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The evolution of
professionalnursing
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History of Medicine
Medical practice can be
dated as far back as the
ancient Egyptians Imphotep was the
physician to King Zozer
and lived in about !"" #$
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History of the non%medical professions
&ursing has e'isted in variousforms in every culture over
millennia( e)g) wet nurses *merica+s first trained nursegraduated in ,-./
0he most significant development
was during war time when1lorence &ightingale laid thefoundation stone for professionalnursing
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History of other professions
2hysiotherapy practice dates backto #$ times( for e'ample inancient 3reece and the practice of
hydrotherapy In ,-45 the 6K recognisedphysiotherapy as a specialisedbranch of nursing
0he polio epidemic was a turningpoint for the physiotherapyprofession and its establishmentin its own right
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7o what does the history tell us8
0he practice of healthcare and medicine has
been around for a long( long time in various
forms 0he practice of healthcare and medicine has
been consistently valued and has evolved in
accordance with demographic re9uirements
0he various professions have evolved in
accordance with demographic re9uirements
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7o what does the history tell us8
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History of the &H7
0he &H7 was born on :uly ;,45- officially started by *neurin#evan
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0he 0imeline
,45- the &H7 commenced ,4;/ the structure of =&* was discovered
,4!" the first kidney transplant ,4!. the 7almon >eport ,4.- the first test tube baby ,4-" keyhole surgery
,4-- breast screening introduced ,44" internal market introduced "". robotic intervention
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&ursing uniformsc,-4"
7tudent nurse uniforms
c,4!" from ?oungstown
Hospital *ssocation and
7t) Elizabeth Hospital
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?oungstown 7tate 6niversity student
nurse uniform( ,4!.
0hroughout the ,4!"s and."s( many hospitalsdiscontinued their nursingprograms or partnered with
local universities to providesome of the academictraining) 0hese newprograms with collegesand universities opened up
the profession to a morediverse populationincluding married women(minorities( and men)
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Healthcare professions of today
=octors and dentists
&ursing and midwifery
*llied health professions
Healthcare scientist professions and the
smaller professions
Healthcare support workers
Management( ancillary and other staff
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1ields of practice
More than ,; specialties of medical practice withadditional sub%specialties
5 main branches of nursing with enhanced
specialisation in practice @ multiple sub%specialties *round , allied health professions with multiple
sub%specialisms
Aver /" healthcare scientist professions with a host
of sub%specialisms 2rimary( secondary and tertiary care settings
Integrated services e)g) with social care
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$hanges in practice
*t one time( nurses and
other professionals couldn+t
take blood pressures @ this
was a medical procedure
Be now have highly skilled
practitioners who undertake a range ofprocedures and are also responsible
for diagnosis e)g) advanced
practitioners in cervical cytology
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Bhat does this say about current
healthcare practice8 Its comple'C
Its reliant on a range of
practitioners in differentsettings and sectors with
the appropriate skills
0echnology advancesand will continue to
advance
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Healthcare workforce @ a recent
history 0he ,44"s saw serious
workforce shortages
Health 7elect $ommitteeen9uiry into workforceplanning in ,444
&H7 2lan produced in""" @ a ," yearstrategy
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&H7 2lan Headlines
More staff( better paid
Modernisation of
workforce andservices
Improved outcomes
$ritical targets
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0he Key Borkforce Messages
MORE
STAFF
WORKING
DIFFERENTLY
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Borkforce AbDectives
,;"(""" more staff =oubling in applicants and !"F more
trainees E'plosion of new roles
@ =elegated tasks e)g) prescribing@ E'tended roles e)g) nurse endoscopist@ &ew roles e)g) advanced practitioner
2ositive staff survey results Gower vacancy and sickness absence rates Aver 4"F of staff on new pay systems
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Bhere are we now8
&ew workforce planning crisis@ 3raduates in some professions unable to
find a Dob in their vocation &ew Healthcare 7elect $ommittee
En9uiry in ""!
&ew attempts to ring%fence educationand training and strengthen workforceplanning
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7winging pendulum
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2olicies since the &H7 2lan
2ayment by >esults@ 0ariff%based commissioning system
$hoice and $ompetition@ 7tronger patient opinion and voice
2ractice #ased $ommissioning@ 7tronger role in primary care
$ommissioning a 2atient Ged &H7@ MaDor reorganisation
*ll have had an impact on workforce))
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* world class &H7
1air @ e9uitable to all
2ersonalised @ tailored to the needs of the
individual
Effective @ outcome%focused7afe @ public confidence
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Eight defined areas of care
Maternity and newborn
$hildren+s health
2lanned care Mental health
7taying healthy
Gong term conditions *cute care
End of life
to
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0he focus on workforce
0he &H7 employs over ,)/ million people
."F of costs are staffing
0he &H7 spends over 5 billion annually oneducation and training
&eed to overhaul the system and strengthenworkforce planning and commissioning
education and training &eed effective clinical leadership
&eed to avoid repeats of the boom and bust
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Bhat are we aiming to achieve
Be need a workforce with the rightskills in the right 9uantity in the rightplace at the right time
* workforce that is appropriatelyeducated and trained to deliver theservice
* workforce that can deliver 9uality care
to patients
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How is the workforce planned8
&ot dissimilar to history @ its based ondemographic re9uirements( however thehealthcare arena is significantly more comple'today
Borkforce planning is designed around thepatient
#ased on the skills and competencies to deliverthe re9uired services
2lanned in harmony with finance and services
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/ current key priorities in &B
,- week wait @ where are the workforce
gaps8
2ublic health and health promotion @ what arethe workforce needs in terms of education
and service delivery
Health ine9ualities @ some significantly
deprived areas % need to ensure appropriate
workforce with correct skills is available
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#lurring of professional boundaries
0he average patient sees over 5" different
people associated with delivering their care
during a single episode of care * patient is often assessed more than once
Many of the professions have overlapping
skills and roles in patient care
Many of the professions dispute who should
be carrying out particular roles
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Borkforce modernisation
Modernised roles focused on delivering the carepathways and targets
* workforce that demonstrates the appropriate
attitudes and aptitudes #reaking down of professional barriers where
appropriate
* fle'ible workforce
* workforce that embraces continued professionaldevelopment( advancing technology and evidence%based practice)
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)* workforce capable ofdelivering world class
healthcare in the ,stcentury
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?ou know you work for the &H7
when =iscussing dismemberment over dinner
seems perfectly normal
?ou firmly believe unspeakable evils willhappen when someone says
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