Review

Reasons to be cheerful

Nursing development units: work in progress
G Black (ed)
King’s Fund Centre, 1992, £10.50

Articles in the nursing press speculate ominously about the future role of nursing. Against 17,000 management jobs gained since the first trust wave, 8,000 clinical nursing jobs have been lost. It is a time of great uncertainty and working nurses feel very vulnerable when thinking about the future.

There is one brighter light in clinical nursing practice, and that is the Nursing Development Unit movement. Building on pioneering work in Oxfordshire 10 to 15 years ago, this movement is being supported and co-ordinated by the King’s Fund, and aims to set up well-motivated, self-managed teams of nurses in various clinical settings, to challenge the deeply ingrained habits of many nurses and to produce innovations which will benefit patients.

It has the secondary effect of making nurses realise their particular skills, especially their closer personal contact with patients over longer periods than other health care workers, and those areas of clinical care where they have particular knowledge. This in turn enables nurses to see their important role in acting on behalf of patients and helps to break down the traditional situation where clinical nurses have been at the beck and call of other professionals and of a clinically inactive hierarchy of managers and administrators. In a nursing development unit, the nurse, as the person closest to the patient, tends to co-ordinate activities.

Several of these units are already operating successfully, and more are planned. This interesting boxed set of pamphlets gives both a progress report and details some of the innovative research in practical techniques such as pain and wound management. It also addresses wider issues such as changing the traditional nursing customs of obeying one’s superiors while directing the patient, towards the empowerment both of patients and of nurses.