Nurses as change agents for a better future in health care: the politics of drift and dilution

Abstract

This paper takes the 70th Anniversary of the National Health Service (NHS) in the United Kingdom as an opportunity to reflect upon the strategic direction of nursing policy and the extent to which nurses can realise their potential as change agents in building a better future for health care. It argues that the policy trajectory set for nursing at the outset of the NHS continues to influence its strategic direction, and that the trajectory needs to be reset with the voices of nurses being more engaged in the design, as much as the delivery of health policy. There is a growing evidence base about the benefits for patients and nurses of deploying well-educated nurses at the top of their skill set, to provide needed care for patients in adequately staffed and resourced units, as well as the value that nurses contribute to decision-making in clinical care. Yet much of this evidence is not being implemented. On the contrary, some of it is being ignored. Policy remains fragmented, driven by short-term financial constraints and underinvestment in high quality care. Nurses need to make their voices heard, and use the evidence base to change the dialogue with the public, policy makers and politicians, in order to build a better future for health care.

Engaging nurses in health policy in the era of COVID‐19

“…Front‐line nurses may believe it is impossible to create policy change at the national or even local level; many may think their role is too small to make a difference in health policy. However, the engagement front line nurses have with patients, and other healthcare professionals, make them ideal healthcare policy advocates 9 …”

The Florence Nightingale’s nursing theoretical model: a transmission of knowledge

“…In addition, it collaborates to provide a suitable environment, facilitating the recover of the person. Being the nurse totally loyal to the patient (9)(10) (Figure 2).…”

“…In addition, it made it easy to imagine that the religious reform that preceded the contemporary nursing period was fundamental to make way for nursing at home and hospitals. Both environments significant for the care, the promotion and the recovery of health (7,9) . Therefore, her own desire to care for the patient with quality, helped to design, in the field of health sciences, the nursing profession (9) .…”

“…Both environments significant for the care, the promotion and the recovery of health (7,9) . Therefore, her own desire to care for the patient with quality, helped to design, in the field of health sciences, the nursing profession (9) . Also this woman affirmed that the look of the person who cares for must observe the intangible aspects (10) .…”

Gender equality policies, nursing professionalization, and the nursing workforce: A cross-sectional, time-series analysis of 22 countries, 2000–2015

“…In turn, the failure to adequately appreciate the work performed by women has been linked to the insufficient social and financial recognition afforded to such occupations (Limoges, 2007;Mandel & Semyonov, 2005). Other studies have explored the gendering and devaluing of caring/caring work, which, instead of being recognized as requirements for all health organizations and health practitioners (Apesoa-Varano, 2016;Caffrey & Caffrey, 1994;Goodman, 2016), have been linked to emotion and self-sacrifice, characteristics commonly attributed to women (Rafferty, 2018;Treiber & Jones, 2015). The exploration of the socially shaped care/cure binary, which compares and contrasts nurses' caring work with the curing work performed by physicians, has brought valuable insights to the understanding of the differential recognition experienced by various categories of health professionals (Sandelowski, 1997(Sandelowski, , 2000Treiber & Jones, 2015).…”