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7 reasons why nurses should care about the upcoming Francis Report

As a nurse why should you be bothered about the upcoming Francis Report? Here’s seven reasons why

  1. Whether you’re on the ward, in the community or sitting in a director’s office, the Francis inquiry is likely to impact on how essential nursing care is delivered in your organisation. It is expected to discuss areas including: neglect of privacy and dignity, continence care, pressure area care, hygiene, nutrition and hydration, safety, record keeping and communication
  2. There will be much talk of how nurse education and training needs to change, for example whether students need to be taught “compassion” and how much continual professional development registered nurses need to carry out each year
  3. If you’re a health care assistant or you work with health care assistants, the report could recommend tighter rules on delegation and regulation
  4. Patients and relatives may want to talk with you about the findings of the Francis Report and seek reassurance about the standards of care they are receiving
  5. The Francis Report will question – are you capable of providing compassionate care?
  6. Next week there will be an onslaught of public and media criticism of nurses. As a nurse you will need to communicate nursing’s core values and work to win back public confidence
  7. This report is your opportunity to discuss your concerns about standards of care and how core patient centred values can be embedded into health services

Do you want to keep up to date with the latest from the Francis Report into the Mid Staffordshire Foundation Trust? Visit our tailored Francis Report channel with the latest rolling news and analysis

Readers' comments (97)

  • tinkerbell

    i welcome the Francis report and hope it will be honest and frank about needs to be done to improve this disastrous situation.

    I am hoping that it will not be diluted or a whitewash that doesn't reflect the true reality.

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  • will there be any advice, guidance and support made to staff on how to safely report poor standards, poor staffing, poor skill-mix, uncaring attitudes. can we now be guaranteed that our concerns will be taken seriously, we will have a response from management when we submit incident reports, our staffing and skill-mix will be right, our patients will be cared for properly and our staff will be cared for properly. can we also now guarantee that managers at whatever level will be held accountable.

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  • It should not have come to this.

    Governments and managers need to take their substantial share of the blame. But nurses need to accept their part. How many refused to work under such dreadful conditions? How many took to the streets to expose what was happening and demand that it stop? Mid Staffs is only being talked about because it has been found out. This is happening elsewhere. Perhaps where you work. We are all accountable here and if we continue to do as little as we have in the past, it will never stop.

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  • we have tried everything, what else can we do, no-one is listening, we are at our wits end. can anyone help me and others like me to make nursing a good, proud profession like it used to be. every day I and my colleagues go home crying, we cannot cope any more but no-one seems to care.

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  • Anonymous | 31-Jan-2013 8:32 pm

    "we have tried everything"

    No we haven't.

    I have seen nurses do little other than supporting and perpetuating the silly working conditions and environments. Instead of taking breaks and working only their rostered hours, they slave on for free and play into the hands of management. They don't need to staff wards and other areas, because there are those who work hours extra for nothing!!

    Stop it. Dry your tears. Take your breaks every time you are due them, bury the management under a pile of incident forms by completing them every time an incident occurs, refuse to participate in audits and the completion of unnecessary paperwork, refuse to do anything superfluous that takes you away from patient care. I'll bet you and your colleagues have hundreds of ideas about how to do things better. Flood the trust CEO with emails outlining those ideas. Tell your patients and relatives to aim their complaints at named managers and trust CEOs, and ask them to 'please complain'. Go home on time. You are too valuable to your family, to your patients and to we, who are your colleagues. Look after yourself. Better for you, better for your patients.

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  • people often tell us to make sure we take our breaks and go home on time. if we take a break knowing that we are leaving the ward unsafely staffed what will happen to us. what happens if we go off the ward knowing that patients are needing help, are in a wet bed, need analgesia etc. What happens when we go home and have left just one trained nurse on the shift because of sickness/staff shortages?

    are we able to say "I went for my break, I went off duty on time" - what is the legal and moral position, does anyone know.

    what would you think if you were a patient and you wanted something but the nurse was on a break and there weren't enough staff left on the ward to help you?

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  • Anonymous | 1-Feb-2013 10:38 am

    Well supernurse I will never be able to match your dedication!

    The answer to your question is to make a list of when you and your collegues intend to take your break -----give it to your line manager ----problem solved -- it is the managers responsibility to ensure the ward is safe !

    Similarly ensure that your brain dead manager knows when your shift ends ! Tell them that at that time you are leaving !

    Simples ----now go do it !

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  • Anonymous | 1-Feb-2013 10:38 am

    whatever happens after your official working hours are finished it is not your responsibility. However, if you leave the ward with nobody to take over from you it is your responsibility to take this up with your manager and their responsibility to resolve the issue which may result in asking you to stay until a replacement is found.

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  • I used to try to do everything and stayed on to complete my documentation. If not done, the NMC or the Coroner, could rip us to pieces. Even when done; can they read it, does it make sense. Its a litigatious society nowadays.

    However, I'm reminded that nursing care is 24/7/365; we need to promptly hand over our patients. A fresh person can take responsibility of the patients, and provide better care than a tired person. However documentation of your care cannot be handed over. Another person can start outstanding/missing paperwork. They wouldn't know what happened on your shift and cannot sign for you. So this must also be done as part of and during the care of patients.

    I'm not sure, once you've handed over care; if you then stay behind (well passed a short duration to wrap up minor loose ends), I don't think you've covered if something goes wrong for you and/or affecting your colleagues or the patients, as; 1. you're tired + potentially unsafe, 2. its after your designated hours, 3. you're technically not supposed to be on-site (some staff will soon forget that and will rope you into more work, because you're an extra free pair of hands) and 4. you'll be completely knackered on the following day/night's shift possibly leading to impaired judgement and more errors.
    Will your patients thank you for your dedication when you make the odd mistake? No, they will rightly complain, take it up with the NMC for potentially causing harm or unsafe practice, or worse.

