Comment

Narrowing the range of responsibilities

The University of Birmingham's Yvonne Sawbridge asks if there is a case for chief nurses to concentrate solely on leading the nursing workforce.
Director, matron, sister

The University of Birmingham's Yvonne Sawbridge asks if there is a case for chief nurses to concentrate solely on leading the nursing workforce

At RCN Congress in Liverpool this year, I attended a fringe meeting to discuss the role of nurse directors, specifically in relation to the quality-monitoring and regulation processes. It was a debate informed by plenty of inspirational nurses who were proud and capable, yet also humble.

One intriguing aspect was the degree of positivity that framed the range of roles and responsibilities that nurse directors hold.

We may have unique skill sets, and an ability to turn our hands to most things, but, given recent serious issues of care, such as those highlighted in the Mid Staffordshire NHS Foundation Trust public inquiry

...

The University of Birmingham's Yvonne Sawbridge asks if there is a case for chief nurses to concentrate solely on leading the nursing workforce

Director, matron, sister
Is leadership the most important responsibility in the role of nurse directors, matrons
and sisters? Picture: Charles Milligan

At RCN Congress in Liverpool this year, I attended a fringe meeting to discuss the role of nurse directors, specifically in relation to the quality-monitoring and regulation processes. It was a debate informed by plenty of inspirational nurses who were proud and capable, yet also humble.

One intriguing aspect was the degree of positivity that framed the range of roles and responsibilities that nurse directors hold.

We may have unique skill sets, and an ability to turn our hands to most things, but, given recent serious issues of care, such as those highlighted in the Mid Staffordshire NHS Foundation Trust public inquiry (Francis 2013), there is an urgent need to reframe the discussion about the prime purpose of nurse directors as leaders.

Competing pressures

If the complexities of care were fully recognised, should chief nurses be expected to have such wide-ranging responsibilities as they do, covering human resources, clinical governance and even estates, coupled with the competing pressures of leading nursing and fulfilling organisational priorities?

Is it any wonder that the focus on nursing becomes dispersed, and that the time and energy required to enthuse, motivate, develop, reward and challenge practice diluted?

This dilution of professional leadership is also evident at ward sister or charge nurse level. They are the linchpin of good patient care and are important role models for the next generation of compassionate nurses (Sawbridge and Hewison 2011). Yet, the Royal College of Nursing (2009) has found that, while these postholders ‘viewed their management work as one component of their role alongside clinical expertise, leadership and teaching’, they perceived that healthcare managers tended to view them ‘primarily as managers of staff and ward resources’. Role definition and work overload were identified as issues.

Sophisticated technical skills

If we cannot articulate the need for a dedicated resource at director level, what chance do junior leaders have to argue their case effectively?

The role of the nurse can involve supporting people when they are distressed, suffering, suicidal, frail, frightened or dying. It demands the ability to take critical decisions and employ highly sophisticated technical skills. The realities of this are rarely discussed, and the range of skills required to manage the associated emotional labour required is seldom explored.

In reality, the roles and responsibilities of nurse leaders in today’s NHS are multifaceted, which may suggest that senior managers, policymakers and, indeed, the public have difficulty recognising that the leadership of nursing, whether at the level of ward or community team or at board level, is a full-time occupation.

Maybe it is time we reclaimed this territory? Maybe we should no longer celebrate our ability to undertake many leadership roles, and instead argue for chief nurses to be solely focused on leading the nursing workforce, with all that this entails.

Yvonne SawbridgeYvonne Sawbridge is senior fellow at the Health Services Management Centre, University of Birmingham

 

 


References

Francis R (2013) Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry, Executive Summary. The Stationery Office, London.

Royal College of Nursing (2009) Breaking Down Barriers, Driving Up Standards. RCN, London.

Sawbridge Y, Hewison A (2011) Time to Care? Responding to Concerns about Poor Nursing Care. University of Birmingham.  

Want to read more?

Subscribe for unlimited access

Enjoy 1 month's access for £1 and get:

  • Full access to nursingmanagement.com
  • Bi-monthly digital edition
  • RCNi Portfolio and interactive CPD quizzes
  • RCNi Learning with 200+ evidence-based modules
  • 10 articles a month from any other RCNi journal

This article is not available as part of an institutional subscription. Why is this?

Jobs