Choices and challenges
Introduction by the Chief Nursing Officer
Nursing and midwifery are relatively new players in the research and development field, with a history that spans only forty years or so. It is truly remarkable to think of the advances that have been made over those years.
In Scotland, the roots of our international research reputation can be traced back to 1971 and the birth of the Scottish Home and Health Department-funded Nursing Research Unit at the University of Edinburgh, the first of its kind in the UK. That pioneering unit set the pace for similar developments in a host of countries and laid the groundwork for the development of research in academic nursing and midwifery departments throughout Scotland. There are now 13 such departments, some of which already have an active research profile. The task for the future is to ensure that all are involved in research activity to varying degrees.
Scotland also has two national units - the Nursing Research Initiative for Scotland (NRIS) and the Nursing and Midwifery Practice Development Unit (NMPDU) - which are dedicated to the pursuit of excellence in nursing and midwifery research and development.
No one would doubt that nursing and midwifery research has come a long way in Scotland. Equally, no one would doubt that it still has a way to go. This strategy has been developed to set the direction of travel - the route map - for nursing and midwifery research and development to move to the next level.
I want to see nursing and midwifery research informing and guiding practice throughout NHSScotland. I want to see nurses and midwives developing careers in research, and continuing to contribute to NHSScotland at the same time. I want to see research in Scotland having a significant influence not only on our own health and health care services, but also on those of the rest of the UK and internationally. And I want to see nursing and midwifery becoming key players within the multidisciplinary research agenda.
This is not the first strategy for nursing research that has been developed in Scotland. The Scottish Home and Health Department and Chief Area Nursing Officers produced a strategy in 1991 in response to concerns that nursing practice, management and education were not underpinned by evidence. This was a bold and innovative strategy which set out to stimulate a commitment to research in the professions, but the necessary infrastructure and expertise to take it forward were not in place. Its impact was therefore minimal, and it gathered dust on the shelf. I am determined that will not happen this time around.
Some might question why, at a time when multidisciplinary working is being encouraged and developed within NHSScotland, this strategy concentrates specifically on nursing and midwifery. No profession can stand alone in modern health and health care, and nurses and midwives have eagerly endorsed the principles and practice of multidisciplinary working. However, it is my belief that for nursing and midwifery to play a full role in multidisciplinary research, they must first define and describe the particular skills, perspectives and qualities they can offer as discrete professions.
This strategy, while fully acknowledging the importance of multidisciplinary research activity, therefore inclines towards a uni-disciplinary focus. In doing so, it helps nurses and midwives to define the contribution they can make not only to research into their own professional practices, but also to the wider, multidisciplinary health and health care research effort.
The strategy sets out steps that need to be taken across a variety of fronts. Its scope is necessarily wide, with progress likely to develop at variable rates in different areas of focus. For this reason, setting out a single action plan with clearly defined implementation dates would not be appropriate. Rather, actions and timescales will emerge in response to the strategy's recommendations from the many organisations involved in research and development in Scotland - NHS Boards and Trusts, higher education institutions, the Chief Scientist Office, NHS Education for Scotland, the Scottish Higher Education Funding Council, NRIS and NMPDU, for instance.
There are many challenges in attempting to improve quality in nursing and midwifery research and development, and many challenges are presented within this strategy. Key among them is the need to address gaps in research capacity, to recognise that not all academic departments can or should become centres of research excellence (Scottish Executive, 2002), to strive for greater collaboration and partnerships in research endeavours, and to define a stronger focus for nursing and midwifery research activity.
Equally, however, there are now more opportunities and greater support for research in nursing and midwifery than ever before. The infrastructure for health and health care research and development in Scotland has grown significantly in recent years, and the importance of research and development to the delivery of quality services is increasingly recognised. With the advent of clinical governance, quality and evidence-based practice has once again been placed at the top of NHSScotland's agenda.
There is much to celebrate in nursing and midwifery research, but there are also issues of concern which this Strategy addresses directly. Nurses and midwives in Scotland are moving into a period of choices and challenges - choices on how we want to move forward as evidence-based professions working within a multidisciplinary context, and challenges in ensuring that the services we offer to the people of Scotland are based on a robust and systematic research process. I am confident that the nursing and midwifery professions, working in close collaboration with partners across a variety of key sectors, will make those choices and meet those challenges for the good of the people of Scotland.
Miss Anne Jarvie, CBE, RGN, RM, BA
Chief Nursing Officer
Directorate of Nursing