Abstract
It’s a strange thing, even for a nurse, to wake up thinking about Florence Nightingale, but that’s exactly what I did the day I started writing this editorial. When you see the line-up of this issue you will realise why she was in my thoughts. Known for her attempts to reduce and control infection and her campaigning for better environments, she was bound to find some mention here. But neither of these was behind my thinking of her; it was rather that I have always respected her ability to do four things – to observe and see what was really happening, to listen and hear what was being said, to select where and how improvements could be made and to then argue how they would result in better care and make the improvements happen. The guest editorial, the papers and their respective reviews, the perspective and the closing letter in this issue all show these qualities, and it is this link to my idealised view of Florence Nightingale’s brand of nursing thinking that made me wake up with her on my mind.
This issue presents, for me, some of the challenges of nursing in the 21st century – not only in its topic -- communicable diseases and infection prevention and control -- but also in the various ambiguities that simmer below the surface of its contributions, many of which nurses surely face regularly in their practice and are highlighted in the papers that follow. Nurses, for example, need to adapt structured local, national or global guidance sensibly to meet the needs of patients and circumstances. They need to deliver care effectively and efficiently in sometimes less than ideal situations. They need to consider how the human factors of their lives influence what they think and do in their work and home lives. They need to feel safe at work and when they get home, wherever work or home may be. Addressing any one of these challenges requires that nurses don’t just simply do things, but that they have time to think about what they are doing and why.
Educators and researchers are often seen as the people with the luxury of ‘thinking time’, but if nursing is to succeed in improving health, wellbeing and care we need every nurse to take every opportunity to do and think, combining what we know with what we see, hear and feel. Doing this can only make us more effective and efficient. Finding time to think doesn’t mean we have to set aside large amounts of it as Florence Nightingale did when she allegedly took to her bed for months on end; none of us could do that these days. But all of us have five minutes here and there that can be used to think through a task before we do it or to think about how care could be improved with a colleague or patient. Setting aside time to think, and doing so productively, will mean we can deliver better care and feel invigorated by the results. If nurses can do that, having thought things through thoroughly, they will be better able to act in the most creative, efficient and flexible of ways.