Extract from 2020health’s report ‘Too Posh to Wash? Reflections on the Future of Nursing’
Article by Baroness Sally Greengross, Chief Executive, International Longevity Centre-
UK (ILC-UK) and Deborah Sturdy RN MSc (Econ), Trustee, International Longevity Centre UK (ILC- UK) / Director of Care, Red and Yellow Care.
The current changes we are seeing in the way in which Health and Social Care is being delivered gives rise to the need for professions to respond in creative and innovative ways. Nursing is well placed to do this if it desires to take up the challenge and place itself centre stage in delivering new solutions to the growing ageing population, and in particular the needs of those with dementia.
The move towards greater integration between health and social care will blur the boundaries and the profession will need to respond to different systems, values and cultures. Stepping out of the traditional health role and structures of hierarchy will cause discomfort and anxiety for many but for the few they will quickly see that the egalitarian opportunity of the changes for creating a system which will truly put people ‘in charge’ of their health and wellbeing. Personal health and care budgets will further empower individuals to make choices about how and where they receive their care. Creating a nursing response through entrepreneurial and innovative solutions could make a significant contribution to achieving this. Small independent practices of clinicians tailoring care to the individual rather than fitting into the confines of traditional structures provide ample opportunity for the brave. Nursing has an important role to play in the new emerging world and in particular in its response to the needs of frail older people. Nurses, as both advocates and pragmatists, will be well placed to deliver solutions based on need rather than available services.
With the estimated 750,000 people with dementia in the UK today nursing has a critical role to play in supporting people to live full and active lives. Supporting both the person with dementia and their families through investing in sustainable relationships through the life course of their dementia journey will enable real choice and control, provide advice, support and care to enable people to live and die in their own homes wherever possible and retain their dignity and relationships through to the end of life. A new hybrid of practitioners who can navigate complex systems and processes, translate the languages of health and social care and engineer outcomes driven by the individuals wishes would see a truly person centred approach to care.
Nursing has to place itself centre stage in the debate and ensure its creativity and drive, reminiscent of Florence Nightingale and her foundations of clinical practice, if it is to reach its potential and ensure its future. The fiscal, national and global challenge is a platform for radical ideas and opportunity to step away from the inertia of care practices. Never has there been a time such as now where the old adage ‘when the going gets tough the tough get going’ been true. Nursing through its history has been at the forefront of providing a critical role in the delivery of healthcare not only as a major staff group in the NHS, but before its inception too.
Nursing spans the generational boundaries and its influence on the population is immense from cradle to grave. The children of today are our older people of tomorrow. The role of the nurse in ill health prevention and promotion of well- being influences the shape of our society.
The profession should not underestimate the impact it is having along the age spectrum. Nursing is a constant partner in the well-being of the nation and as we see the demographic challenge ahead, keeping the nation well and healthy across the ages will be necessary in contributing to the reduction in the demands for health and social care in future years. The profession has to take the long view of its role in shaping our society, its opportunity to be enablers of choice and control rather than advocates and interventionists. Nursing needs all its creativity, leadership and vision to both recognise the critical role it plays today but also its imperative role in creating a healthier ageing population. Without stepping away and acknowledging where it has come from and the role the profession has played to date along with the acceptance of its responsibility and privilege in shaping the future, it will not reach its vast potential in being the driver of the change we need to see for sustainable care.