Calvert-Simms D
Can J Nurs Adm. 1993 Mar-Apr;6(1):24-8.
The British health care system is undergoing dramatic change as it moves from a management system based on scientific management principles towards a management system based on internal market principles. This restructuring, outlined in the British Government's White Paper, "Working for Patients" (1989), will have a significant impact on the practice of nursing. The changes will seriously affect, not only the nurse at the bedside, but also nursing management roles, practices and responsibilities. Ultimately these changes will require the radical restructuring of nursing education as British nurses know it today. This restructuring is essential if nurses are to meet and surpass the difficulties they face as their present role in the health care system is challenged, and in some areas seriously undermined. Similar problems are already being faced by Canadian nurses as they struggle to redefine the goals of their profession in light of new government strategies and policies on health care. An objective analysis of the problems faced by our British counterparts may offer insight into our own difficulties, and generate some solutions.
英国医疗保健系统正在经历巨大变革，它正从基于科学管理原则的管理体系转向基于内部市场原则的管理体系。英国政府白皮书《为患者服务》（1989年）中概述的这种重组，将对护理实践产生重大影响。这些变革不仅会严重影响床边护士，还会影响护理管理的角色、实践和职责。最终，这些变革将要求对当今英国护士所熟知的护理教育进行彻底重组。如果护士要应对并克服因其在医疗保健系统中的当前角色受到挑战且在某些领域受到严重削弱而面临的困难，那么这种重组至关重要。加拿大护士在根据政府关于医疗保健的新战略和政策努力重新界定其职业目标时，也已经面临类似问题。对我们英国同行所面临问题进行客观分析，可能会让我们深入了解自身困难，并找到一些解决办法。
