis on the educational preparation of nurses and the establishment of a common foundation programme (CFP) which constituted the first 18 months of training and was undertaken by all students, regardless of the branch of nursing on which they intended to register. With P2000 came more politically correct labelling of the braches of nursing as: adult; children; mental health; and learning disability. Midwifery remained a separate direct entry programme. Student nurses were now more commonly referred to as ‘nursing students’ and EN training was discontinued; all nurses who qualified post-P2000 were considered to be ‘first level’ nurses and conversion courses for ENs wishing to become registered nurses were offered.<o:p></o:p></span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12pt;">Concomitant with the changes to the educational preparation of nurses, but not directly coupled to these changes, was the development—initially in <st1:country-region w:st="on"><st1:place w:st="on">Scotland</st1:place></st1:country-region>—of colleges of nursing. These were formed through a process of rationalising the myriad schools of nursing that existed in relatively small geographical areas and, while they often retained premises within hospitals, this led to the closure of most small hospital-based schools of nursing. The preparation of nurses thus moved away from individual hospitals with which student nurses and nurse tutors used to identify into amalgamated colleges which assumed more of an educational as opposed to a training identity. The fate of these colleges of nursing will be picked up below.<o:p></o:p></span></div>
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<b><span style="font-family: "Times New Roman","serif"; font-size: 12pt;">Nursing in universities<o:p></o:p></span></b></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12pt;">In the 1960s, with funding from the Rockefeller Foundation, an entirely novel venture in nurse preparation was undertaken with the establishment of a nursing degree programme at The University of Edinburgh. This was the first university nursing programme in Europe, although it should be noted that university education of nurses has a long history in the USA—including the Ivy League Yale University—and Turkey. Within a short time university nursing programmes were established in <st1:city w:st="on">Manchester</st1:city> and <st1:city w:st="on">Hull</st1:city> and another early degree programme was offered in <st1:city w:st="on">London</st1:city> by <st1:placename w:st="on"><st1:place w:st="on"><st1:placename w:st="on">Chelsea</st1:placename> <st1:placename w:st="on">College</st1:placename></st1:place></st1:placename> (now the Florence Nightingale School of Nursing and Midwifery at King’s College London). Degree programmes produced a very small percentage of the numbers of nurses entering the register and coexisted alongside hospital schools of nursing and then colleges of nursing. Over the decades since the 1960s other universities, and many non-university institutions (colleges and polytechnics) also offered degree programmes for nurses but the number of graduates remained in the hundreds as opposed to the tens of thousands of non-graduate nurses in training.<o:p></o:p></span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12pt;">The 1990s was the next period of change in nursing education which saw the dismantling of P2000 to make way for Making a Difference, the main feature of which was to reduce the CFP to one year, thus decreasing the former emphasis on the educational component of nurse preparation. Concomitant with this but, again not coupled to it, colleges of nursing and any remaining schools of nursing became associated with a local university or polytechnic. Ultimately, they all became associated with universities as polytechnics were awarded university status. In some universities this led to two-tier systems of nurse preparation within the same university with two separate streams for graduates and non-graduate nurses. Making a Difference, however, meant that learning and teaching had to be merged for all nursing students with those on the degree track undertaking additional assessments. All nursing students were now university students and all of the teaching staff of the former colleges and schools of nursing transferred into universities. During this process, the state examination for nurses was replaced by examinations set by each of the institutions delivering nursing education. A central state exam did not sit well with the autonomy of universities; however, there ensued an additional process of quality assurance—superimposed on the extant internal and external university quality assurance processes—which was specific to the delivery of nursing and midwifery programmes accredited by the nursing education bodies across the UK.<o:p></o:p></span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12pt;">In conjunction with the Making a Difference recommendations, Sir Leonard Peach chaired a UKCC commission into nursing education entitled Fitness to Practice. Many of the changes suggested here were reflected in Making a Difference (and vice versa). Fitness to Practice represented the last major report by the UKCC which was subsequently disbanded, along with the national boards for nursing, midwifery and health visiting (or equivalent) in the four countries of the UK. Both the educational and regulatory functions were subsumed by one body: the Nursing and Midwifery Council (NMC) which oversaw the professional regulation of nurses across the <st1:country-region w:st="on">UK</st1:country-region> and also quality assurance of educational provision in <st1:place w:st="on"><st1:country-region w:st="on">England</st1:country-region></st1:place>. The quality assurance of nursing education was devolved to new bodies in the other three counties of the <st1:place w:st="on"><st1:country-region w:st="on">UK</st1:country-region></st1:place>. The movement of nursing education into universities was completed and in 2010, the most recent change to nursing education was the implementation of all graduate entry to the nursing register (midwifery had already achieved this) for nurses entering programmes in 2011.<o:p></o:p></span></div>
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<b><span style="font-family: "Times New Roman","serif"; font-size: 12pt;">Public perceptions of nursing<o:p></o:p></span></b></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12pt;">A generally positive view of nurses is held by the UK public; one whereby nurses are inevitably referred to as ‘angels’ and usually considered to be female and in a job to which they were ‘called’ rather than attracted for personal and professional reasons. The view of nursing is more of ‘skilled manual labour’ than as a profession, and few outside nursing realise what the training and educational aspects of the work of a nurse entails. Generally, nurses are not considered to be particularly intelligent and to be in a job where they simply follow the orders of the medical profession. The gendered nature of nursing—in the UK a predominantly female profession with only approximately 10% of men in nursing—reinforces the view that nursing is for women. Nursing has not, traditionally, been considered an appropriate career for men and the view persists that men in nursing are largely homosexuals. It should be noted that, traditionally, a higher percentage of men in nursing have worked in mental health than in general nursing.