This essay sets to give an overview of the knowledge and analysis of the nursing profession in the United Kingdom (UK) concerning the developmental changes that the profession has gone through. In addition, this essay will discuss nursing policies, nursing regulations, the interprofessional relationship that nurses have with other professionals (with specific reference to the elderly and children), the effective strategies to ensure that nurses are always employed. Finally, there will be a discussion of the highs and lows of the nursing profession.
A nurse is an individual charged with the responsibility of looking after physically or mentally ill persons in clinical settings or the home environment by professional conduct and due care (Cambridge, 2020; Nursing and Midwifery Council (NMC), 2018). In the UK, the nursing profession consists of children nurses, adult nurses, mental health nurses, and learning disability nurses who must all be registered by the Nursing and Midwifery council (subject to passing the required assessments and completing training in placement settings) before they can be called registered nurses (NMC, 2018; NMC, 2020).
The history of the nursing profession in the UK dates back to the mid-nineteenth century when the requirement to treat it as a profession worthy of training towards and generating skills sets (University of Glasgow, 2020). Before this period, people looked after ill patients but never took it as a profession; rather it was a routine left for people that were not too busy (like the elderly) (Mortimer, 2015). As a result of the people’s perceptions in those days, looking after ill people was seen as a task to be undertaken by family members and not spinsters (University of Glasgow, 2020). Also, feeding and cleaning up after invalids were designated to servants in the household (University of Glasgow, 2020). These practices were strengthened because hospital treatments were uncommon at that time (University of Glasgow, 2020). In 1854, Florence Nightingale went to Turkey leading a team of nurses to look after so0ldiers that fought during the Crimean War (Thomas, 2016). This initiative was a stepping stone to greater things in the nursing profession. In the year 1860, Florence Nightingale made a remarkable progression by institutionalizing a training school called the “Florence Nightingale Training School” that opened at St Thomas’s Hospital in London (Thomas, 2016; Isaac, 2015). This training school was a landmark achievement in the UK because it was one of the foremost establishments to formally educate people on nursing and midwifery based on the philosophies and practices set out by Florence Nightingale (Thomas, 2016).
In the year 1887, the British Nurses Association, (made up of nurses seeking professional enrolment) was born; and started by Ethel Fenwick; the aim of which was to create an association of professionals in nursing that were bound by unified principles (Nursing Times, 2014). Before this, Eva Luckes, who as of 1880 was Matron of the London Hospital had already set up a two-year training scheme that was a mix of theoretical and practical learning (Nursing Times, 2014). The nursing profession was taking giant strides in the formal recognition and regulation; in the year 1908, London hosted the foremost National Council of Trained Nurses of Great Britain and Ireland; with Mrs. Bedford-Fenwick emerging as its founding president (Nursing Times, 2014; Thomas, 2016).
The outbreak of the global wars upsurged the need for nurses with nurses increasing from 2,200 to 10,500 by the end of the war because of the rise in demand for health care (Nursing Times, 2014; Nursco, 2018). In the year, 1916, the foundation of the Royal College of Nursing (RCN) was laid with thirty-four members and in 1919, the General Nursing Council generated an approved register bound by the Nurses’ Act (Nursco, 2018). 1951 was a landmark year for males as they were ushered into the professional register of the nursing profession eliminating sexism (Thomas, 2016). Jaramillo (2016) opines that nursing is treated as par with females, thereby creating discrimination against males; an unethical practice. This brought us to the concept of knowing in nursing; this involves focusing on effective patient care irrespective of the person’s subjective views (Bonis, 2009). The nursing profession has now evolved to embrace males because the underlying aim is to deliver person-centered care irrespective of who delivers it (as long as it fulfills patients’ choices and is in their best interests (Bonis, 2009; Thomas, 2016; NMC, 2018). Over the years, the nursing profession underwent various changes especially with the introduction of the National Health Service in 1948. Nurses had a duty of care to look after patients in a structured health care system irrespective of their finances as all care was free at the point of delivery (Berridge et al., 2011).
There are four main principles of the NMC namely: “Prioritise people”; “Practise effectively”; “Preserve safety”; “Promote professionalism and trust” (NMC, 2018). The principle of prioritising people is based on person-centeredness; this means that everyone should be treated with dignity and respect and provided with care that is tailored to their health care needs as long as it is in their best interest to do so (NMC, 2018; RCN, 2016). Practicing effectively involves working in partnership with fellow nurses and other practitioners to act in the best interest of the patients (NMC, 2018; Glabsy and Dickinson, 2008). Nurses are very influential in health care sector as they are closer to the patients; therefore, they must be treated with utmost respect and dignity. This is because negative attitude in the work place deters nurses from staying in the job (Twigg and McCullough, 2014). Nurses must communicate effectively with one another, other professionals so that patients can be kept safely and no harm will come to them (NHS, 2014).
Preservation of the safety of patients is one of the important principles set out by the NMC (2018). This principle sets out the necessary measures to ensure that patients are adequately safeguarded from harm. Children and elderly patients are very vulnerable; therefore, it is in their best interest to be properly safeguarded. Most times, children and older adults (especially cognitively impaired adults) may not cooperate with nurses because they do not understand the rationale for safeguarding them; however, nurses must ensure that their choices are treated as secondary especially when they are in danger (HM Government, 2018; HM Government, 2003; NHS England, 2017; Social Care Institute for Excellence, 2017). Consent is very important in nursing as doing otherwise will mean a violation of human rights (Human Rights Act 1998; NMC, 2018). However, ethics is very important in nursing because it helps nurses to be confident, morally responsible to patients and make best judgements about patients’ care so that their best interests are preserved (Holt and Convey, 2012; Cranmer and Nhemachena 2013; NMC, 2018). Also, apart from Twigg and McCullough (2014), McHugh and Ma (2014) noted that the work environment plays an important role in retaining nurses. McHugh and Ma (2014) also noted that good pay packs would motivate nurses to work effectively to promote the safety of patients.
Promotion of professionalism and trust is also very essential in nursing practice because patients are vulnerable when they are ill and these patients and their families trust the nurses to give the patients the best care so that they can get better or be comfortable (if they are at the end of their life) (NMC, 2018). Nurses must act professionally at all times by adhering to the NMC Code and the policies of the Department of Health, RCN and other health and social care policies; this is to ensure that nurses act ethically and do their best to promote patient’s health and safety at all times (NMC, 2018; Beauchamp and Childress, 2013; Department of Health and Social Care, 2018).
Another important nursing role is the effective documentation of patients’ records and care plans in the right (confidential) places at the right time for ease of access to authorized persons (NMC, 2018). Dimond (2015) and Griffith and Tengnah (2017) both attest that effective documentation of patient records by nurses is good practice for keeping them safe. Nurses have done well to keep up with this; although nurses have had various setbacks in their professions like the crisis at the Mid-Staffordshire hospital as reported in Francis report by Powell (2013) where lots of harm came to patients because of a decline in care. With the latest development of coronavirus, the nurses also have a duty of care to promote effective and regular handwashing in clinical settings and the community to minimize the spread of Covid-19 and other infections (NHS England and NHS Improvement, 2019; RCN, 2020a; RCN, 2020b).
This essay has provided an overview of the historic perspective nursing profession in the UK including policies, interprofessional relationships, and strategies to ensure nurses are retained. Nurses must communicate the healthy options to parents of children and adults in a clear, unambiguous way so that they can make life-changing and rational choices (NMC, 2018).
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