This is set to be a bumper year for JRN. We already have an exciting line-up of papers to inspire readers, as well as guest editorials and perspectives to get us all to think more widely. As always we have Twitter chats planned throughout the year to engage readers in debates about key papers. We also have calls for papers to tempt more authors to contribute to nursing’s knowledge base. However, JRN would not exist without the people who review the manuscripts and we thank them all in this edition for their invaluable work. Finally, our search for the best paper of 2017 has begun, and we must thank the panel of judges who have the unenviable task of picking just one out of the cornucopia of excellent contributions from the world of nursing research.
Relaxing at the start of 2018 often means catching up on some of last year’s TV and radio programmes, and this year I was doing just that when I came across a podcast of Edna Adan Ismail’s BBC Radio 4 interview for ‘Desert Island Discs’ (http://www.bbc.co.uk/programmes/b099w3v2). A pioneering Somalian nurse and midwife born in 1937, she was inspired to nurse by watching and helping her doctor father during her early teenage years. She trained in nursing and midwifery in 1960s London, and after working as a midwife in south London she returned to Somaliland to establish the professions of nursing and midwifery, which had hitherto had such low status in that country that they were non-existent. She succeeded despite periods of civil war, vilification and house arrest, achieving not only her goal of establishing those professions but also ultimately gaining high political office. She retired 15 years ago, but rather than relaxing, she set about achieving the dream she had had as the 12-year-old girl working alongside her father; against all odds she founded the first maternity hospital in her country. Now open and running, the hospital has extended its remit to non-maternity care as well as educating nurses, midwives and other healthcare workers (http://www.ednahospital.org/). Listening to the programme made me wonder what kind of support Dr Ismail drew on throughout her career. Inspiration from key role models certainly played its part. Her sheer determination – as captured in her catch-phrase ‘If I don’t do it who will?’ – must have carried her forward when things got tough. Above all, what shone through in the interview was the obvious delight and satisfaction at being able, either herself or with others, to provide the best possible care. It struck me that these things keep most nurses going, but what was different about Dr Ismail was the level of control she was able to have over her work and her working environment.
The respect, support and encouragement that were so hard won by her every step made me reflect on the lack of these key factors in so many nurses’ everyday working lives. This deficit may be due to many things, such as workforce pressures, under-resourcing, the challenging behaviours of colleagues, bosses, patients and their families, or undermining by the media and the powers that be. Increasingly we are told that we can lessen the effects of these, at least in part, by becoming more ‘resilient’. The optimistic miasma of resilience, often evangelically dispensed, gently wafts over us lulling us into the false sense of security that each of us can use resilience to protect ourselves from the pummelling storms of working in healthcare. This, of course, is not necessarily so. For the notion of resilience to work in any meaningful way, the organisations in which healthcare is provided need to become more resilient themselves, and in so doing strengthen their capacity – and the knock-on effects on patients – to respect, support and encourage everyone working within them. Only through doing this will the satisfaction that Edna Adan Ismail radiated permeate every nurse’s and midwife’s working life across the world – certainly a New Year challenge worth striving for.
This edition of JRN brings together a number of articles focusing on support. None offers cookbook recipes for gaining or providing greater support, nor are there any quick-fix strategies for survival in the constant maelstrom that characterises nursing in the 21st century. Instead, they offer food for critical (in all its meanings) thought. The edition starts with Michael Traynor’s guest editorial, which not only sharpens our thinking about our ‘new best friend’ resilience, but also provides a rallying call for action within our profession rather than the passivity that might ironically stem from the promised benefits of resilience. The papers and reviews that follow focus on a wide range of people who benefit from specific support from nurses, their families and their peers, and include mothers of children with thalassaemia major (Abu Shosha and Al Kalaldeh), adolescents in schools (Nassar et al.), men and women following coronary artery surgery (Hweidi et al.) and people approaching the end of their lives through chronic liver disease (Sohail et al.). The remaining paper (Assarroudi et al.) gives a detailed description of a qualitative research technique that could shed useful light on the support received and needed by patients, their families and lay carers and nurses. We conclude this edition with Claire Nadaf’s report of the latest London South Bank University Health debate – always a lively place to be. This one was no exception as it asked ‘When does Advanced Clinical Practice stop being nursing?’ – an important question to mull over in 2018 as we watch the fudging of professional boundaries become a common phenomenon in our working lives.
If nurses and nursing are to survive the battering of low morale, insufficient remuneration, reducing numbers of appropriately skilled nurses and other clinical colleagues, then we must recognise the importance of these kinds of debates. Nurses, if they act together, can collectively make 2018 a year in which the best care is easier to provide. JRN hopes to join in that action by continuing to bring readers papers, debates, guest editorials and perspectives that keep you thinking and moving forward throughout the year.
Happy New Year to you all.