Sir, - I write in support of Professor Cowman's article in which he stresses the importance of addressing the needs of the nursing profession as they are outlined in the Report of The Commission on Nursing (The Irish Times, April 5th). As he points out, nursing is both the forefront and the backbone of the health services and has been taken for granted more than once too often.
At the same time, it is not in the best interest of society to redefine nursing yet again as a quasi-medical profession. Nor do most nurses wish to exchange the old mould pressed upon them as physicians' handmaidens for a new mould as physicians' extenders, who might perform activities such as minor surgical procedures. Nursing's definition is distinctly different from that of medicine, and is consistent with its age-old social mandate to nurture human life from conception through death. The ideal and principal responsibility of nursing is to tend and nurture the natural healing process intrinsic in the human person by providing protection from harm and fostering health and well-being in individuals, families and groups - sick or well.
Ideally, nurses work to fulfil their responsibility through careful and astute observation, assessment, diagnosis and treatment of human responses to actual and potential health problems. Prescribing in nursing refers to the prescription of nursing treatments which may include, for example, provision of personal care, monitoring of responses to medical or surgical tests and treatments, massage and other procedures to promote relaxation and comfort, regimes to restore or maintain natural patterns of activity, and programmes of health teaching or to foster self-care.
The nursing profession does not seek to take on medical roles, other than to claim what is rightfully in the domain of nursing in the first place. It seeks to work collaboratively with the medical profession, on an equal and respectful footing, to provide the best possible overall health service to society. For example, while the focus of medicine is on disease and its medical or surgical treatment, the focus of nursing is on assisting the individual who has the disease to cope and adapt so that the greatest benefit from nursing and medical or surgical treatments is obtained.
A high quality of nursing service in our increasingly complex, fast-paced and rapidly changing society is inescapably linked to professional nurses' need for comprehensive third-level education. A knowledgeable nurse who is able to think critically and draw upon a range of ideas is best fitted to understand complex health problems and help solve them in individualised, innovative and cost-effective ways. This nurse is also best fitted to contribute significantly to the management of health services and the on-going development of health policy.
In upgrading the nursing profession it is essential to understand the true definition of nursing and the importance of third-level nursing education. Only then will nursing become fully developed and society reap its full potential. - Yours, etc., Therese C. Meehan,
RGN, RNT, PhD, School of Nursing and Midwifery, University College Dublin,
Earlsfort Terrace, Dublin 2.