What do nurses actually do?

Nurses are working in challenging times and are facing unprecedented pressures regardless of whether working within our beloved but over-stretched NHS, or the independent sector.


Over the years they have evolved from arranging flowers on the wards, fluffing cotton wool and folding gauze to carrying out surgical operations. In 1959 a cadet nurse earned £2.19 shillings a month and adhered to strict rules living in nurses’ lodgings with a curfew at 10pm. Now, the starting salary is in the region of £23,000 with no interest or concern for accommodation.Their appearance has also transformed from starched aprons and white caps to more practical trousers and tunics. Is this just the nursing profession adapting to the modern day working environment, or is there more to it?


Nurse training is now a degree course, with learning taking place equally within the university lecture halls and practice-placement settings throughout the three year course (or four years at Scottish universities). Training, originally, was on the hospital wards under the supervision and command of the matron. The scope and variety of the role has developed and evolved due, possibly, to the strain that the NHS is under but also due to the more academic nature of the training. This has enabled nurses to take more of a lead in the care of patients and take on much more responsibility.  They are now valued members of multi-disciplinary teams where they are encouraged to give their opinion, something which would have been unheard of years ago.


Nurses are also caring for a new type of patient who know and demand their rights, have fingertip access to an enormous amount of health information via the Internet and often think that they know best! There is, therefore, the need for the nursing profession to become more and more specialised with, for example, Advanced Nurse Practitioners (ANP) and other such roles that have the skills needed for, amongst other things, specialist medical technology.


Advanced Nurse Practitioners are educated to masters level and are able to make autonomous decisions in the assessment, diagnosis and treatment of patients in their care. A Nurse Independent Prescriber can prescribe medication for any medical condition within their own proficiency, and the variety and scope of practice available within the profession is enormous. Senior nurses – known as ‘surgical care practitioners’ – perform surgery for conditions such as skin cancer and carpal tunnel syndrome and assist in theatre for major operations.


The onset of trousers replacing stockings sees the profession inching towards gender equality. Sadly the number of male nurses remains low, and one might blame the old fashioned stereotype for this. In contrast, there has been a monumental shift in the gender perception of doctors from the male domination of years gone by; but sadly nursing still has a long way to go. In 2016, only 11.4% of registered nurses were male.


As well as the low numbers of male nurses, one can’t avoid mentioning that the nursing profession is struggling with recruitment in general. Is this due to the removal of the bursary for nurses in training? This can’t help, but it’s not only new recruitment, it is retention of the existing nurse workforce that is a concern as sadly the books do not balance with more leaving than joining the profession. This can be attributed, largely, to the unmentionable word that is ‘Brexit’ as since Britain voted to leave the EU there has been a shocking 89% decline in nurses and midwives from Europe joining the NHS, an issue which needs to be addressed sooner rather than later. Daily staff shortages on the wards add to the workload pressures which are increasing daily with, amongst other things, an ageing population, poor access to continuing professional development, an undervalued workforce and pay restraints painting an ugly picture. The pressures being faced by nurses are rapidly reaching unacceptable levels, a situation which can only be disastrous for us all.


It is a tragedy that this brilliant, highly skilled profession isn’t more valued by society. A career that saves lives and one that we, as a nation, heavily rely and trust in and which forms the bedrock to the entire NHS should be held in the highest of esteem and recompensed appropriately.


The progress that the nursing profession has made over the years, and certainly since the birth of the NHS, is quite staggering.  It is without a doubt an exciting, stimulating and highly rewarding profession that gives endless opportunities and variety for a long, stimulating and hugely valuable career. Technology is improving all the time, and the age of Artificial Intelligence and robots is already a reality within the healthcare industry. This sounds scary but if one uses the term ‘augmented intelligence’ and ‘augmented care’ instead, one can see how highly skilled nurses, and other healthcare workers, can use technology to aid rather than replace their skills. Patients will always need the human touch. Monitoring our health via our personal computers and smartphones with websites and healthcare apps could cut out the tiresome and complicated diagnosis stage, where the waiting lists are long and often a cause of distress to the patient. Skilled nurses will be able to interpret the information and put a care package in place possibly without the need for the patient to sit in hospital waiting rooms. The possibilities are endless and there seems to be no doubt that this is the way forward and a picture of what the future of healthcare is going to be like.


If you are considering working within a healthcare setting, then nursing should be high on your list to explore. Unlike doctors, nurses are able to build relationships with patients, as they are with them from admission onto a hospital ward through to discharge. They are there to relieve the pain, ease anxiety and distress as well as being able to notice and respond to any complications and concerns. They are adept at being able to observe subtle, and sometimes lifesaving, changes through their highly skilled training, perception and excellent communication skills.


I hope that the next seventy years of the NHS sees a shift in the perception of the nursing profession and that society can appreciate and value this wonderful occupation. Few jobs and careers stand still but evidence shows that the nursing profession has transformed dramatically. However, I think it is good to remember that nurses still have at their core a duty of care and respect for not only their patients but also to their patients’ families. The highly trained and skilled nurses of today ensure that a patients’ dignity is maintained at all times, regardless of the nature of the task and treatment being administered and I hope that this will never change.


If you are interested in embarking on a nursing career, look at the NHS careers website to find out more about the variety and opportunities available which are, quite frankly, huge.



Author: Debbie Spens

Debbie has extensive experience working in independent boarding schools with a particular interest in pastoral care. She is a teacher of Special Educational Needs, a sports coach and has spent many years delivering PSHE lessons including delivering the Mindfulness in Schools Programme which she has been qualified to do since 2010. She currently works as a schools’ consultant, a Careers Guidance Counsellor, a trainer in Mental Health First Aid and delivers mental health awareness talks for the Charlie Waller Memorial Trust (www.cwmt.org.uk).

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