Everything we say and do sends out messages to others. Nursing has traditionally been a silent profession and somewhat mysterious to those outside of it.

Although valued by people who receive care, those who make or influence decisions in areas like finance or business planning do not generally understand the complex nature of caring. This has led to assumptions being made about the number of nurses needed to care for acutely ill patients and assuming that nursing not complex work.

This is a particular challenge to advanced practice specialist nurses.  Not only do they struggle with the perception of the finance director but sometimes they struggle to get their worth across to their own nurse leaders.

The reality is that people who know little about your work are making assumptions about your work and its value-they may also be making decisions about whether they should commission it.

One of the things you can do is put together a really simple Service Summary  which covers key aspects of your service. It brings together the good news of your service with the bad news of any areas or spend you might need so that a manager can see where to invest to save. You can use this to communicate with managers or even for things like appraisal. You can also build a job plan  which shows in detail how you spend your time and the complexity of your work.

Some employers ask specialist nurses to do time and motion studies or write down in a diary every few minutes what they are doing. These techniques do not reflect the complexity of the role and should not really be used as they are not likely to give a useful or accurate result but If there is a demand from the organisation to show how your time is spent you can use Cassandra  which samples activity and will produce charts.