Opinion  

Firstly, the enthusiasm of the nurses, who somehow find the energy, initiative and tenacity to take their ideas through the application processes and gain funding. And, after all that, they go on to implement their projects in the face of all the change, uncertainty and gloom that so often prevails in primary care.

Secondly, I am saddened by the reminder of the inequalities that still exist in our society. The group of nurses starting their project year with us this time will be trying to initiate or improve services for some of the most vulnerable groups of people, who still struggle to achieve the basic levels of care many would take for granted: drug users with blood clots and ulcerated legs that won't heal; people with mental health problems whose physical health is often overlooked; gypsy and traveller communities, whose women suffer the highest rate of miscarriage, maternal and infant mortality of any community in the UK.

Community nurses see society in all its forms and at all its levels. They see it as it really is. They do their work in the muddled, imperfect, interesting, real time world that every one of us inhabits. That is one of the wonders of nursing in primary care, compared to nursing in hospitals.

It is amazing, but thankfully true, that nurses in primary care continue to be passionate about best care, improving services and meeting unmet needs, in spite of the size of the task and the inadequacy of the support they sometimes experience.

The recent television programme about Florence Nightingale, which concentrated on her career in the hospitals of Scutari, missed out on something even more important. When Ms Nightingale worked with William Rathbone to institute district nursing, and begin the development of nursing outside hospitals, she was starting a movement that has produced some of the most imaginative, committed and enterprising of nurses. Our award winners stand in a long and illustrious line.

Rosemary Cook, director, Queen's Nursing Institute