Developing nursing's future role: a challenge for the millennium: 1

Abstract

Over the past decade health care in general and nursing in particular have experienced a period of unprecedented change resulting from a variety of factors including demography, advances in technology and the introduction of differing service delivery systems. For nursing this has created a number of tensions, especially between professional aspirations and the demands of a new managerial culture. Many nurses have found themselves torn between the push towards the ideal of individualized holistic care and the reality of resource constrained environments. The new White Paper 'The New NHS: Modern, Dependable' (Secretary of State for Health, 1997) heralds a move away from the 'short termism' of the internal market towards a partnership model of integrated care. It also reaffirms the Government's commitment to further develop the role of the nurse. This article, the first of two, considers the challenges nurses face in responding to a managerial agenda while simultaneously maintaining the development of the nursing profession. The opportunities afforded by the recent White Paper are identified and the need to address a number of current tensions are highlighted. Developments at the Northern General Hospital in Sheffield are briefly described, with the results of a major survey being presented in the second article.

Reflection: nursing’s practice and education panacea?

“…Does reflection do nursing a disservice by virtue of the fact that its philosophical approach to care is in direct opposition to the demands of the internal market (with its emphasis on financial constraints and throughput, Naughton & Nolan 1998). Might this fuel feelings of frustration and cause even more nurses to exit from the profession?…”

Tensions within management roles in healthcare organisations

“…Given the challenges faced by ward leaders this is not surprising. Not only is there conflict, confusion and ambiguity surrounding the role, postholders are often illresourced and poorly supported to face complex and conflicting demands (Lewis 1990, Naughton andNolan 1998).…”