Manifesto

September 20, 2006 -- Today the News Wales site posted an article about a policy "manifesto" issued by the Royal College of Nursing in Wales in advance of next year's Welsh legislative elections. The attention-grabbing headline is "Wales boozing worries nurses," but the manifesto covers a wide range of key health "demands." These include a large increase in the number of school nurses, expanding nursing responsibilities in community care, improvements in emergency care, and measures to improve nursing recruitment and retention. The unsigned piece has good quotes from the RCN Wales director, and it appears to be essentially a description of the RCN's press release. So it might have benefited from some outside comment on the extent to which the manifesto is politically feasible. But it is clearly an example of strong advocacy for nurses and their patients.

The piece says that RCN Wales issued the manifesto to "challeng[e]" all political parties to make health a key part of their election platforms. According to the piece, the nurses' "demands" include: reducing alcohol consumption, which the RCN notes could help "save thousands of lives and millions of pounds every year," through public education, expanded services, and "consideration of the impact of advertising and licensing hours"; full funding for a National Health Service plan to improve pay and conditions for staff; funding for nurse-led community health hospitals and clinics as well as more community nurses; an increase in school nurses, which the RCN says would help protect young people from drug abuse, poor nutrition, and depression; improvements in emergency care, including measures to protect staff from abuse, a key factor in nurses leaving the profession; and a "focus on recruiting and retaining nurses," specifically measures to ensure that "nursing staff numbers do not fall in Wales." The article notes in passing that nurses "deliver the majority of patient care," which would presumably be news to the producers of Hollywood hospital shows.

The piece also includes an extensive quote from Tina Donnelly, the director of RCN Wales:

We have set out, after consulting with our members across Wales what we believe are the most important things for the next Welsh Assembly Government to deliver. ... We know that all of our decision-makers believe that we should have a community health service but if this is going to work – then you need community nurses! Without community nurses, Design for Life will surely fail. In addition, we need to take steps to empower nurses through independent prescribing, nurse-led walk-in centres and nurse-led community hospitals. Wales needs nurses and not only for nursing! As nurses we are powerful advocates for our patients and improving the health service.

This is indeed a "powerful" statement about advocacy for patients and nurses. And the piece does a good job of giving readers a sense of what the nurses want and why. In particular, the piece and Ms. Donnelly's comments underline the holistic nature of the nursing practice model. Nursing does not occur only at the bedside, but in policy and media advocacy as well. Of course, some of the RCN manifesto will presumably be controversial. The expansion of nursing practice roles, including independent prescribing, has encountered bitter opposition from many physicians in the U.K. And even the proposals that are not controversial in theory may be difficult to achieve depending on the cost and other potential challenges, which this piece does not discuss. It might have been helpful to get some comment from a government health representative or a physician leader. It might also have been good to hear more about why "Wales needs nurses"--what do they do for patients, exactly? However, on the whole the piece presents nurses as serious professionals who have ideas about how to improve health care and the initiative to pursue them.

We thank News Wales for its coverage of this strong nursing advocacy.

See the article "Wales boozing worries nurses" from the September 20, 2006 edition of New Wales.