A vision of possibilities for nursing by 2033

As I am writing this month’s blog we are still awaiting the long overdue government announcement about this year’s pay award. In the current context for nursing, where the cost of living is at an all-time high and the soaring cost of petrol is directly impacting on all - but in particular on community nurses being able to afford to travel to see patients and student nurses getting to their placements - the need for a fair pay award has never been so urgent.

This need doesn’t just impact nursing professionals, but directly impacts on the populations that we serve, and the huge resources attributed to the cost of harm when patient quality and safety is compromised. These risks present an overwhelming economic business case for the full funding of safe quality nursing care.

Where nursing staff are not supported to deliver safe quality care they feel this deeply and we are seeing more and more nurses simply walking away and leaving the profession, something that was clearly illustrated in the NMC’s recent report. The current resurgence of COVID-19 cases is further compounding the issue - with staff sickness rising, it is becoming more and more difficult to find nursing staff to cover these gaps. 

The government simply can’t afford to delay their announcement. But whilst we wait, please be assured that the RCN will be there for you all in readiness to respond to this announcement. Make sure your details are up to date so that all the crucial information on next steps reaches your inbox.

It was really good to meet so many members face to face at my first (and last) AGM and RCN Congress in Glasgow as your President - it was actually the 35th RCN congress that I have attended!

The AGM was well attended and members heard from RCN Council about work of the College during 2021/2022, the progress of the KPMG report that RCN Council commissioned to review the governance of the RCN, and Bruce Carr QC updated members on the progress of his report and the plan for a future meeting when the report is published.

I was very pleased to have the chance to address members at the opening ceremony. In my keynote speech, I spoke about my vision for nursing over the next ten years and how we could achieve this – so hard to do when we are addressing the very serious issues of today right now - however I used Stephen R. Covey’s theory to ‘Start with the end in mind’ as a focus to imagine what the headlines in 2033 could be if we achieved this vision. 

My ten-year vision

• Nursing to be a highly valued, acknowledged and respected profession. It should be well-rewarded in terms of salary, safe working conditions and access to education and training with clear career progression.
• Student nurses to receive sufficient financial support throughout their courses and the majority of students completing their course.
• Safe staffing levels established in legislation across all health care settings and across all UK countries and the RCN’s Nursing Workforce Standards embedded in every health care setting.
• The UK having learned the lessons from the COVID-19 pandemic and robust emergency plans put in place ensuring that health care staff will never be put at significant risk, nor will they witness the scenes they endured in 2020 onwards.
• Populations consistently reporting high levels of satisfaction with their care and high standards of safe quality care as the norm.
• Harm events being very rare and where they have occurred the response to harm being compassionate, open and transparent.
• Advance care planning being the norm, as is shared decision making.
• Patients and service users considered equal partners in both the planning and the delivery of their care.
• Career pathways being effective, inclusive and wide access encouraged, and pathways that support progression points.
• More investment into public health and population health improved.
• Care in all settings equally valued. Care homes and the charitable sector able to attract the skilled staff they need. Primary care and community services should resource allocations that enable them to deliver high quality services.
• Mental health services receive significant funding and parity of esteem being achieved.
• Significant progress in achieving Equality, Diversity and Inclusion across health care.
• Senior nursing posts representative of the wider nursing workforce.
• Overseas nurses consistently welcomed, supported, highly valued and receive equal opportunities for career progression.
• Health and wellbeing of nursing staff a top priority for all, incidents of incivility and bullying not tolerated and speaking up encouraged and rewarded.
• Flexible working opportunities the norm across health and social care.
• The RCN respected by all stakeholders and an influential contributor to health care policy through a national and international centre of excellence for nursing, education and research.
• The professional and trade union arms of the College speaking as one voice and have a shared purpose.
• RCN members fully engaged and participative – the College using many forms of engagement to achieve this - ensuring elections are inclusive, attract many nominations, a large percentage of the membership vote in the elections, key roles have effective succession planning and mentoring and coaching and development is the norm for all RCN reps.
• Nursing staff always kind and supportive of each other, welcome critical challenge, and are responsive.

How we could we work together to achieve this vision for nursing?

