ProNurse

I am a bit long in the tooth and battled scarred these days to feel let down, I just get on with it and scream and shout and make a nuisance of myself with management as often as I feel justified to do so. What does really get to me is that the management structure doesn't encourage nurses into it as NHS trusts are run as businesses and that is not what most nurses trained for, my line manager is an occupational therapist, next in the heirarchy is a podiatrist and lovely, professional and knowledgable people that they are, they are not nurses and have no perception of my role other than I am expected to do x number of contacts and over and above that is a good thing as it generates income. I feel let down by government for allowing our NHS to be all about number crunching and not about caring anymore.

The nursing profession is going through a lot of change  ( whether we like it or not) and how we handle that change will determine the role of the nurse in the future. I have been thinking about how much of what nurses do is invisible but specifc to the role of the nurse and if we do not make those invisible things visible then nursing itself too will become invisible. Assessment tools are all very well but it is what you do with them that counts

ameliajane says ...

Wow - where does one start..? 

My own pet hate is the slow, insidious removal of nurses' clinical judgement.  This is increasingly being replaced with scoring systems where a particular action must be taken according to the score (falls risk, waterlows, nutrition, MEWS, mouthcare etc) and many of these systems are badly flawed. Obviously, if you need to take action you will do so regardless of the score, however there are many occassions when the action dictated is not required.  In the past these formal assessment tools were used as a guide to clinical decisions and so the suggested action could be over-ruled by clinical judgement, but they are now used as audit tools - checking whether nurses are complying with the prescribed actions - a low score on the audit is assumed to represent poor care.  This is frustrating and insulting, it creates work and leads to unessessary referals.  If nursing decision making is going to be reduced to ticking boxes and adding up scores what is the point of an all degree profession... or any profession...

 

Good points well made