    Its good we try to look out for each other on our ward and stop this bad practice. If your ward, work area is short staffed, call for more staff, inform your line/site manager, if nothing happens escalate it and report the incident.

    You'd escalate a patient you had concerns about, so escalate unsafe working conditions. If its not reported, no one else will know, or have any obligation to do anything about it.
    Your manager, has overall responsibility of all patients on your ward, wouldn't want to deal with complaints of poor patient care either. Staff might be pulled from other wards, and if they're short, hopefully they'll do the right thing too for the safety of their patients and staff.

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  • Anonymous | 1-Feb-2013 10:38 am

    Firstly, you have identified the problems. But then the actions that you are taking to deal with these issues are actually very dangerous and fail completely to address them. If you do not have enough staff, the answer is NOT to work longer and with fewer breaks. You become tired, harrassed, frustrated, bitter and miserable. Your work will be of poorer quality. You are exposing your patients to much greater risk from mistakes and poor care delivered by tired and demoralised nurses. All the while, there is no proof about inadequate staffing levels being delivered to your manager. He/she does not need to act to rectify the situation, because as far as he/she is concerned, there is no problem. No. This mentality of simply continuing with the status quo, until 'someone else' comes along to rescue us, is half the reason we're are in our current situation.

    Nurses should be taking the lead here. Report every and all staffing issues (or any other problems affecting patient care) to the management, in writing, with copies to the most senior people in your organisation and your union. Stop living in fear. Unless it is an emergency, for which, any nurse would stay, you must take your breaks and go home. The manager is duty bound to stay and deal with staffing issues. Phone him/her if there are not enough staff and tell them to relieve you whilst you have a break. If they refuse, write it down and report it evry single time it occurs. If it is he/she who has to stay, you will be amazed at how quickly it would be resolved. Carrying on as you suggest is not caring. It is supporting a system which has created an environment of abuse and neglect of patients. That is criminal and nurses seriously need to look at their role here. Just wait for the Francis report. Nurses will have to come to terms with the fact that only a few nurses who saw what was going so horrifically wrong actually raised concerns. Many more were complicit because they lacked courage to stand with their colleagues.

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  • Another report, fine, but is any one listening to the answers from nurses?
    I feel no one really cares about nurses.
    The other week a carer was sitting and holding a patient hand as this carer felt the patient needed to feel some compassion from someone. The rest of the team was exhausted as they were running around doing every other job on a shift that did not have proper staff to patient ratio.
    The question is will you stay on and show compassion by giving time to a patient while two people are busting to go to the toilet and almost messing themselves?
    Who was showing more compassion, the nurses who were making sure the patients did not suffer the indignity of messing themselves or the carer sat holding the hand of patient?
    I was suprised to know how many nurses I personally know that are on antidepresant just so they can cope wih the job.
    My colleague was reported by a relative for causing them distress when she told them the ward was understaffed.
    My colleague was so stressed when she said that, then had to apologised to the relative for causing her distress.
    Nurses are not supported yet they give out all the time.
    The RCN is one unsupportive union I will be a fool to even consider to ever join them.
    I agree that nurses reflect the people in our society. So the more incompassionated nurses you meet, the more incompassionate our society is.

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  • if you report short-staffing to a manager and they ask you if you can stay on a bit longer to help out because there is no cover available what is the next immediate step.

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  • Anonymous | 1-Feb-2013 2:31 pm

    How about;

    "No. I have committments and I have made you aware of the situation. This is not an emergency. Your solution lies elsewhere and you are responsible. That's why you are the manager and get paid the big bucks. Now I don't want to see patient safety being comprimised, so I won't keep you from your task of finding the required staff for the next shift."

    What did you think was the next immediate step? For you to stay on and let the manager away with with his/her responsibilities...again? Nurses are supposed to be professional and autonomous practitioners, individually accountable for their actions in safeguarding their patients. Not snivelling little 'yes men' who tolerate harmful and dangerous environments.

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  • michael stone

    From what I reaed somewhere as 'predicted comments in the Francis report' (I think it was the Guardian), almsot nobody is going to be spared: senior management and regulators included.

    With luck, Francis will stress the 'the management was bullying staff and patietns into silence' aspect, and perhaps we can get a more open, honest, rapid and transparent system for raising concerns ! PERHAPS !

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  • Gosh! Another enquiry, another report, is it chaired by yet another titled person?

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  • Was he the right man for the job?



    "Robert Francis QC: the man behind the NHS Mid Staffs report

    'Formidable' QC who chaired the public inquiry into the Stafford hospital deaths does not pull his punches

    Denis Campbell, health correspondent

    The Guardian, Wednesday 30 January 2013 21.00 GMT"


    http://www.guardian.co.uk/society/2013/jan/30/robert-francis-man-behind-nhs-mid-staffs

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  • Anonymous | 1-Feb-2013 3:24 pm

    Up to 1,200 patients may have died needlessly and in appalling conditions in Mid Staffs NHS Trust. Management, systems and culture must take a share of the blame. But, nurses with few exceptions, appear to have done little to prevent these deaths. Do you think that is worthy of a silly, sarcastic little remark? Your attitude displays everything that is wrong with this profession. As far as I'm concerned, there had better be criminal proceedings as a result of this report.

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  • an unthinkable tragedy that precious and unique lives just like yours and mine, relatives and loved ones of others, lost or ruined through medical/nursing malpractice and organisational mismanagement, can never be recovered.

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  • tinkerbell

    there had better be criminal proceedings as a result of this report.Anonymous | 1-Feb-2013 3:24 pm

    I sure hope so too.

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  • There will be. This is the first case of corporate manslaughter in the history of the NHS.

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