Sharon Whiting RN PhD, Practice Educator, Critical Care North Manchester General Hospital (NMGH) recently handed over a fantastic thesis on the history of nursing in Critical Care at NMGH and presented to NMGH library.
Sharon has written a piece for CSS News to share the work she has been doing. The abstract of the thesis is below her introduction.
About the study
As I began this study, I sensed that there existed a ‘gap’ in understanding among contemporary CCNs — a lack of awareness regarding our origins as critical care nurses. I hoped that this thesis would address that gap and initiate a broader conversation within critical care nursing. This hope was recently affirmed when I presented aspects of the study at a national CCN conference, where delegates demonstrated a keen interest in engaging with the past.
As the challenges faced by contemporary CCNs are neither lesser nor greater than those encountered by our CCN predecessors, my aspiration is that this study will inspire current and future CCNs to engage with my analysis and ‘draw valuable lessons from past practice.’ I encourage them to learn from the past experiences of applied leadership and human ingenuity, from examples of collegiate multi-professional collaboration, and from the enduring strength of CCU teams who support and recognise each member’s contribution to high-quality, safe practice. Moreover, it is my hope that this work will reaffirm the right of CCNs to retain their bedside presence and continue to provide compassionate, fundamental nursing care — melding clinical expertise with technological proficiency while never losing sight of their patient.
By narrowing this ‘gap’ in our understanding and broadening the historical discourse surrounding the foundations of critical care nursing in the UK, I hope that this thesis will inspire other CCNs and future nurse historians to pursue further research in this vital area.
Abstract of the study
The National Health Service (NHS) in England currently admits approximately 200,000 critically ill adults per year to 200 critical care units (CCUs), in which more than 18,000 critical care nurses (CCNs) provide continuous expert nursing care. In 2009, the World Federation of Critical Care Nurses (WFCCN) described CCNs as an ‘essential’ part of the multidisciplinary CCU team, whose ‘unique combination of knowledge and skills’ enhance the ‘delivery of comprehensive patient centred care’. A functioning critical care service is reliant on the skills of this brigade of registered nurses.
The NHS introduced its first general adult CCUs during the 1960s. New fields of medicine and nursing developed in parallel, enabling an adult critical care service to be established. To date, little has been written about the contribution of rank-and-file CCNs to service developments, and there is no published UK history of critical care nursing. To address this ‘gap’ I conducted oral history interviews with thirteen early CCNs and a CCU doctor who worked at North Manchester General Hospital (NMGH), all now retired, and analysed this primary data alongside a range of public and private documents. The time period covered in this thesis begins in 1967, when the CCU opened, to 2000, the year the Department of Health published its most recent major review of NHS critical care services in ‘Comprehensive Critical Care’.
My analysis of oral testimonies demonstrates the importance of ‘space’ to the manifestation of new processes, methods of working, and conceptions of critical care and critical care nursing: serving to both isolate and insulate, space created room to experiment and build a cohesive CCU team. My research illustrates how CCNs melded fundamental nursing care skills with high levels of pathophysiological understanding and mastery of technology. Being a CCN introduced new opportunities to learn from each other, from doctors, and from other CCUs, both at the bedside and more formally on specialised courses. The early CCNs were a diverse, youthful, competent, and candid cadre of nurses who embraced opportunities and challenged both opinion and the old nursing order. Their extended professional practice was increasingly called on to assist colleagues beyond the confines of the CCU, progressively cementing a place for CCUs and CCNs within a modernising NHS hospital service.
This thesis provides original insights into the experiences of CCNs on one of the UK’s earliest CCUs. As the first historical analysis to focus on critical care nursing in an NHS hospital, it is hoped that this study will encourage contemporary CCNs to learn valuable lessons from their past and inspire others to extend its range with further study.
Sharon also said: “For me personally wider dissemination of this work is the next step. This and encouraging others to contribute to a more complete UK story of British critical care nursing and nurses.
“With these responsibilities in mind I will be working in the next year to convert the thesis into a monograph. My aim is to work with the Manchester University Press and produce a book that makes the story accessible to a diverse public and academic audience, people interested in British history, history of women’s work, stories of the NHS and its twentieth century developments.
Separately, I’m wondering if working with together with the RCN History of Nursing Forum, British Association of Critical Care Nursing, Intensive Care Society, we might be able to secure backing from The Heritage Lottery Fund for a nationwide project replicating my research.”
Watch this space!
Sharon (Dr Shaz) 😊
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