Quick guide to the EU Referendum for nurses.

How important is the EU Referendum for nurses?  In a nutshell?  Very.

Nursing could arguably be one of the professions most affected by the outcome,  and the NHS is certainly being used as a key battle ground for both sides of the argument.

Vote Leave argue that the £350 million we ‘send to Brussels’ every week could be spent on the NHS.  Britain Stronger in Europe suggest we will face £40bn of budget cuts if we leave, hitting the NHS hard.


Image ©Jacquie Hughes and kindly reproduced with permission from the artist.

Why will the referendum affect nursing?

The Royal College of Nursing states it does not have a position on the referendum, but it does detail the role of the EU in shaping our profession.

EU policies and legislation have had a major impact on policy issues that directly impact on nurses’ working lives, such as employment rights; equal opportunities; health and safety at work; environmental and consumer protection. (Royal College of Nursing)

Often derided, EU health and safety initiatives have undoubtedly improved the health and wellbeing of health professionals and patients, including many we now take for granted. For example:

  • Manual handling
  • Prevention of SHARPS injuries
  • Biohazard management

In addition, working conditions for nurses have significantly improved with the introduction of the EU working time directive.

Common minimum requirements in nurse education mean that EU nurses (including UK) can move freely between countries and practice to an agreed standard.  NHS Trusts have been actively targeting our european colleagues to fill the 10,000 unfilled nursing posts across the UK.  Over 20% of UK nurses are born abroad.

Similarly, the UK is the biggest exporter of nurses, with 50,000 of us working abroad, including in the EU.

Women and Europe

As 90% of the nursing workforce is female, it is important to consider the impact EU employment laws have had on women.

  • Equal rights for part-time workers and those on fixed term contracts.
  • Maternity leave
  • Equal pay
  • Anti-discrimination laws

It’s unclear what the impact of leaving the EU might be on these issues.


Or Transatlantic Trade and Investment Partnership Agreement.  Read more about it here.

This has caused a great deal of concern in relation to the NHS, which it’s feared could essentially be privatised and sold to the US.  There is a counter argument however, that the EU is negotiating safeguards within TTIP to protect the NHS.

Key figures in the field argue that the real threat to the NHS comes from domestic legislation in the shape of the 2012 Health & Social Care Act. (For an example of this, here is a recent article in the Financial Times regarding US ‘investment’ in the NHS.)

Decisions, decisions.

It can be hard to tell fact from fiction in this debate, but there are some organisations who are trying to do just that.

38 Degrees have taken a neutral stance on the referendum, instead fact-checking what both sides of the argument are saying.  You can visit their facebook page here.

The RCN has a really detailed and balanced article on the relationship between nursing and the EU.  Read it here.

Another group worth checking out (although clearly not neutral) is Healthier In Europe. Run by and for health professionals who wish to remain in the EU, they outline a number of key issues relating to healthcare and Europe.

As a nurse, a woman, a mother, for me it’s a no brainer.  I’ll be voting to stay in. There is no doubt that I have benefited from the policies and directives introduced by the EU.  If we were to leave, I don’t feel there have been adequate reassurances and safeguards that these rights would be extended.

But whatever you do, don’t do nothing.  This is a huge decision which will impact on our working and family lives for years to come.  The worst thing any of us can do is sleepwalk into a future we didn’t play a part in shaping.

And because I rarely get an excuse to include The Clash in my blog, here’s some referendum inspiration.

©Jo Higman

Jacquie Hughes is a Nottingham based professional illustrator.  You can find more examples of her work on Instagram: jacquie_hughes, or email her at: jacquiehughes64@yahoo.co.uk

Nurses and social media: where do we go from here?

I recently attended an in-the-flesh meeting of tweeting healthcare professionals, organised by the ‘We Community’.  It was a vibrant day, with lively conversations around the role of social media in healthcare.

The subject that interested me the most, was this:


©We Communities

This question generated a lot of debate around my table, largely as it raises a number of issues around the role of nurses in social media.

We asked:

  1. Should we be trying to improve peoples’ lives through social media?
  2. Do people want healthcare professionals to try and improve their lives via social media?
  3. Where do nurses stand in terms of duty and accountability?

Needless to say, we didn’t necessarily answer the question!

I recently wrote about the value of social media, especially twitter, for nurses.  It is an excellent space for engaging with the healthcare community and maintaining professional development.  But what about beyond that?

Should we be trying to improve peoples’ lives through social media?

As a nurse, I have a tendency to try and help others wherever possible.  Twitter is an amazing platform to communicate health information, share knowledge and demonstrate our value as a profession.

But what about beyond that?  Given the small number of nurses (compared to the number of UK registered nurses) who actively engage with twitter, is there scope to do more?  Or are we indirectly improving lives by being engaged professionals, passionate about nursing?

Do people want healthcare professionals to try and improve their lives via social media?

Writing in Forbes recently, Reenita Das talked about disruptive influences in healthcare. She reports that a key element of contemporary healthcare is patient to patient, or peer support.  It could be argued that patients and service users are ahead of the game when it comes to technology.

