As 2020 is the ‘Year of the Nurse and the Midwife’ it is only fitting to take time to celebrate the many positive contributions made by the nursing and midwifery family to health care. Nurses and midwives at all clinical and leadership levels give much by immersing themselves in their occupation, and commit to participating in continuing professional development to ensure that delivery of care is up to date and evidence based. However, with the recognised shortage of 40 000 nurses and midwives (Rolewicz and Palmer, 2019), and the Annual Fitness to Practise Report 2018-2019 (Nursing and Midwifery Council (NMC), 2019), showing that of the 698 237 registrants at that time, 5373 had concerns raised about them to the NMC, I wonder if as a profession we are doing all we can to support ourselves and each other?
The majority of the allegations raised to the NMC came first from employers, and second from the patients or the public. Of course, not all of the allegations raised would have been proven, and the NMC has a robust system of investigation that includes the input of lay members. The standards in the Code (NMC, 2018) act as a moral compass for all professional registrants in the UK. Usually, there are professional teams in which registrants work and in the hierarchy of command there is an identified nurse or midwife leader to whom registrants can turn for guidance and support. Individual registrants often feel the emotional and physical demands of caring, and they know they need to take care of themselves by managing stress levels and developing appropriate resilience, but does this allow for noticing the needs of another colleague and making the time to reach out and offer support?
We are a profession centred on caring for others with competence and compassion, and the NMC has a focus on protecting the public from harm, but in considering all the pressures, at work and in society generally, I believe the time has come for the profession to consider whether there is overall sufficient holistic support for nurses and midwives. In short, are we caring for our nurses and midwives to the same extent that we expect them to care for patients and families? As a profession we cannot condone criminal or negligent behaviour, but that should not prevent us from understanding the total picture surrounding any nurse or midwife's fall from professional grace. Can we not understand and still care for the person who, until a moment of poor judgement, was one of our inner circle?
Nurses and midwives are not angels, nor superhumans with extraordinary powers. They are humans with their own unique personalities, strengths and weaknesses. They are not divorced from the society in which they live and work, and consequently they are affected by the complexity of that society. As explained by Tainter (1995), society is ever-changing due to the direct impact of political, economic, and social drivers, which can have negative as well as positive consequences. Cultural influences, including spiritual beliefs, also impact on personal life choices so I ask the question: how easy is it for nurses and midwives to separate their personal from their professional life to identify a nursing dilemma, or a conflict of interest, on or off-duty, that could have a professional impact? All actions have consequences, foreseen or unforeseen. The gift of hindsight is a wonderful thing, but does not always help individuals at the time they are facing a new situation for which they are ill prepared. As humans, nurses and midwives can fall in love with someone whose lifestyle and behaviour is at odds with what society expects; offspring do not always turn out the way parents hope with challenges such as anti-social behaviour; financial problems associated with unemployed partners are not unknown; and addiction to alcohol, drugs, and gambling are now fairly commonplace.
More employing organisations might find that nursing and midwifery retention improves, along with the employees' health and welfare, if the services of an independent counselling and referral service were engaged. Someone to turn to in time of need is sometimes all that is needed to prevent or cope with a professional and personal catastrophe.