Cliff Kilgore currently works for Dorset Healthcare NHS trust as a community consultant for older people. He has been a consultant for 10 years. He started his nursing career in 1999 and has specialised in the care of older people for most of this time. He is the Chair for the BGS Wessex region and is also a visiting fellow to Bournemouth University. He tweets @kilgore_cliff
We know that nursing is a highly skilled profession that is provided in a wide range of settings that encompass primary, community and hospital care. However, I feel the use of the term ‘nurse’ is sometimes misunderstood, particularly by those that have been fortunate enough not to require the professional expertise of these healthcare professionals. In some ways nursing can be a bit confusing as it covers such a diverse range of roles from healthcare assistant to consultant practitioner. However, it is the diversity that stands out for me, with roles that have grown to meet the needs of patient care over a timespan that stretches from the inception of the NHS to current times.
There is much written on the history of nursing but on this Nurses Day, I want to highlight something that speaks of the enormous flexibility within nursing to adjust to both crisis situations and the ever-changing demands placed upon it in a constantly evolving modern world. It is the adaptability within nursing that has enabled the increasing complexity within older people’s healthcare to be met with professionalism, skill, and kindness.
The very nature of nursing is about problem-solving. Many nurses see themselves as pivotal in the patient’s journey, ensuring that there is a response to crises as well as providing decision-making and treatment in what many nurses would regard as routine care. These qualities have enabled patient care to continue throughout the pandemic and the same attributes have continued beyond this to the national strategy now seen in England for hospital at home and virtual wards. The latter has particular benefits for older people and focuses on patient-centred care with services that provide intervention for acute health crises without the deconditioning that can be associated with inpatient care. For some colleagues, this has been a very different way of working. But I have seen how nurses have adapted to the new approach, managing risk while recognising the necessity to communicate with the wider multi-professional team.
There have, of course, been many innovations within hospital nursing and also within general practice nursing (GPN). New roles and services created to minimise length of stay for those who have been admitted to hospital have huge benefits. In addition, GPNs have continued to deliver care and treatment for those living with long-term conditions, helping people to live as well as they can.
The International Council of Nurses (ICN) nursing definition says that ‘Nursing encompasses autonomous and collaborative care of individuals of all ages, families, groups and communities, sick or well and in all settings’. I like this as a definition because it highlights the many variations of nursing provision. There is no doubt that holding a patient’s hand and making the odd cup of tea are important at times, but what will ensure that nursing remains a vital necessity in healthcare will be the knowledge, skills and a high level of professional leadership that this role brings.