From the early days of the internet, self-help forums and online communities have flourished, providing the public with unprecedented access to information and support. This extends to social media where tweet chats are numerous and hashtags for every disease or illness imaginable connect people in an instant.

Are we being presumptuous in thinking we have a potential role in improving peoples lives via social media?  How can we add value in this space?

Where do nurses stand in terms of duty and accountability?

A recent We Community tweet chat on professional boundaries provides a great summary of some of the issues nurses need to consider when using twitter.  Several nurses have been the subject of NMC conduct hearings in recent years, in relation to social media.

It would be a brave nurse indeed who used social media to offer individual advice and support to the public.  I would consider it an accountability minefield.  However, the NMC Code stipulates that we are to “act in the best interests of people at all times.”  So where does that leave us?

If we go back to the original question, how can we improve peoples lives and services through social media?  The Code may actually provide us with some of the answers.  Take these three points:

  • “Share your skills, knowledge and experience for the benefit of people receiving care and your colleagues”
  • “Always practise in line with the best available evidence”
  • “Uphold the reputation of your profession at all times”

Any nurse engaged with social media in a professional capacity will know that these three elements make up the core of what we do in the digital world.  Are we then already improving peoples lives and services through social media?  If we are, where do we go from here?

As I pointed out earlier, the vast majority of registered nurses don’t appear to be actively engaged with social media in a professional capacity.  Maybe what we should be asking is ‘how do we engage our non-digital colleagues in improving peoples lives and services through social media?’

Clearly it’s a personal choice and a contentious issue.  I’ll be the first person to advocate switching off after a busy shift.  But what do you think?  Should more nurses engage with social media or is it too much to expect given the challenges they face day-to-day?  

©Jo Higman

Beginners guide to health in the digital age

I recently signed up to a health bloggers community, but was surprised to find that no-one was writing about, well, health.  Lifestyle, definitely.  Wellbeing, maybe.  But health?Obviously my outmoded nurse-y ideas of health need a reboot.

‘Dr Google’, blogs, vlogs, apps; the internet is fast becoming an integral part of our health and wellbeing, with 49% of UK adults seeking health information online.  But in this digital world, what does it mean to be healthy?



Back in 1947 health seemed fairly straight forward, defined by the World Health Organisation (WHO) as, “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”


If you were to define health now, what would you include?  Would you talk about diet, appearance, self-monitoring?  What about clean eating?  And meditation? On her mad lifestyle blog Goop, Gwyneth Paltrow recommends steam cleaning your vagina!  (She also recommends lymphatic drainage as ‘a great way to start the year’ 😯 )

You see, it’s all about wellness and wellbeing now isn’t it?  We should all try and be better than we currently are; happier, healthier, fitter, thinner, cleaner, more productive, less stressed. To eschew wellbeing could be considered an act of rebellion, subversion even.  As Cederstrom & Spicer argue, “Today, wellness is not just something we choose.  It is a moral obligation.” (Read more about their fabulous book on wellness here)

Even the government is measuring our wellbeing.  Somewhat ironically maybe, given they keep trying to make us all so bloody miserable.

I wonder what my gran would make of it all.  She keeled over aged 84, having lived on fags, Guinness and bread pudding. She would take me into town for fish and chips and give me her peas.  I don’t think I ever saw her eat anything that wasn’t beige.

But it’s all good, right?

There’s no denying that access to good, evidence-based health information is a positive. We can now manage our health in a way that my gran would never have dreamed possible. Sometimes even I can’t quite believe it.  When I was a student nurse, I had this:


I thought I was living in the future because I had a colour version! Which turned out to be a total lie. Does this look ‘colour’ to you?


As a student nurse spending hours in dusty medical libraries to find stuff out, it’s hard to believe that much of that information is now available on my phone.  Phones are now considered to be medical accessories; I thought mine was a device for beaming drivel into my eyes.  (It is.)  There are apps for pretty much any health issue imaginable, and we can take control of our health like never before.

What about the hooey?

The problem with wellness is it’s potential for vagueness.  All kinds of quackery and jiggery-pokery can sneak in under the wellness banner.  And there is the small question of who is giving us wellness advice.

In case you missed it, there was a high profile case of a blogger claiming to have cured her terminal cancer through diet.  Of all the things she had – a huge following, a book deal, enormous influence – it turns out cancer wasn’t one of them.  People who did have cancer were following her advice, hoping to be cured.

There are many successful, influential wellness bloggers out there making health claims based on anecdote and personal experience.  Personally, I like a slightly more robust evidence base behind my health information.

And let’s not forget steam-cleaning our Lady Marys.


Oh Gwyneth!

It’s also worth considering this: the wellness industry is worth trillions of dollars. Your body, your face, your hair, your insecurities about your appearance are all up for grabs. And this is one heck of a powerful industry, with unprecedented, privileged access into your home, your habits and your wallet.  Just sayin’.

Definitions of health seem fairly constant, but wellness and wellbeing appear to be far more nebulous and subjective.  Good apps can be fun and the wealth of support and advice available is astounding.  Like I said in my new year post, it might just be worth asking if the person giving advice is qualified to do so.

©Jo Higman