Cost of changing nurses’ roles

The chief nursing officer for England, Jane Cummings, plans to launch a new nursing and midwifery strategy next year. This is an important step in setting the future direction for nursing, with recommendations for all nurses irrespective of their specialty. Tamsin Newton Snow discusses the strategy in more detail, including perspectives from senior oncology nurses.

The nursing landscape in the UK is changing, in large part due to the development of advanced practice. However, while this has created opportunities for individual nurses, the nursing profession has paid a price for medicalising nurses’ roles. In some areas of oncology, fundamental nursing values have been lost.

The responsibility of ensuring compassionate care lies with individuals, yet organisational and service pressures are compromising nurses’ clinical practice. Many specialist nurses are overwhelmed by service demands and are powerless to implement changes that would ease the pressure. As a clinical outsider, I find the situation worrying.

Specialist nurses and those in advanced practice must prove the value of their roles. Nurses have shown that they can reduce the burden on medical staff, for example by substituting for doctors and running their own clinics, but at what cost to nursing and patients? As nursing services become overstretched, nurses’ ability to deliver compassionate care will diminish and the risk of burnout will increase.

The priority of advanced nursing practice should be to enhance patients’ experiences through communication skills and empathic care, bringing added value to consultations, rather than simple doctor-nurse substitution. Greater vision is required for nursing, and nursing values must become embedded into all nurses’ roles, with demonstrable benefits for patients, their families and informal caregivers.