One of the things that I have always loved about nursing social media is that hierarchies are irrelevant. The way that a nursing student can contact a chief nursing officer, or a director of nursing can chat with a newly qualified nurse, or even a professor of nursing can engage with a person who is merely thinking about coming into nursing is so valuable. Each person can start to understand the other’s perspective, ideas can be shared and learning can take place across the board. I have always considered myself anti hierarchies, however recently I have really started to rethink my stance on hierarchies.
Here’s where I feel I need to split myself in two … one version of me is firmly in the ‘smash the hierarchy’ camp and the other see’s the benefit of hierarchies (cue dramatic music to signify this shocking statement)
Smash the hierarchy perspective – Hierarchies can stifle people and innovation. People can feel confined, un heard and like they have no control. Every decision made is top down and unless you are at the top it’s tough. This is something that I have seen happening in nursing for many years and it’s through innovation like social media that we have been able to circumnavigate this system.
The benefit of hierarchies perspective – In hierarchies there are clear lines of accountability, there is clear understanding of who does what and where the responsibility lies. This is something that I see every day in my work as a nurse in social care and hierarchies can work really well and really cement who is responsible and accountable for what.
Seems simple doesn’t it? It’s almost a list of pro’s and con’s ! I’m not so sure that it is this simple though.
In nursing, as in many professions, it’s not as clear cut as being in one camp or the other. Perhaps the true crux of this blog is not in the hierarchy, or wanting to be rid of the hierarchy, but it lies in the imbalance and subsequent abuse of power that can occur. It’s this that can suffocate people and make them feel unworthy, it’s this that can lead to the stifling of innovation and of good ideas.

This blog is my way of saying that I no longer want to smash the hierarchy, instead I want to quote the amazing Colin Walke (life coach and all round guru type person) who wisely said to me “together we row the boat” Nursing is not merely about it’s hierarchies, flattened or otherwise, it’s about respect, understanding and taking a person centred approach to each and every colleague. Nursing is about being part of one team where everyone knows their role and responsibilities and works together to “row the boat” Nursing is a place where everyone can add value and feels valued…. A touch Utopian? Maybe but the road to Utopia is surely paved with the values of those who travel there?
Do I still want to smash the hierarchy … no, probably not ….. but I do see the immense value in flattening it, squishing it a bit and circumnavigating it and I see huge worth in being open and connecting with everyone who gives their time to add value.