The changing role of nurses within the NHS

In the 68 years since the NHS’s inception, and certainly the 150 years since Florence Nightingale founded the first nursing school, much has changed within the nursing profession. While the central tenant of providing ‘compassionate care’ is still at the core of quality nursing practice, today’s nurses have a level of autonomy and formal education that would amaze their predecessors.

Before the NHS was formed, a nurse’s role was very much concerned with meeting doctors’ demands. While the doctor was perceived as authoritative and professional, a nurse was regarded as subservient and essentially unskilled. The contrast with how nurses are perceived today could not be more marked but the journey to get here has been a long one and many factors have come into play. Developing gender equality, scientific advancement, better access to education and greater public reliance on NHS services have all played a role.

During the 1950s and 1960s, when the NHS was in its infancy, nurses were answerable to the ward sister and the matron, who in turn answered to the doctors and consultants. Nursing was seen as a respectable job, but not necessarily a high-status one and male nurses were extremely rare. In the 1970s, British nurses began to stand up for themselves. During this decade, the profession’s first significant pay dispute took place, leading to a 22% pay rise and greater respect for the role. However, it was from the 1980s onwards that nursing really began to transform, in response largely to wider changes across the NHS, the scientific community and British society as a whole.

The tasks and duties that comprise a modern day nurse’s job would be unrecognisable to his / her counterparts working in the 1950s, 1960s, 1970s or even 1980s. Today, a nurse can conduct detailed medical assessments, prescribe drugs and contribute to medical research data gathering. Additionally, while once nursing was regarded to be a generalist type of role, the job is now split into ever more nuanced specialisms. A nurse can pursue the areas of medicine he / she finds most interesting or rewarding, whether that’s midwifery, oncology, palliative care, or a myriad other specialist areas. In part, this need for specialist nurses has been fuelled by the sheer speed at which our understanding of medical science has grown over the last 30 years; we have the theory and we need the nurse to put it to practical use. Today almost all nurses are degree holders and they all hold professional qualifications. Distinct bands have been introduced, and the level a nurse has attained is represented via colour-coded outfits. Nursing is no longer just a job, it is a well-respected lifelong career with fantastic rewards for the most talented and committed individuals.

Nursing is a far more diverse profession that it has ever been before. Today, male and female nurses alike are taking the basic components of the job and shaping them to their own ambitions and talent. Like any dynamic role so closely connected to both scientific and societal changes, nursing is likely to continue to evolve. Where the profession will be in 20 or 50 years is impossible to predict but it seems likely that both growing gender equality and unimaginable medical advancements will define the journey.