Jenny Winslade: 'Most of the change needed to boost care doesn't cost a penny'
Ask people if they feel cared for to encourage a conversation with your patients, says Jenny Winslade
For years people have been saying that nurses aren’t what they used to be. They have degrees, they spend less time with patients and are “too posh to wash” patients.
I have never had much time for these arguments, not least because nursing has moved on in leaps and bounds since I started out in the 1980s. Back then, the doctor was always right and, unless you were a matron, you’d be lucky if you had any influence over how a patient should be cared for.
We now have the respect of patients as well as peers. This is not the same as saying that matters should stay as they are. Fundamental change is needed - and we know it.
“Most of the change needed is cultural. It doesn’t cost a penny and it relates directly to why we, as nurses, entered the profession in the first place. We care”
Reading the reports and media coverage on the distressing events at Mid Staffordshire, I feel deeply for those affected.
It is a physical feeling - one that I know others in my profession feel when somebody is hurting, physically or mentally. The feeling cannot be trained, it’s instinctive, almost primitive. It’s the kind of feeling you get when you see a little child sobbing because they have lost a parent in a crowd.
I am confident the Francis and Keogh reports are addressing major issues.
Most of the change needed is cultural. It doesn’t cost a penny and it relates directly to why we, as nurses, entered the profession in the first place. We care.
When I took my first steps on to a ward I knew all I wanted to do was care. The term can be over-used but it felt like a “calling”, something I was “born” to do. I’ve spoken to a lot of colleagues about this over the years and they feel it too.
The difficulty is that “caring for people” has not always been easy to measure. This is changing and patient experience is rapidly gaining importance. It is acknowledged you can have all the data and metrics in the land but they are no substitute for sitting down and listening to patients.
How could “never events” happen if we did? Can you imagine a surgeon removing the wrong finger if he or she had sat down and discussed with the patient which digit was to be removed? The same would be true of most surgery.
Lying at the heart of this is how NHS organisations act. My own - the NHS Northern, Eastern and Western Devon Clinical Commissioning Group - commissions more than £1.1bn of healthcare. We started out by placing the patient at the centre of all we do. One reason for this is that a patient’s experience of care is subjective. It has to be. It’s unlikely that one person’s experience will be like any other’s.
People have to be treated kindly, with respect - which means being listened to. When they are, they will feel more valued. And, when people feel valued, they feel able to say more about themselves or their care.
We can start by asking the right questions and keeping it simple - no one wants to answer pages of complicated questions.If you ask people if they feel cared for, it will encourage a conversation. This may prompt further conversations about the their home life and if they feel they have the right support there.
As chief nurse, I am wedded to learning more about patients’ experiences. Care will not improve unless we listen. The act of listening - which means acting on what people say - will contribute to a fundamental shift in how the NHS treats people.
Nurses are privileged to experience the very best and worst moments of a patient’s life. It’s emotional and very satisfying.
Fundamentally, a hospital is a building with specialist equipment. If you are one of the hundreds of thousands of people who have experienced world-class care from dedicated nurses in Devon you will know it is the staff who make the difference.
Jenny Winslade is chief nurse at NHS Northern, Eastern and Western Devon CCG
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