Let's talk nursing

The QNU launched the Let’s talk Nursing project at the 2006 QNU Annual Conference. The project is an important one for nursing in Queensland, reclaiming nursing values and defining  nursing so a clear and consistent position on what nursing is and why it is important can assist nurses in their day to day working lives. Another aim of the project is to give nurses the tools and language to defend nursing from the views others hold about nursing.

Background

The status of nursing is under attack. The attack is not from one malevolent anti-nursing source, but from the culmination of economic, social, political and health pressures. This form of attack is difficult to identify and equally hard to confront and correct. It is erosive, not explosive. Just as erosion is difficult to notice and reverse, so too, is the current attack.

How does the Queensland Nurses’ Union know there is an attack on nursing? Our members, scientifically researched, tell us so and the current health crisis is open for all to see.

Excessive workloads, the dilution of nursing skill, rapid technological change, an ageing population, the pursuit of efficiency over health care and economic rationalism are just some of manifestations of these pressures.

In late 2001 and again in late 2004, the QNU commissioned independent research of its membership by the University of Southern Queensland (USQ). A wide-ranging survey was conducted on a random selection of members employed in the public sector, private hospitals and aged care. The findings were presented to the 2002 and 2005 QNU annual conferences.

The aim of this research was to survey members on key issues affecting their working lives across the three sectors. This research was conducted as part of the QNU’s overarching campaign to improve wages, workloads, working conditions, educational support and workforce planning—Nurses. Worth looking after.
The major findings of this research (Hegney, Plank, Buikstra, Eley 2005) were that:

• Nursing is emotionally challenging and physically demanding;
• Workload is heavy;
• Skills and experience as a professional nurse are poorly rewarded (remunerated or recognised);
• Work stress is high and morale is perceived to be poor and deteriorating, similar to 2001;
• There are insufficient staff and the skill mix is inadequate; and
• Most nurses cannot complete their work to their level of professional satisfaction in the time available.

QNU members have delivered a clear message—there is a yawning gap between what nurses know is necessary for appropriate care and what actually happens in their daily working lives. The research also highlights that working nurses do not neatly divide their concerns into either industrial or professional. They are entwined.

Similarly, the QNU rules set out objectives that reflect both industrial and professional. This is one of the great strengths of the union and it is why the QNU is well placed to take action to narrow the gap between what is, and what should be, the experience of nursing.

The past decade has seen unprecedented campaign work in this area—industrial, professional, political and communication activities—without substantial headway on nursing issues across the board. The QNU holds that this is partly because key decision makers do not understand, accept or value the views of nurses. The views others hold about nursing dominate the views of working nurses.

To deal with this effectively and bring relief to the nursing crisis, nurses must be clear about the fundamentals – the values and purpose of nursing. This has proven elusive in the past.

For this reason, the 2005 QNU Council endorsed a project to develop policy on the core values of nursing. QNU Councillor Kym Volp was given responsibility for this vast task. To frame the debate and communicate positions within the debate, the QNU believed it was necessary to ask the foundation questions first:

• Who performs nursing work and who is appropriate to perform the work?
• What is it that nurses do, what should they be able to do and under what circumstances?
• Why nurses are required, and why they need, to be regulated?
• When is nursing required and who determines this?
• Where does nursing occur (across all settings and roles)?

The paper launched at 2006 QNU conference provides an introduction to the subject. It does not answer the who, what, why, when and where questions for nurses. The QNU’s ongoing project aims to help nurses answer these questions as a collective using the core values articulated in this document as a starting point.

This paper informs QNU members of the model for nursing and the framework for policy we have developed. It requires reflection on the values that unite and define nursing and proclaims these publicly—in essence, to re-value nursing.

A clear starting point about nursing’s core values will enable nurses to defend and expand nursing within an environment of constant reform. If we fail to determine this clear and consistent position on what nursing is and why it is important, the views of non-nurses will continue to determine matters relating to nursing.

This framework provides assistance for nurses to act individually and collectively to support the integrity of nursing and argue publicly for the value of nursing. The work of this project is ongoing. We believe this paper provides an important summary of key issues as well as providing a framework for nurses to make sense of their current predicament. 

We invite nurses to continue to ‘talk nursing’ in ways that validate our concerns and make it possible to plan our responses effectively.