Saturday, 24 October 2015
Monday, 2 February 2015
Text of editorial on Lancet Commission in British Journal of Nurisng
The Lancet Commission on Nursing
Ian Peate
The terms of
reference for the Lancet Commission on Nursing were published in May 2014 and
stated that the purpose of the Commission was in
the public’s interest and that the Commission was charged (by the Lancet
presumably) to consider the nursing contribution to improve
UK health care outcomes.
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.
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. 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. 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.
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.
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.
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.
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.
The Royal College of Nursing (RCN),
whose job it is to represent the interests of nurses and nursing locally, nationally and
internationally, has encouraged the Commission 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’.
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.
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.
References
Dean, E.
(2014) “Lancet Commission to Tackle the Poor Perception of UK Nursing” Nursing
Standard Vol 28 No 21 pp10
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
Lancet (1932) “Nursing Commission’s Report” Lancet Vol
219 No 5660 pp 409
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”.
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
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