This is my last column for Independent Nurse as I leave the Queen's Nursing Institute this month. Looking back over my last seven years at the QNI, I feel I have been here during the most important period for community nursing for a very long time. So much has happened to health services outside of hospitals.
So much has developed in the world of healthcare technology and innovation. And there are so many new opportunities to be exploited - chances which must be grasped urgently or the tide of change will sweep away the valuable history and contribution of our community and practice-based nursing services.
If I could leave a 'to do' list, it would be first: to engage. Nurses worried about changes to services should engage locally, or nationally through the QNI, and make their voices heard. Even if they cannot hold back the tide, they could turn it a bit, while feeling a little more powerful.
Second: bring solutions. It's always tempting to say 'this won't work'. It is much more effective to say 'we could do this instead' or 'this would achieve what you want'. Matching agendas is key. If the managers, commissioners or employers want to save money, work out how to save money - while improving care.
Many nurses have shown how it can be done: it may require investment, leaving behind old ways of working, or challenging dearly-held beliefs. If 'they' are worried about bad publicity, explain how a serious incident or complaint could damage them and how investing in training or better skill mix could be a saving grace.
Finally, patients told the QNI during our Right Nurse, Right Skills campaign they wanted their nurses to be 'proud and professional', to have 'poise'. Put on that approach like a uniform every day, and it will become a reality. If we do not believe in the value and contribution of nursing delivered in people's homes, in clinics and surgeries, employers and commissioners will not either. If we look like the solution to the massive demand for flexible, responsive, expert care outside hospitals, then we will become it. Job done.
Rosemary Cook, director, Queen's Nursing Institute