Current Issues in Nursing PDF
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Current Issues in Nursing Current Issues in Nursing _________________ EDITED BY MOYAJOLLEY Lecturer, Institute of Advanced Nursing Education The Royal College of Nursing AND PETAALLAN Director for Professional Standards and Development United Kingdom Central Council for Nursing Midwifery and Health Visiting SPRINGER-SCIENCE+BUSINESS MEDIA, B.V. © 1989 Springer Science+Business Media Dordrecht Originally published by Chapman and Hall in 1989 Typeset in Times 1O/12pt by Leaper & Card Ltd, Bristol ISBN 978-0-412-32850-3 ISBN 978-1-4899-3328-7 (eBook) DOI 10.1007/978-1-4899-3328-7 This paperback edition is sold subject to the condition that it shall not, by way of trade or otherwise, be lent, resold, hired out, or otherwise circulated without the publisher's prior consent in any form of binding or cover other than that in which it is published and without a similar condition including this condition being imposed on the subsequent purchaser. All rights reserved. No part of this book may be reprinted or reproduced, or utilized in any form or by any electronic, mechanical or other means, now known or hereafter invented, including photocopying and recording, or in any information storage and retrieval system, without permission in writing from the publisher. British Library Cataloguing in Publication Data Current issues in nursing. 1. Medicine. Nursing I. Jolley, Moya II. Allan, Peta 610.73 ISBN 978-0-412-32850-3 Contents CURRENT ISSUES IN NURSING Acknowledgements vii Preface viii Foreword by Maude Storey IX 1. The Professionalization of Nursing: The Uncertain Path MoyaJolley 1 2. Nursing Education: A Luxury or Necessity? PetaAllan 23 3. Theory to Practice: Implementation in the Clinical Setting Audrey Miller 47 4. Nursing Management and Leadership - The Challenge Colin Ralph 67 5. Nursing Research: Growth and Development Claire Goodman 95 6. Nursing and Politics: The Unquiet Relationship Trevor Clay 115 7. The NHS: Evolution or Dissolution? Christine Hancock 131 8. Nursing in the Future: A Cause for Concern Jane Robinson 151 Index 179 v Contributors PetaAllan, MA, DipFEd, SRN, ONC, RNT, FB/M Director for Professional Standards and Development United Kingdom Central Council for Nursing, Midwifery and Health Visiting. Trevor Clay, MPhi/, RGN, RMN, FRCN General Secretary Royal College of Nursing, London Claire Goodman, MSc, BSc, NDN, RGN Lecturer in Nursing Research Dept. of Nursing Studies King's College University of London Christine Hancock, BSc(Econ), RGN General Manager Waltham Forest Health Authority General Secretary Designate, Royal College of Nursing, London Moya Jolley, MA(Ed), BSc(Econ), DipEd, SRN, RNT, Dip in Nursing Education (Lond) Lecturer, Institute of Advanced Nursing Education Royal College of Nursing, London Audrey Miller, MSc(Nursing), BA, SRN, RMN, RNT Lecturer, Dept. of Nursing Studies University of Wales College of Medicine Colin Ralph, MPhi/, RGN, Dip in Nursing (Lond) Registrar and Chief Executive United Kingdom Central Council for Nursing, Midwifery and Health Visiting. Jane Robinson, PhD, MA, A/PM, RGN, ONC, RHV, HVT, Cert Ed Director, Nursing Policy Studies Centre University of Warwick vi Acknowledgements The editors wish to extend their grateful thanks to all the contribu tors to this book. Without their enthusiasm and hard work this book would not have been possible. Thanks go also to Miss Maude Storey for writing the Foreword. Appreciation and thanks are also extended to Miss Helen Thomas, Assistant Librarian in the Library of Nursing at the Royal College of Nursing, for her untiring efforts in checking and preparing references; and to Mrs Jean Smith for all her help and support in preparing the final typescript. vii Preface The editors' intention in the production of this book was to provide a realistic picture of the present state of nursing. This has been presented from a number of different but inter-linked perspectives. The decades since the inception of the National Health Service have been ones of significant change, both in society at large and in the field of health care. The period has witnessed political, economic, social, scientific and technological change taking place ever more rapidly; whilst, in terms of health care, demand and expectations continue to increase apace. Nursing, throughout the period, has been influenced by, and has responded to, these prevailing influences, and continues to do so. Contributors to this volume have sought to examine in depth some of the current issues in nursing at the present time. Each chapter examines a specific issue in the current nursing context and is, therefore, capable of standing alone. But considered together the chapters enable many aspects of the current debate on, and development of, nursing to be seen as a whole. It