Education And Debate

Nursing: no regrets

BMJ 1995; 311 doi: (Published 29 July 1995) Cite this as: BMJ 1995;311:307
  1. Heidi Lempp
  • Accepted 21 March 1995

If innovation in the nursing profession is the future then the future is already here, but it is not yet evenly distributed. The nursing profession claims direct patient care as its own special area of expertise.1 To provide patient care effectively and to innovate, nurses need to have control over their professional practice. The concept of a profession includes accountability and autonomy for personal actions: accountability means that the nurse is answerable for his or her own behaviour, while autonomy means that she or he has the freedom and the authority to act independently.2 Historically, both have been in short supply, with nurses often being left with feelings of inadequacy and powerlessness, as their attempts to establish areas of autonomous practice have been frustrated. Indeed their situation is weaker because nursing has little theoretical foundation of its own; rather it has often borrowed theories from medicine and from behavioural and physical sciences. Turning this to advantage, however, newer approaches to academic nursing training, under the umbrella of Project 2000, are now developing from the results of theory-building research, grounded in clinical work. Within this structure that is clinically rich, poor in theory, and laden with hierarchy, how can a nurse be creative? Three factors have helped me to remain positive about nursing after over 20 years in the profession. These factors—innovation, the move from secondary to primary care, and ongoing further education—even helped me to return to nursing after I left for six months when I felt completely exhausted.

Innovative nursing posts

The first factor that has helped me to remain positive about nursing was my decision to innovate by taking posts that had been newly created. In 1986, for example, I began a job share post as ward sister, the first in Britain, after a battle lasting almost a year …

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