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What is a nurse? If someone were asked to describe the role of a nurse there could be many different answers. To a lot of people, a nurse will be viewed as someone who is there to support their patients, to be a friendly face and to give patients and family reassurance when needed. When asked what a nurses role entails, a few examples could be: giving medications, checking observations, completing paperwork and giving feedback to other members of a multidisciplinary team. A nurses role is very diverse, there are so many types of nursing and different people have different experiences with them. Because of this, nursing is hard to define. The Royal College of Nursing (RCN) came up with the following definition for nursing:
The use of clinical judgement in the provision of care to enable people to improve, maintain, or recover health, to cope with health problems, and to achieve the best possible quality of life, whatever their disease or disability, until death. (RCN, 2004)
Nursing is a lot more complex than it used to be. Historically, it was a job taken on by poor women who were neither trained, nor skilled. During the 19th century anyone could call themselves a nurse, without the need for any formal training. In 1919 The Nurses Registration act was passed, meaning that nurses had to receive standardised training and be added to a register. This was thanks to the work of nurses such as, Florence Nightingale, Ethel Fenwick and Dame Sarah Swift who championed the need for the training and registration of nurses. Thanks to this act and the work done by these prominent figures, nursing is now seen as a highly skilled profession. Nurses now have more skills than ever and are encouraged to take on further roles and responsibilities. Nurses also have the opportunity to become more qualified, taking on roles such as advanced and specialised practitioners, these roles, for example, can involve prescribing medications without the need of a doctor. Although time has moved on and nursing has advanced significantly, nursing is still a predominately female career choice. In 2017, only 10.8% of registered nurses were male. This has barely changed over the last ten years. Since 2006, there has only been a 0.1% rise in male Registered Nurses. (RCN, 2017)
In the 1990s, the education of nurses began to change. Instead of training in schools and colleges attached to hospitals, training for degrees in nursing, at universities, began. This scheme was called Project 2000. As people were living longer and technologies in medicine were advancing, it was decided that nurses would need the knowledge and education to reflect the advanced treatments they were administering. These days there is a lot more emphasis on theory than there used to be, so a student nurses time is spent, roughly, 50% in the classroom and 50% on the job, in a placement. (Patterson, C. 2012)
There have been many changes that have impacted on the role of nurses over the years. One of the most significant changes that impacted on the role of nurses was political, the founding of the NHS in 1948 and The NHS Act 1946. When the NHS first came about there was a severe shortage of nurses to the amount of beds in hospitals. The number of student nurses continued to grow over the years, but the role was changing. With new government policies, the public were now to be more responsible for their own health and wellbeing, with more choices. Nurses were also now more accountable for their actions and held more responsibilities than before. (Rivett, G. 2020) The political changes that take place can also have an impact on economical and sociological circumstances. For example, when the financial crisis happened in 2008, the government had to make budget cuts and reduce funding for public health. The financial strain had an impact on nursing with staffing and supply shortages, certain treatments having to be prioritised, the rising life expectancy of the public and health foundations having to budget more effectively. The rising life expectancy of the public is also classed as a social change that is having an impact. Because people are living longer there is more pressure on the NHS including its nurses. The costs for treating the elderly are rising. Technologies are also having to advance, and nurses are having to update their knowledge frequently because of this. (NHS, 2020)
As mentioned earlier, Nurses must be registered. The register is held and kept up to date by The Nursing and Midwifery Council (NMC). To register, nurses need to meet certain requirements. These include having the appropriate qualification, being of good health and character and use of English language skills. (NMC, 2019a) After three years, a nurse is required to revalidate their registration and evidence that they have met all the requirements to do this. It involves several different elements, which include, continuing professional development, reflective accounts and a certain number of practice hours. This is then all confirmed before revalidation. (NMC, 2019b) Apart from holding the register, the NMC are responsible for several other things. The NMC sets all the professional standards, education and skills that are required to become and continue to practise as a nurse. Through the NMC Code, they set the standards, behaviours, expectations and continuing development that are required to be upheld by nurses. Aside from the register, the NMC also deal with concerns about nurses who may not be doing their jobs effectively. The concerns that they investigate can include ill health, misconduct and criminal behaviours, amongst other things. They thoroughly investigate any allegations made and make sure that the nurse meets the NMC standards and is fit for practice. If a nurse is found to have not met the standards, they could be removed from the register for a certain amount of time or if very serious, permanently. (NMC, 2020) Above all, the NMC has a commitment to keeping the general public safe, through the work that they do.
The NMC Code, as mentioned previously, is the professional standards set that must be adhered to by registered nurses in the UK. Employers and educators should support their staff and students to uphold the Code. There are four themes that The Code is based around, prioritise people, practice effectively, preserve safety and promote professionalism and trust. These themes are then broken down into 25 sections, in the form of statements that indicate what good practice looks like, to make up the code. The code is not only about the standards of the NMC, but also those that are expected by the public. It can be used as a tool by the public to provide feedback on the care that they have received. Not adhering to the code can cause implications in relation to a nurses role.
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