is hoped that this book will serve two fundamental purposes. First, to stimulate debate and activity by all nurses in their particular sphere of influence, and in the wider world of nursing. Second, it aims to inform those undertaking pre- or post-registra tion nursing programmes and thus assist their understanding of the state of nursing. The editors' purpose in presenting this book is to assist nurses to maximize their contributions to the factors which lead to improved standards of patient and client care. viii Foreword ___________M AUDE STOREY President, Royal College of Nursing The growth and development in and around nursing and the complexity of nursing has never been so marked as at this time. Many of the major developments require informed comment as an aid to understanding. A book which will bring into focus some of the major areas of professional development, highlighting current and future issues, is a valuable resource to assist in providing an important knowledge base. This is an historical period in the life of the nursing profession. I write this foreword at a time when we have received positive announcements on two long sought developments on clinical career grading systems and on a reform of nurse education. Each of these achievements will have effects not only upon individual career progression and on the education of nurses, but upon the future development of nursing in its widest sense: the skill mix in providing care, the standard of care given, development of primary health care and in many different areas which as yet many of us can scarcely envisage. In a large gathering of nurses, following the Secretary of State's announcement of an agreement to the fundamental principles enshrined within 'Project 2000', a member of that group exhorted those present to await judgement until they have written the 'fine print'. Here was evidence of a great lack of understand ing, for in truth the nursing profession must recognize that it is nurses not 'they', whoever 'they' may be, who are now responsible for writing the 'fine print' and developing the means whereby reform can be achieved. Nursing has traditionally been seen as an art and a science. However, with a nursing education system which, in the past, has created the artificial separation between the practical and theoreti cal elements, we have hardly reinforced the art and science base. ix x Foreword There is still much more that needs to be done to ensure that the art of nursing is comprised of sane nursing actions informed by sound knowledge and research. Nurses need to gain insight about the developing state of the art, should know how far education, the linkage of theory to practice and research in nursing has progressed. More importantly, that knowledge should inform on how much further these matters need to be developed in the pursuit of excellence in care provision. Most nurses work within the NHS and thus the importance of an understanding of the context in which practice takes place for the majority of the profession is vital. This subject quite rightly holds an important place in this book. Any developments in nursing are greatly influenced by the context in which nursing is performed. The working through of the, as yet, uneasy relationship between functional management of nursing and general management has and continues to present a challenge. Never has there been a greater need for sound leadership, for the recognition of potential leaders and for their development. Some leaders within the profession have, for many years, recognized that developments in nursing which have the greatest professional impact depend, for achievement, upon fighting within the political arena. Great professional desires, such as those specified earlier, could only have been achieved in that scenario which for many nurses is as yet unknown and fearful territory to tread. Dame Sheila Quinn in her address to an RCN Congress exhorted nurses to 'get political- stay professional'. That is still an important axiom. Nurses must recognize the importance and reality of politics in every aspect of life, not least nursing. There is a need to educate, to overcome our political naIvete, to begin to feel more comfortable and sure in the political sphere and above all, to rid ourselves of remnants of antagonism which still exist on the matter of further involvement. Without political acumen the future of nursing will continually be decided by others outside the profession and by those who have learnt to play the political game. Nursing, in its professional emergence, must depart once and for all from the dependence upon others to dictate its practice. In recent years great stress has been laid upon the nurse's individual professional responsibility and accountability for nursing actions.
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