Once a nurse, always a nurse

This time last year, the UK government announced that it intended to make the title ‘Nurse’ a legally protected title. At present, only ‘Registered Nurse’ and ‘Advanced Nurse Practitioner’ titles are legally protected. Without such legal protection, it’s possible for anyone to call themselves a nurse and practise as a nurse; this is a situation that does not protect the public. There have been many cases, where a registered nurse, having been struck off the Nurse Midwifery Council (NMC)’s register, continues to present as a nurse. This is something that is not only potentially harmful to individual patients, but also risks undermining the hard-won reputation of the nurse profession.

The Early Day Motion calling for the title ‘Nurse’ to be legally protected was long overdue and most welcome. The former Secretary of State for Health and Social Care, Wes Streeting, fully supported the motion and a potential three-month consultation across all four nations of the UK was proposed. As far as I’m aware, and please dear reader if you know something different, we are still waiting for the consultation to start and conclude.

New legislation can take a long time to reach fruition. Of course, Wes has been busy over the last 12-months trying to manage the self-inflicted chaos of the reforms (not reforms), aimed at bringing together NHS England and the Department of Health and Social Care. And now he’s gone, hoping to become the UK’s next Prime Minister. We now have a brand-spanking new Secretary of State, James Murray. He has assured us that there will be no changes to the pace and purpose of the reforms (not reforms). So, watch this space folks, but please don’t hold your breath for too long.

Just as an aside, the UK has had 11 health Secretaries of State since 2015. Only two have been in the role for more than three years. The average time in office is just 487 days. Wes lasted for 677 days. Probably the most inappropriate health minster was the cigar-smoking, wine-drinking Therese Coffey who, thankfully, lasted just 49 days in the role.  

Hmm, well that has been a very long introduction to what I wanted to write about this week. We held our first Nursing Awards Day at Greater Manchester Mental Health Trust last week. I was fortunate and privileged to attend and take part, as was our Chief Nurse, Chief Operating Officer, and our Chief Executive Officer. All four of us were, or still are, practising nurses. For a large mental health organisation such as ours, this fact alone made me feel very proud.  

As well as announcing some of the winners, I had also been asked to introduce the afternoon and say a few words. My starting point was to share that I was a nurse. When I retired, I also took myself off the NMC register. As such I cannot practise as a nurse (see above), but my belief is, ‘once a nurse, always a nurse’. In my introduction, I told of the work of both Virginia Henderson and Carl Rogers. I think the hundred or so nurses in the audience were more familiar with the work of Carl Rogers and in particular, his concept of unconditional positive regard, when we work with our patients (and colleagues too, I suggest).

On a former part of my life journey, I was the Dean of one of the largest nursing schools in England. Twice a year, I would welcome eager new student nurses, and like last week, share the works of Henderson and Rogers. I would also talk of how it was the work of Michel Foucault and his notion of the importance of revealing ‘the language of the silenced voice’: that is listening, with attention to what is not being said, that helped shape my own practice.

Whilst last week’s Nursing Awards were a triumph, it was sad to read a survey published by the Royal College of Nursing last Monday. This reported that 64% of nurses taking part in the survey believed there are too few of them to keep patients safe and provide good quality care. I think there is a great deal of work going on nationally, on what safe staffing might mean in practice. We are doing similar work in our Trust, but I don’t think that safe staffing levels can purely be about numbers.

However, I don’t want to end this blog on such a downbeat note, especially as our Nursing Awards event was such a celebration of both individual and team achievements, of pride in the contributions being made across our improvement journey. It was an absolute testament to the powerful contribution nurses continue to make to improving the health of our nation and the varied ways they continue to make a difference to the lives of others. I was left with a warm feeling that the profession was in good hands.