Once a nurse, always a nurse

Submitted by Programme Director, Global Nursing Leadership Institute, ICN
May 5, 2020

When the COVID-19 call came here in the United Kingdom for nurses to return to work in the National Health Service, I wasn’t sure how to respond. Once a nurse, always a nurse? Yet I haven’t been regularly at the bedside for many years.

My roles in nursing focus on international nursing development and policy activism. As programme director of the ICN Global Nursing Leadership Institute, I aim to support front-line nurses by helping nurse leaders to get to the top table, and to be effective once there. Yet my work, though I think it matters, feels remote from the overstretched hospitals, care homes and community services in the town where I live in lockdown. So where and how can I be most useful?

I mentioned my dilemma to a fellow volunteer at our local food bank. ‘Don’t you dare abandon us!’, she said. ‘We need your nursing skills here!’ And I think she was right. I’ve volunteered weekly at the food bank for three years, filling bags with fresh produce for 50 households in need, writing leaflets and helping with strategy. In that time we’ve provided around 80,000 meals. So much of what I contribute is based on what I have learned in my many years in nursing – whether in clinical care, leadership training, policy work, writing, or editing Nursing Times.

Now I’m spending 3 to 4 days a week on food bank work, and using those nursing skills all the time. When coronavirus appeared on the horizon, I researched how best we could protect volunteers and clients, so when the lockdown came we were already primed and trained. Even Sister would have admired my seminar on hand-washing. Now I monitor the evidence and we discuss it – to mask or not to mask? Would we contract or pass on the virus by bagging up a crate of apples? How can we make our coffee safely?

At-risk volunteers are staying away and we are now a lean, mean team. Channelling Sister again when I lead the sessions, I focus on priorities, problem-solving, keeping up morale, and reminding everyone to maintain physical distance. While encouraging and reassuring others I often feel far from calm myself, as the work is (like nursing) surprisingly complex and stressful. At the end of each session we review and improve our policies and procedures as necessary (ah, the nursing process!).

Delivering big weekly bags of fresh fruit, veg and dry goods to around 100 adults and 60 children in need is our reward. Our clients (except the odd difficult patient) say their sense of being cared for by their community is highly valued, as well as the practical help. It’s not just what you do, but how you do it (ask any service user).

My voluntary work reminds me of my role in the Prime Minister’s Commission on the Future of Nursing and Midwifery in England in 2012. Painting a new picture of nursing, our report highlighted the enormous value of nursing to society, above and beyond our centrality to health services. We introduced the concept of ‘nursing capital’, a subset of ‘human capital’ – our stock of skills and knowledge that produces economic and social value. This stock provides an additional return on public investment, we said, ‘when nurses apply their skills and knowledge in other roles…in their private lives as carers and unpaid health advisers to families, friends and communities.’

In a very small way that is what I am doing, putting my pebble on the pile, though I still have pangs of guilt when I hear the stories from service front lines. We stand on our doorsteps once a week to applaud the bravery and commitment of our healthcare colleagues, and I also weep for them. The celebration of this long-awaited International Year of the Nurse and Midwife has taken a back seat, but awareness of nurses’ value, quality and commitment is at an all-time high. What better legacy could there be, once this pandemic calms down, than nursing finally receiving the recognition, support and rewards that the profession and society deserve?