To mark International Nurses Day we asked the many researchers who are qualified nurses to answer these three questions:
- What nursing means to you? And is there a different view of it if you’re originally from another country?
- How you would encourage other nurses to progress and conduct research?
- What are the challenges facing the future of nursing that you can see?
Here’s what they said.
I remember being asked in my interview for nursing why I wasn’t applying to be a doctor. There’s no simple answer to ‘what nursing is’ or ‘what it means to me’ but the answer I gave then is probably as close as I’ll ever get.
I’m not that interested in disease but I am interested in people. Nursing is about supporting and helping people, often through their most difficult times. While it’s hard to distinguish this from many other caring professions the key (to me) is that the focus is on the person comes first and the rest follows.
I would encourage nurses to ask searching questions about their practice and to recognise that systematic and critical enquiry is an essential tool for identifying and filling gaps in knowledge.
On one hand there is ample evidence that a sufficient and well educated nursing workforce makes a huge contribution to the ability of a health system to deliver high quality, effective and efficient care with humanity. I’d say it is essential. On the other hand I think that many factors are coming together in a way that makes nursing appear a less attractive career option than it once was at a time that the potential ‘supply’ of nurses from traditional sources is dwindling. At the same time we continue to face a situation where many senior policy makers seem to regard professional nursing as an optional extra – nice to have but not strictly necessary.
To me nursing is more than just a job. It’s a way of life that moves beyond the workplace and extends into every relationship you have with every person. It, like life, can be challenging but at the same time incredibly rewarding.
I would encourage other nurses to progress and conduct research by asking them what they would change, why and how they think it could be done. Then I’d tell them that they were already thinking like a researcher and open their eyes to the possibilities ahead!
The challenges facing the future of nursing…growing and retaining our workforce in a time of uncertainty for our country’s future and where the older population is increasing, but those thinking of joining the profession are limited by finances, educational entry requirements or lack of support, whether personal or from employers.
It is an enormous privilege to be a nurse, especially in my field of cancer and palliative nursing, where our nursing skills are called upon whilst patients and their families are dealing with intensely challenging physical, psychological and sometimes spiritual crisis, and we often find ourselves with patients at the most intimate moments of their lives.
Nurses need to take ownership of generating the research that underpins our practice. Our research agenda should be developed from our encounters with patients, the public other health professionals and the organisations we work in and we need to prosecute this agenda in collaboration with our colleagues from other professions and disciplines.
Given the intense shortage of nurses, and indeed doctors, with constant adjustments to role boundaries we risk losing sight of the essential essence of what nursing is.
The understanding of nursing is or should be universal, nursing means being there and caring for people. Florence Nightingale firmly believed in the science and art of nursing and had a key contribution to what nursing is today worldwide. However, some of the problems the profession face in the UK are also present in Spain like the unfair social image of nursing. It is sad to see that despite the humanitarian contribution of nursing to society, nursing is still not clearly understood and undermined in some spheres even within universities.
In Spain, we have always looked up to countries like the UK and US when it comes to more advanced training for nurses like the Advanced Nurse Practitioner or the Clinical Nurse Specialist and the access to competitive research and Doctorate Programmes. It seems disappointing that while countries like Spain are willing to develop the discipline with further competences and training, in the UK the shadow of the apprenticeship is felt after so much progress.
I would say that nursing research is the door to a knowledge society. And if we want to have an impact on patients’ and families’ quality of life we need to first improve nursing practice and care through translational research.
Not all nurses are meant to undertake research but while some nurses are promoters others are consumers of research and therefore, research becomes important to everyone. There are many types of research projects and even small contributions to nursing research can make a big difference in daily routines.
The main challenges for the future of nursing are sometimes inside the profession since there is a tendency to believe those stereotypes of nursing that frame nursing as a “Cinderella discipline” with a weak body of knowledge. We need to overcome our insecurities and realise that nursing theory and research has well established roots and more potential than other disciplines to transfer knowledge to practice and society, and ultimately, fulfil all the missions of the University.
Being a nurse to me means wearing many different hats, in the sense that as nurses we are in the unique position to support patients in so many ways. From psychological support, medication reviews, diet and exercise advice, physiological testing to smoking cessation provision.
Nursing requires both clinical skills and interpersonal qualities, to support patients at their most vulnerable moments. To know I may have potentially made a difference to the quality of life of a patient, in even in a small way, is a truly rewarding experience. I am very proud to be a nurse and have worked with some wonderful colleagues who all work really hard to care for patients in the NHS.
Working in research allows us to strive to achieve the best care our patients should expect to receive. My role as a research fellow, requires different skills to that of a respiratory nurse, but both roles require organisation and perseverance, with lots of resilience.
Whilst the NHS face many challenges at the moment, patient-centred research has the potential to improve care whilst supporting the role of dedicated staff.”
