January 29, 2023
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‘Why do politics and policies affect us as nurses and humans?’

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I am not sure there has been a time when nursing staff have been so affected by what is happening to our profession due to politics or governmental policy.

The current cost of living crisis affects us all as nursing staff and humans. It directly impacts us as a profession and all of us as individuals.

Stories about nursing staff using food banks are not “clickbait” journalism; for some, it is an everyday reality.

The recent increase in National Insurance to fund the health and social care services has caused a real-time pay cut for staff who work in these services.

When we look at our pay packet at the end of the month, we are all taking home less; this directly impacts us, our families, and those we care for.

Nursing staff working under Agenda for Change in health and social care have not seen a substantial increase in their wages, reflecting inflation rates for decades.

We are working harder, for less, taking on more responsibilities as we struggle to recruit and retain staff. Why do we do it? Because we care about the populations we serve. But we also need to be able to pay our bills at the end of the month.

The Covid-19 pandemic has highlighted what we have all been through as nursing staff and individuals. I understand that engaging in politics and political discourse can be challenging and is not for everyone.

Sadly, it is often the nursing staff and individuals most affected by politics and governmental legislation who can feel the least heard or able to engage.

Parents, those with caring responsibilities, and nursing staff who work over and above their working hours, sometimes even struggling to take breaks to eat or go to the toilet on shift, often may have more pressing concerns, or even time, to watch the news or get involved. And they should feel absolutely no guilt for that fact.

Those who are more engaged are responsible for listening to those most affected and helping elevate their voice and not drive our agendas. We are advocates as nurses and consistently voted the most trusted profession for a reason.

However, even for those of us most engaged in politics, the current climate can at times be so polarising. Engagement can be exhausting and, at times, feel pointless. Who is listening? Can we affect change?

It is not correct to say that nursing staff should “stay in their lane” and not be engaged in political discourse.

Of course, we should not offer our party political views to our colleagues and, most notably, our patients. Doing so would be in contravention of our professional code.

Politics and governmental decision-making affects us as a profession. It affects funding, resources, and our abilities to do our jobs to the best we can.

Some say nursing is not a political act; that we should not engage in politics. But every action we do as nursing professionals is affected by politics and governmental legislation.

That might be when nursing staff are forced to decide who to discharge, because so many people are waiting for beds with so few staff to care for them.

Or when we have to make decisions about what the most cost-effective treatment options are for our patients.

It could be when nursing managers put together business proposals to recruit more specialist nurses for a service.

Or when they are having to work out how quality improvement plans can be implemented to develop services with limited resources.

There is an exhaustive list of examples of nurses being political agents, having to spin gold from straw under governmental policy.

Politics and governmental legislation have always affected nursing. However, something has occurred very recently that should all give pause for reflection.

In the Queen’s Speech, the UK government announced a new proposed Modern Bill of Rights to replace the Human Rights Act 1998. What does this proposed change mean for us as nursing staff and as humans?

How will the government ensure that access to care, patient safety and our professional standing as nurses is not affected by any new legislation?

In 2013, the World Health Organization advised that all international governmental legislation adopt a “Health in All Policies” approach.

However, as you may have seen in the news, it could be argued that the Nationality and Borders Act 2022, which planned to offshore potentially vulnerable asylum-seekers to Rwanda, is not centred on health in all policies approach.

Last night the first planes full of asylum-seekers were due to take off for Rwanda. These planes were grounded due to the intervention of the European Court of Human Rights (ECHR). Notably, this court is not directly related to the European Union, which the UK has now left.

However, there is potential for the UK government to use the ECHR’s intervention as a catalyst to break away from this court.

A court Winston Churchill and the UK government at the time were instrumental in creating following World War Two.

Notably, the only European countries ever to leave were Greece, temporarily, and recently Russia when it invaded Ukraine. Does the UK government want to pursue this course of action? And if so, why?

How would leaving the ECHR further affect the introduction of the proposed Modern Bill of Rights? The Nationality and Borders Act 2022 offers one example of where the UK government did not implement the advised “Health in All Policies” approach.

This government legislation was passed without international human rights laws being adhered to, which the UK government is committed to operating under.

Without the involvement of the ECHR, if this proposed Modern Bill of Rights is enshrined in UK law, who will ensure that access to care, patient safety and our professional standing as nursing professionals is not affected? Who will ensure all UK citizens do not have their human rights infringed?

Nursing staff caring about, or having an interest in, how legislation and policies may directly impact access to health and social care, affect patient safety, or risk damaging our professional standing and trust is not the radicalised far-left ideology some politicians and members of the mainstream press would encourage us to believe.

It does not make us “woke” or “snowflakes” as nurses and society members to care about how governmental legislation potentially impacts nursing staff, our patients, and society more broadly. Caring makes us who we are as nurses and humans. It is our commonality.

As nursing staff and humans, our ability to care for, work in coproduction with to support, and advocate for potentially the most vulnerable in society, who, through no fault of their own, cannot always make their voices heard, is one of our greatest strengths as a nursing profession and as humans.

Understanding how any current or future government legislation that potentially threatens our ability to do our job as nursing staff or impacts our rights as humans, those of our families, and those we care about is something we all hopefully should care about deeply.

We are talking about an issue that potentially affects our most basic human rights and those that we love and must protect as nursing professionals and humans.

And, although engaging in political discourse can be challenging at times, confusing to engage with and understand fully, and sometimes even exhausting, I hope you agree it is our duty as nurses and global citizens to care about how these can affect us all.

However, political engagement can be complex for us as nursing professionals. How can we carefully navigate political discourses without alienating those we most want to listen to us and influence, our colleagues and the government alike?

Being militant at times has its place. But this course of action can inadvertently stoke division, making those we most want to listen to and influence switch off and get defensive.

There is merit in skilfully manoeuvring political discourse and influencing using the evidence-base. By working with rather than against those, we want to engage with; by achieving a win-win. As nursing professionals, we have these skills.

As fans of Spider Man will know, Uncle Ben famously once said to Peter Parker, “with great power comes great responsibility”. We have a responsibility to act now; how do we use our power?

Craig Davidson, senior asylum-seeker health nurse and Royal College of Nursing professional activist

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