EDITORIAL
VOL 16 No 2 - July 2000
Editorials are not neutral. They are written to persuade. This one is no exception. My intention is to urge nurses to write, and write more, about those aspects of nursing they most value. It is intensified effort rather than new direction that I am advocating. The majority of manuscripts submitted to Nursing Praxis (both now and historically) are centred in nursing practice, although education and other topical issues such as scope of practice are not neglected, as is evident in this issue. A high proportion deal with aspects of nurse/patient interaction, that is to say the human face of nursing. On these subjects nurses write with purpose, sometimes passion and often, I think, love, about a part of nursing which is recognisable both in its presence, and absence, yet is - and possibly always will be - elusive when it comes to making a link with specific outcomes to which a market value can be assigned.
In a previous editorial, some ten years ago, I opined my lack of a crystal ball. I note that currently the authors of the discussion papers associated with the Nursing Council initiated, and KPMG directed, review of undergraduate nursing education are more confident. In a series of scenarios located in the year 2010 they bravely venture to define the nurse of the future. I found these
forecasts compelling reading, yet in the end I wished I had left the documents unopened. I think I was expected to see, and perhaps be heartened by, a vision of nursing regenerated - as it might be in a world ruled by IT. Some visions for the future of nursing have power to fire and inspire; these mainly chilled.
I don’t intend this to be a critical response to the KPMG papers (KPMG, 2000a, 2000b, 2000c). There are other more appropriate avenues for that exercise. Instead I will share some of my thoughts and feelings prompted by reading them. Despite the repeated references to new possibilities and new roles I could not shake off a sense that key elements were missing in these futuristic images. By the time I reached page sixteen of the third paper uneasiness was acute. In my understanding of nursing, caring - in its broadest sense - has always been so closely woven into the fabric of practice that the two are inseparable. Consequently a situation of fewer nurses with less time (due to increased casual and part time work) and spread more thinly geographically (servicing rural populations) so making it very likely that the concept of caring would need to be redefined, is not cheering - especially when it is assumed from the outset that “one on one contact, in a personal way, … may be limited …” (KPMG, 2000c, p.16). The acknowledgement of nurses’ flexibility and adaptability is pertinent. Both will be essential for those confronting the challenge to develop strong interpersonal relations with consumers by means of “technology mediums”. It is foreseen that flexibility and adaptability will set the nurse apart from other professionals. That could well be so, but my fear is that the distinction may be akin to what marks refugees and the
dispossessed from other citizens.
The environmental scan referred to in the introduction reveals little that is new. The implications identified there are, if not one hundred per cent positive, at least not without positive aspects. Some are trends already so well established that there is no alternative but to focus on turning them to advantage. So these predictions should not take me by surprise. To what then should I attribute my lack of enthusiasm? Is it just wanton sentimentality
- nostalgia for a disappearing past? Or perhaps apprehension in the face of a
future characterised by diseases of old age, dementia and depression?
Like many other people I am at times bewildered by the alleged power of smart appliances to dramatically change our way of being in the world. Even a hint that they may render the person in nursing obsolete unsettles me. That efforts to translate caring into practice often fall short of the ideal is no reason for nurses to be forced to abandon the concept of caring, or pass guardianship to others. Like the strength to hope, the will to care is almost as important as the fulfilment. Without it the view becomes intolerably bleak.
In the belief that even in this electronic age the printed word is still a potent force, I urge nurses to continue to write about those aspects of nursing closest to their hearts. Much is at stake, given that “… a thing is not truly discovered until it is written about, for only then does it take shape in the minds of those who have no direct experience of it” (Flannery, 1998, p.4). By slackening effort to portray nursing in its totality we could be doing a great disservice to future generations of nurses, and as well those whose health they aim to foster.
Norma Chick
Emeritus Professor
MASSEY UNIVERSITY
REFERENCES:
Flannery, T. (Ed.). (1998). The explorers. Melbourne: The Text Publishing
Company.
KPMG. (2000a). Discussion Paper 1. Trends and influences on health and disability support services and implication for nursing 2010. Wellington: Author.
KPMG. (2000b). Discussion Paper 2. Trends and influences on education and implications for nursing education 2010. Wellington: Author.
KPMG. (2000c). Discussion Paper 3. Defining the nurse of the future.
Wellington: Author.
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