EDITORIAL
A ‘named nurse’ for each patient: some implications Considerable discussion ‘named nurse’ concept
Charter which has been circulated Department of Health in London relevant standard in the Charter
widely by the (1991). The states ‘Each
patient will be told the name of the qualified nurse or midwife who will be responsible for his or her nursing/midwifery care when admitted to hospital, or midwife, community nurse or health visitor when in need of care in the community.’ Although the nurse named might initially be the ward charge nurse Department sources have made it clear that a move to more individual nurse-patient allocation is expected. In some ways it might seem that this is easily achieved in critical care areas where there are relatively few patients and the majority stay such a short time that this can be completed between the off-duty days of a named nurse. But there are still units where nurses are allocated work without full regard for continuity of care-givers and care, sometimes through lack of thought but sometimes for apparent reasons. The allocation of a named nurse (other than the unit charge nurse) to each patient, with responsibility for the patient’s care while the requirement is for critical care, can facilitate continuity and excellence of care within the unit and after transfer, within a therapeutic nurse-patient relationship; and also supportive relationships with the patients family/friends. But there are a number of factors which can affect the success of this system and the outcomes. Some of the major factors are as follows: -
self, and their own needs and how to meet them and avoid damaging co-dependency (a concept
has been provoked by the included in the Patient’s
Nurses’ commitment to providing personalised care; a named nurse could provide continuity of a routine service of nursing procedures. - Nurses’ preparation for critical care practice which involves being so competent in technical care that attention, energy and knowledgeable thought can be concurrently devoted to the personal needs of the patient receiving it, and his/her human support system. Education for such practice must include nurses’ awareness of
described by Barker 199 1 and others). Availability of support systems. Given the nature of the work, it is not suprising that at least one critical care nurse is involved in the National Association for Staff Support (NASS) in the United Kingdom. - Managers who recognise, and respond appropriately to, the need for an adequate level of quantity, expertise and continuity of nurses, with supporting staff to conserve nurses’ time for nursing. The ‘named nurse’ concept is unlikely to achieve the full potential benefits in a critical care unit where there is little continuity in the nursing team, where few of the nurses have the expertise to nurse very sick patients or those requiring more complex care, and where nurses have to spend time on clerical, domestic or other work which does not require nurses’ skills and knowledge.
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The Prime Minister’s inclusion of the ‘named nurse’ concept in the Patients’ Charter is, as Hancock (199 1) says, a ‘public affirmation of the contribution nurses make to patient well-being and recovery.’ This is particularly welcome at a time when in some places it is necessary to tight hard to convince those who control resources of the need for qualified nurses caring for patients. But the benefits to patients, staff and society which are associated with the ‘named nurse’ concept will only be fully realised if clinical nurses, educators and managers recognise their contribution to achieving them and co-operate to make them happen. PAT ASHWORTH
References Barker 1’ 199I Co-dependency. Caring chameleons. Nursing Times X7(5 I): 55-75 Department of Health 1991 Patient’s Charter. Her Majesty’s Stationery Ot’fice, London Hancock C 1991 The named nurse concept. Nursing Standard ti(17): 16-18 1
A ‘named nurse’ for each patient: some implications Considerable discussion ‘named nurse’ concept
Charter which has been circulated Department of Health in London relevant standard in the Charter
widely by the (1991). The states ‘Each
patient will be told the name of the qualified nurse or midwife who will be responsible for his or her nursing/midwifery care when admitted to hospital, or midwife, community nurse or health visitor when in need of care in the community.’ Although the nurse named might initially be the ward charge nurse Department sources have made it clear that a move to more individual nurse-patient allocation is expected. In some ways it might seem that this is easily achieved in critical care areas where there are relatively few patients and the majority stay such a short time that this can be completed between the off-duty days of a named nurse. But there are still units where nurses are allocated work without full regard for continuity of care-givers and care, sometimes through lack of thought but sometimes for apparent reasons. The allocation of a named nurse (other than the unit charge nurse) to each patient, with responsibility for the patient’s care while the requirement is for critical care, can facilitate continuity and excellence of care within the unit and after transfer, within a therapeutic nurse-patient relationship; and also supportive relationships with the patients family/friends. But there are a number of factors which can affect the success of this system and the outcomes. Some of the major factors are as follows: -
self, and their own needs and how to meet them and avoid damaging co-dependency (a concept
has been provoked by the included in the Patient’s
Nurses’ commitment to providing personalised care; a named nurse could provide continuity of a routine service of nursing procedures. - Nurses’ preparation for critical care practice which involves being so competent in technical care that attention, energy and knowledgeable thought can be concurrently devoted to the personal needs of the patient receiving it, and his/her human support system. Education for such practice must include nurses’ awareness of
described by Barker 199 1 and others). Availability of support systems. Given the nature of the work, it is not suprising that at least one critical care nurse is involved in the National Association for Staff Support (NASS) in the United Kingdom. - Managers who recognise, and respond appropriately to, the need for an adequate level of quantity, expertise and continuity of nurses, with supporting staff to conserve nurses’ time for nursing. The ‘named nurse’ concept is unlikely to achieve the full potential benefits in a critical care unit where there is little continuity in the nursing team, where few of the nurses have the expertise to nurse very sick patients or those requiring more complex care, and where nurses have to spend time on clerical, domestic or other work which does not require nurses’ skills and knowledge.
-
The Prime Minister’s inclusion of the ‘named nurse’ concept in the Patients’ Charter is, as Hancock (199 1) says, a ‘public affirmation of the contribution nurses make to patient well-being and recovery.’ This is particularly welcome at a time when in some places it is necessary to tight hard to convince those who control resources of the need for qualified nurses caring for patients. But the benefits to patients, staff and society which are associated with the ‘named nurse’ concept will only be fully realised if clinical nurses, educators and managers recognise their contribution to achieving them and co-operate to make them happen. PAT ASHWORTH
References Barker 1’ 199I Co-dependency. Caring chameleons. Nursing Times X7(5 I): 55-75 Department of Health 1991 Patient’s Charter. Her Majesty’s Stationery Ot’fice, London Hancock C 1991 The named nurse concept. Nursing Standard ti(17): 16-18 1