Nationally

We can all work together to campaign, lobby and influence governments across the UK to:

• Recognise, acknowledge and take action to address the critical nursing shortage.
• Develop and implement a long-term workforce strategy.
• Implement pay review body recommendations in full and make sure they’re not constrained.
• Implement legislation for safe staffing across the UK and across settings.
• Be accountable for funding health and care services to ensure high standards of care are delivered.
• Recognise cost of harm is more expensive than investing in the workforce.
• Make the connection with the need for safe staffing levels together with the cost of temporary workforce and have a compelling economic business case to fund safe nursing care.

Design of our health care system

• We need the various parts of the health care system across the UK to understand their contributions and co dependencies.
• We need effective care pathways to be implemented and progressed at pace – rather than organisational barriers.
• We need effective, quality commissioning.
• And we need investment in population health and a focus on prevention.

Employers

• Staff wellbeing needs to be a top priority –with a focus on a robust approach to ensuring equality, diversity and inclusion.
• Workplaces must be safe learning cultures and the components of learning organisations must be introduced and implemented.
• Employers should revise their disciplinary policies – ensuring a fair process for all and so that disciplinary action is rare (embedding a fair and learning culture)
• Grievance policies should be reviewed and instead focus on being resolution policies.
• Employers must place staff retention as a top priority - understanding what causes staff to leave and have actions in place to address this.
• Employers should introduce flexible working wherever they can and invest in their staff.

RCN leading the way as the nursing professional union

As the RCN we need to:

• Collate robust evidence from all of you for the COVID-19 enquiry.
• Implement the recommendations of our governance reviews, so we are able to deliver for our members in the best way. Including progressing action on equality, diversity and inclusion
• Explore ways to ensure greater engagement and participation.
• Support the professional and trade union arms of the College will work closely. together on having a shared purpose in progressing health and well-being of nursing staff which in turn ensure quality of care delivery.
• Be data driven, proactive and speak for the nursing profession clearly.
• Be leaders in best practice, education and research and influence nursing nationally and internationally – driving our profession forward and ensuring the best for our members.

As nursing professionals we need to:

• Treat each other with kindness and respect.
• Support each other professionally and ensure we are delivering the best care we can.
• Be inclusive and support equality, diversity and inclusion in all of our roles and with those populations we serve.
• Act as formal and informal mentors – coaching and role modelling nursing best practice to colleagues and newer members of our workforce.
• Be encouraging to others and making sure we’re reflective and self-aware in our roles.

These are just some of my thoughts, what are some of yours?

During RCN Congress 2022 members discussed a number of key issues at our Congress this year – you can find out more on our website.

There were many very important debates and some resolutions which were particularly relevant to the International Committee that I chair (as well as for the Professional Nursing Committee and Trade Union Committee). 

The first was the development of a strategy for the recognition of the skills of, and the development needs of overseas nurses coming to work in the UK and how they might be better supported. Overseas recruitment must be ethical, the RCN is calling on governments across the UK to invest in expanding the domestic workforce and to ensure international recruitment is transparent, dignified and free from exploitation.

Delegates at Congress identified the need to address racism in nursing calling on the UK government to seize the opportunity of its planned reform of human rights legislation so that health and care organisations, regulatory bodies and inspectorates are required to tackle racism, including in the workplace. 

We also want the COVID-19 inquiry to explore why a high number of ethnic minority nurses died during pandemic, including any structural reasons. 

There were many more important debates which members can watch on our website along with all the keynote speeches from Congress.  

You will have seen that nominations are now open for RCN President and Deputy President until 4.30pm on 20 July 2022.  With almost half a million members, this is a fantastic leadership opportunity to take forward the promotion of the value of the profession of nursing. Whilst being RCN President is a big commitment, the role gives a unique opportunity to focus and highlight on key priorities for both the profession, and the populations we serve. An important part of this role is working collaboratively with others, being a team player and having a focus on the changes we collectively as a nursing profession want to see.  

The RCN has made a commitment to driving improvements in equality, diversity and inclusion. If you are a registered nurse and have been an RCN member for five consecutive years, then I urge you to think about this opportunity. I am not planning to re-stand for this role and I’m very happy to be contacted by anyone who is interested. This is your moment, please put yourself forward.