[Working Title: What has the NMC ever done for us?]
In Monty Python’s movie The Life of Brian Reg, the leader of the revolutionary group The People’s Front of Judea, convenes a meeting to discuss the overthrow of the Roman oppressors. He throws open the meeting by asking the question, “What have the Romans ever done for us?” to which a steady reply from the floor turns into a flood of rejoinders: the aqueduct, sanitation, the roads, irrigation, medicine etc. Hence the working title of this piece: What has the NMC [Nursing and Midwifery Council] ever done for us?
Unfortunately I feel I cannot answer this question about the NMC with the same positivity. The processes of the NMC have been variously described as contradictory and illogical (Long, 2005), controversial (O’Sullivan, 2004) and not transparent (RCN, 2004). Many nurses feel out of touch with their regulatory body, as evidenced by the less than 12% of nurses who voted in the recent elections to the NMC board (Nursing Standard, 2006). There was a similarly low response by nurses to plans in 2004 to raise the NMC registration fee, perhaps deterred by the lack of confidence generally felt in the NMC’s consultation processes (O’Dowd, 2003).
The NMC declares that it is working towards a level of financial surplus which it asserts is seen as best practice by fellow charities (Parish, 2006); however all nurses of my acquaintance without exception feel they are continually being fleeced by their registration authority. Nurses see the NMC continually repeating the mantra of “protecting the public” which might be seen as justifying any number of sins visited against the nursing profession, such as removing some practitioners from the register with little comeback (Nursing Times, 2003); and an accompanying increase in the number of disciplinary cases (Snow, 2006).
Either there has always been a number of rogue practitioners who have never been dealt with before or the NMC is pulling the nursing and midwifery professions into line. The NMC swallows the government strategy on health care in the documents it produces, thereby implicitly sharing and advocating the government’s declared sole ownership of nursing reality (under the guise of Clinical Governance). The NMC declares that it seeks standardisation for nurses; this plays into the government’s standardisation agenda and wipes out any notion that every nurse is a uniquely autonomous practitioner.
I have even heard it said that the standards of proficiency for general health care workers, namely those by the Health Professionals Council (Health Professionals Council, 2006) are in fact superior to that given by the NMC. Having studied them, I am not inclined to disagree with this assertion. The only thing the NMC has done for me as a nurse is that following recommendations by the tutor of a post-qualification course on mentorship of student nurses, I found several NMC studies of nurse education to be invaluable and even revealing (Duffy, 2004; Burke and Saldhana, 2005).
If I were taken ill, I would of course like to know that as a member of the public I would receive care from safe and knowledgeable practitioners. As Lynch (2004) pointed out, nurses don’t need to be told to be altruistic because they already are - otherwise we wouldn’t be nurses. I do course agree that such a code of conduct as is provided for nurses is to some extent necessary because arguably nursing carries with it certain responsibilities and intimacies not available to other occupations. I merely object to feeling that I am continually being fleeced of my hard-earned money by a body entirely absent or unwilling to agitate with the government for a higher salary in order to pay for those increased registration fees. It seems there is no joined-up thinking here; and it also gives me the impression that the NMC doesn’t really care about nurses, only about the profession as a sort of milch cow. An acquaintance who is a social services manager privately described the NMC to me as “a tax on nurses”. I could only throw up my hands in despair that this is how the NMC appears to fellow health care professionals.
As Meehan (2003) suggests perhaps to curry favour with the nursing profession the NMC could lobby the government to pay for increased registration fees? Continued fee hikes will only result in nurses leaving the profession.
The NMC is an alien and remote body for many nurses. Jill Jarvis, head of the professional nursing department at the RCN might bemoan the apathy of many nurses to participate in the “democratic process” of electing new NMC board members (Nursing Standard, 2006) but it is surely therefore beholden upon the NMC to ensure that the registration authority is relevant to nurses. Because at the moment it most definitely isn’t.
References
Burke, A. and Saldhana, M. (2005), NMC Consultation on a Standard to support learning and assessment in practice: Final Report, London, NMC;
Duffy, K. (2004), Failing Students, London, Nursing and Midwifery Council;
Health Professionals Council (2006);
Long, T. (2005), When is a nurse not a nurse? Reflections on the NMC register, Community-Practitioner, 78 (12), p437-9;
Lynch, A. (2004), ‘You can't tell nurses to be altruistic: they already are’, Nursing Times, 100 (38), p 16;
Meehan, F. (2003), Fees woes for nurses, Journal of Community Nursing, 11, p3
Nursing Standard (2006), News, 20 (25), p11;
Nursing Times (2003), NMC must retain safeguards for nurses, Nursing Times, 99 (3), p13;
O’Dowd, A. (2003), Has NMC shake-up bypassed nurses?, Nursing Times, 99 (32), p10-1;
O’Sullivan, S. (2004), Fees under consultation, Midwives, 7 (1), p16-17;
Parish, C. (2006), Registration fees could soar next year as NMC approves budget, News, Nursing Standard, 20 (26), p5;
RCN (2004), Motion 18: Has the NMC gone too far?, Congress 2004, http://www.rcn.org.uk/news/congress2004/display.php?ID=1053&N=18;
Snow, T. (2006), Big increase in misconduct hearings will force up nurse registration fees, Independent Nurse, News, 24 March.
NB. This piece was very politely rejected by the Nursing Standard in June 2006....
