Redman Judy
Sheffield Hallam University, Sheffield, UK.
J Nurs Manag. 2008 Jan;16(1):21-8. doi: 10.1111/j.1365-2934.2007.00830.x.
The aim of this paper was to examine the consequences of the lack of a formal role for nurses within the administrative structure of the NHS between 1948 and 1966.
UK health policy since 1997 has emphasized the need to re-create the NHS as a modern, dependable service, with clinicians leading the changes. Over the same period, restructuring of the bodies that determine the planning and provision of NHS services has resulted in fewer places for nurses on key decision-making bodies.
Exclusion from formal decision-making roles in the health committees of the NHS during its first two decades considerably limited the influence that nurses could exert over their own work and the circumstances in which they performed their duties.
Nurses should recognize the importance of involving themselves in the politics of health and of health service delivery.
Nurses are unlikely to be able to deliver the changes in healthcare that current Department of Health policy anticipates without access to political and economic, as well as clinical, influence in the NHS.
Nursing leaders should continually press the Department of Health to guarantee places for nurses at all levels of decision-making in the NHS and seek assurances that further restructuring will not result in further losses.
本文旨在探讨1948年至1966年间护士在英国国家医疗服务体系（NHS）行政架构中缺乏正式角色所产生的后果。
自1997年以来，英国的卫生政策强调有必要将NHS重塑为一个现代化、可靠的服务体系，由临床医生引领变革。在此期间，负责规划和提供NHS服务的机构进行了重组，导致护士在关键决策机构中的席位减少。
在NHS成立的头二十年里，护士被排除在其健康委员会的正式决策角色之外，这极大地限制了护士对自身工作以及履行职责的环境所能施加的影响。
护士应认识到参与卫生政治和卫生服务提供的重要性。
如果护士在NHS中无法获得政治、经济以及临床方面的影响力，那么他们不太可能实现当前卫生部政策所预期的医疗保健变革。
护理领导者应不断向卫生部施压，以确保护士在NHS各级决策中有一席之地，并寻求保证，进一步的重组不会导致更多损失。