It is a noble art based on caring or, what is the same, protection, magic, religion, advanced knowledge and skills, holism, critical thinking, sacrifice, complex interventions, leadership, education, research… and much more!
It’s true that the implementation of nursing is different considering transcultural approaches. I am from Spain, but the basis of nurses’ practice is exactly the same. Caring is universal.
It is necessary to show what needs to be improved, wake up the curiosity and boost critical thinking and knowledge development. These facts are not easy as they need to be undertaken with passion and demonstrate its impact in real life. Innovative based learning and bridging real life with theory world might be possible solutions.
I am quite concerned about several things. To provide the best care, nursing needs to continue being considered as a role that requires advanced qualification and development, there cannot be doubt about this. In the practice of day to day, it is necessary to create learning habits in nurses, which encourages the values of innovation in organisations and individuals. With this development it might be easier to enhance the combination of nursing with other disciplines and create new holistic approaches in order to address complex situations. This growth together with experience must be essential values to considerate leadership of nurses in organizations.
We need to make nursing more visible in society. For example, demonstrating the importance of its integration in local and macro-policies to create innovative and efficient public health interventions. Also, highlighting news, personal experiences, results, etc. in mass media and social media about the role of nurses.
Finally, I reckon that it is necessary to strengthen primary care nursing (community, schools) to promote health behaviours and think about the prevention of illnesses.
Dr Chiara Dall’Ora, CLAHRC Wessex Research Fellow, University of Southampton
To me, nursing is a fantastic profession, one of the few where as a professional you can take care of people at 360 degrees. The focus of nursing is the human being, not just ill people. As nurses, we may focus primarily on unwell people if they are in hospital, but in the community, we work on the prevention of diseases and on health promotion, and in this case, our “clients” are potentially everyone! Moreover, being a nurse is not merely accomplishing a set of tasks. For sure, we provide fundamental care, such as, ensuring nutrition, mobility, and hygiene, to name a few; but it is the attention to detail around these fundamental care tasks that can make a difference. It can reduce feelings of discomfort and distress, and make patients feel well looked after. Because of this attention to detail, nurses are pivotal in delivering patient-centred care.
I think there are so many ways in which nurses can progress and conduct research in the UK. A nurse could choose to work on a PhD full-time, as I did, and focus on developing and performing a research study in an academic settingfor three to four years. However, if a nurse wants to keep working in clinical practice, a part-time PhD is surely an option? This usually lasts four to seven years, and nurses can carve out time to work on their PhD when it works best for them. A further option is to embark on a clinical academic pathway. This offers the opportunity to work three days a week on a PhD and two days a week clinically, usually in the area of your PhD. I think whatever the pathway, if you have the intuition that research could be something for you, you should listen to that intuition and try to explore what opportunities are out there. There are multiple sources of funding and help for nurses who want to do PhDs (e.g. check out HEE/NIHR Clinical Doctoral Research Fellowship and NIHR Doctoral Fellowships), you will find the right one for you.
My research is around nursing workforce, so I spend my time researching issues around staffing levels, long shifts, patient outcomes, and nurse wellbeing. I think nursing is currently facing and will continue to face these challenges in the future. The Mid Staffordshire enquiry, which found that appalling care was happening mainly because the Trust management had decided to put savings before staff and patients, taught us a vital lesson: that having enough nurses on the wards is key to keep patients safe. However, it seems little has changed after this inquiry. We often hear it in the news: “There are not enough nurses!”; “Nurses are leaving the NHS”. We read it in the recent RCN survey: nurses are exhausted, overworked, and feel they are not able to provide the care that they want due to lack of resources.
What should we do in such hard times? I think we all have a role to play. As researchers, we must keep striving to produce research which answers the right questions, such as: “how many nurses should there be in a shift?”; many times we hear conclusions stating: “we need more nurses”, but we must be able to quantify “more”. We need to provide findings that can reliably inform practice; and we must get our messages out there by communicating them to different audiences: patients, nurses, and politicians. Our research should attempt to increasingly involve patients, nurses and other stakeholders, so that we are sure that our questions and findings are relevant to all these groups. I am 100% positive that these challenges can be solved by working together.
Lindsay Welch, COPD research nurse and CLAHRC Fellow
Nursing is not just a job, or a means of employment. It is a profession, an intelligent motivated and giving profession. It is a way of life; a way of thinking though situations – away of constructively applying concepts of care, in artful and intelligent ways.
Nursing is both and art and a science, and we should never be afraid to move away from the medical model and embrace the art of what we do. Always question and always ask why.
Never be afraid to seek support to develop your questions in to line of investigation.
It is disappointing to see less people applying for nurse training, but nursing has a certain resilience and passion – even with lower numbers.