<o:p></o:p></span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12pt;">Notwithstanding this generally positive view of nurses, recent events in the UK National Health Service have led to some negative publicity about nurses and this has been almost exclusively focused on the preparation of nurses. A very negative view of university educated nurses is promoted by particular journalists and the prevailing theme is that university educated nurses are ‘too posh to wash’. This view long preceded the recent Francis report on care at the Mid-Staffordshire NHS Foundation Trust. The view is supported by a great deal of inaccurate information; for example, there is a view that university education for nurses is new, that—prior to 2011—all university educated nurses took degrees when this is only a recent initiative, that university educated nurses spent more time in classroom than on the wards when the ratio of education to practice has never changed at 50:50, and that the subjects that university educated nurses learned were inappropriate; sociology drawing particular criticism in this regard. Contrary views are rarely published and those engaged in university education of nurses are largely demonised. The recent Willis report was unable to demonstrate a link between the university education of nurses and an inability to care; however, it received little publicity. Research from the USA demonstrates the value of graduate nurses in relation to patient safety; however, this research is ignored by the UK press and politicians responsible for health and nursing education.<o:p></o:p></span></div>
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<b><span style="font-family: "Times New Roman","serif"; font-size: 12pt;">Failures in essential aspects of care<o:p></o:p></span></b></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12pt;">Nevertheless, something is wrong. Alongside anecdotal reports of excellent nursing care and poor care, the record of truly shocking incidences of nursing incompetence, neglect and abuse by various bodies which oversee patient care is undeniable. The blurring of care roles, the rise in the number of health care assistants who carry out some tasks previously restricted to nurses—often in uniforms indistinguishable from registered nurses—undoubtedly increases the ‘collateral damage’ to nursing from a wide range of possible incidents. However, somewhere in the process of delivering care in hospitals—the main area for complaints of poor care—and in the community there are registered nurses who, if not directly responsible for care, have a vicarious responsibility. <o:p></o:p></span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12pt;">The range of issues giving rise to complaint is quite narrow and is focused on essential aspects of care, inevitably referred to as ‘basic care’ by the media. These aspects of care can be considered ‘essential’ because, without them, the remaining efforts of the multidisciplinary team are futile. ‘Basic’ implies that these aspects of care can be delivered by anyone and require minimal training to implement; this is, self-evidently, untrue. Specifically, when things go wrong such as: unanswered call bells; patients being left in excrement; deprived of food and fluids; developing pressure ulcers; and being infantilised and even verbally and physically abused, there is a problem which cannot be ignored.<o:p></o:p></span></div>
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<b><span style="font-family: "Times New Roman","serif"; font-size: 12pt;"> What can be done?<o:p></o:p></span></b></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12pt;">Nursing is held in high esteem in many other developed countries; for example in Australia nurses consistently appear in the top five most trusted professions and they top a similar poll in the USA. In the UK nursing is not included in polls of professional status; the view remains that nursing is not a profession. There is little general appreciation of the specialist and advanced roles that nurses play across the world, including in the UK where specialist nurses run clinics for chronic conditions such as rheumatoid arthritis and diabetes, and also specialise on focused areas such as the removal of foreign objects from children’s ears. Nurses also conduct screening endoscopy and in these specialist and advanced roles their work compares favourably with medically trained practitioners; in some cases they perform better.<o:p></o:p></span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12pt;">In the USA nursing is a trusted and prestigious profession and, similar to other developed countries, nurses work with a great deal of autonomy in many specialist and advanced roles. Outside of the UK there seems to be no questioning by the general public or the media of the need for a high level of education for nurses up to, including and beyond graduate level to postgraduate: masters and doctoral level. One crucial feature of the USA system is that educational attainment is coupled to clinical practice; being prepared at masters or doctoral level indicates that the nurse is also prepared to practice at a higher level with the concomitant financial reward. In the UK, educational attainment has never been linked to practice. For example, nurses qualifying from university prior to 2013 with either degrees or diplomas entered practice at the same level with identical job descriptions. Graduate nurses may have generally been recognised as having a higher level of preparation but this was not recognised in any other way. In fact, graduate nurses were discriminated against by the National Health Service by being awarded only a 50% bursary for their studies compared with diploma nurses being awarded a full bursary. Notwithstanding that, their place has been confirmed in universities—and at degree level—but nursing education remains funded, albeit indirectly, via the NHS and this sets them aside to some extent from other UK students who are funded by the Higher Education Funding Council. Nursing students are probably insensible to this, but it does mean than nursing education remains to a large extent under the control of the NHS and the expressed intention, wherever nursing education takes place, is to train nurses to work in the local NHS. Thereby, UK nurses tend not to benefit fully from being in university; their vision tends to be restricted to local health care and, when nursing students do not end up working in their local NHS Trusts, this is viewed negatively. <o:p></o:p></span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12pt;">Therefore, the problem remains of investigating UK nursing education to see what, if anything is wrong with the preparation of nurses. How, for example, do we close the gap between a military nurse—at risk of losing her life—shielding a wounded soldier in a convoy in Afghanistan and a nurse who refuses to fetch a drink of water for a dying older person? How do we raise the profile of nursing, for the right reasons, in the eyes of the UK public and press? How do we use the available evidence that there is a relationship between performance and educational level of nurses to convince decision-makers to back an educational agenda for nurses? <o:p></o:p></span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12pt;">Roger Watson<o:p></o:p></span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12pt;">20 December 2013</span></div>
Roger Watsonhttp://www.blogger.com/profile/07408659363029289322noreply@blogger.com20