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New chief nurse reveals her 'vision' for profession

England’s new chief nursing officer has declared her intention to restore public confidence in the profession, in her first full interview in the post.

Jane Cummings outlined her “vision” for the profession to Nursing Times and set out how she plans to address public and media concern about nursing.

She said it was imperative the public believe nurses will offer them safe and effective care.

Referring to coverage of high profile care failures in recent months and years she said: “There have been some difficult reports to read and you hear horrible stories.

“There is a lot of work to do to build confidence. I am not naïve about that.”

In particular in relation to the public inquiry into the scandal at Mid Staffordshire Foundation Trust, which is due to present its final report to government in October, Ms Cummings said: “We need to acknowledge when things do go wrong.” She said she expected she would appear a lot in the media when the report is published.

But Ms Cummings, who was appointed in March, said she believed she could overcome negative views about the profession. Working closely with Professor Viv Bennett – the nursing director for public health in the Department of Health – she plans to create “a new narrative for nursing”.

She began talks on the new strategy earlier this month in a meeting with 50 high-level nursing representatives, as revealed by Nursing Times.

Ms Cummings said: “The outcomes I want to achieve are: pride in the profession – I want people to feel proud to tell someone they are a nurse; respect for nurses and midwives; and safe and effective care with good patient experience.”

Her vision and narrative will be based around “five Cs”, which Ms Cummings revealed for the first time publicly to Nursing Times (see below).

She said work to restore confidence would include promoting less well known roles and the impact of nurses on care quality measures. She said: “If you looked at the national media, you’d think nursing was about looking after older people in hospital – and usually doing it badly.

“That doesn’t show the breadth and depth of nursing. We need to identify the nursing contribution to health outcomes.”

Ms Cummings and Professor Bennett will begin work on five “domains” to develop the nursing strategy: Staffing, delivering care and measuring impact, patient experience, staff experience and public engagement.

They will work alongside the Nursing and Care Quality Forum – the review set up by the Prime Minister – to find evidence for best practice and spread it.

Ms Cummings said: “We will achieve this by spreading good practice and using patient feedback and staff experience.”

The work will also draw on Energise 4 Excellence, a programme Ms Cummings spearheaded in her previous role as NHS North West strategic health authority chief nurse, she said. It is aimed at improving both quality and productivity in nursing care.

However, Ms Cummings also acknowledged changing nursing care quality – and public perceptions - will be difficult to implement against a backdrop of cuts and low morale.

“We are in a difficult economic situation, and slash and burn cuts do not help quality. But that is why we all have to take responsibility to improve things,” Ms Cummings said.

She acknowledged that the “elephant in the room is staffing levels”. She said she supported “in theory” the care quality forum’s recommendation that nursing directors should be able to tell other directors when they need additional staffing, and for ward sisters to be considered “supernumerary” – or not expected to contribute to basic staffing levels – so they can focus on leadership.

Ms Cummings said if nurses spoke out when they identified poor care, public confidence and nurse pride could be restored.

She said she wanted to help that happen. “It is easier for me to say than for people to do it, but we need to create a culture so people feel much more able to do this,” she said.

Ms Cummings said every nurse must feel able to influence change. “We all have power to make a difference with every patient contact,” she said.

• Care – what we do day to day, we take care of people

• Compassion – not what we do, but how we do it, treating patients with dignity and respect

• Commitment – there needs to be a nursing commitment to improve outcomes and do the right thing

• Communication – we must think about the way we communicate with colleagues and managers as well as patients, relatives and carers, but this C is also about me and my desire to use social media to engage more and deliver key messages

• Courage –being brave enough to do the right thing and speak up when you are not happy with something your organisation is doing

Readers' comments (23)

  • michael stone

    'They will work alongside the Nursing and Care Quality Forum – the review set up by the Prime Minister – to find evidence for best practice and spread it.

    Ms Cummings said: “We will achieve this by spreading good practice and using patient feedback and staff experience.”'

    Nurses are the clinicians who interact most often with patients, and logically that means that the concerns of nurses should be able to influence managerial behaviour, etc (i.e. nursing feedback should be paid attention to - from the posts on NT, nursing feedback is regularly ignored).

    Jane seems to allude to that in this piece, but she also doesn't seem all that confident anything will change:

    'She acknowledged that the “elephant in the room is staffing levels”. She said she supported “in theory” the care quality forum’s recommendation that nursing directors should be able to tell other directors when they need additional staffing,'

    The 'in theory' bit, is the complication !

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  • DH Agent - as if ! | 23-Jul-2012 3:16 pm

    when are you going to take up nursing?

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  • michael stone

    Anonymous | 23-Jul-2012 3:31 pm

    Never - I'm psychologically unsuited to nursing (if pushed, possibly pathology).

    You've miss the point - I am interested in how nurses (and other clinicians) 'think', because nurses and other clinicians interact with patients, and I am interested in improving certain areas of those interactions. So nurses interest me, but nursing doesn't.

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  • There are a few things I disagree with here.
    Yes, nursing has more breadth and depth but little actual power to change or influence in reality. Until that changes, and power structures are reconfigured then we will continue pedalling round in familiar circles.
    Compassion is underpinned by empathy, out of which, respect grows. No mention of that is alarming.
    Care is an optimistic vision of what we do now, delivering treatments based on health assessments is somewhat nearer I would say. Again this is unlikely to change unless social justice and communal accountability is back on the curriculum, rather than shareholder dictats.

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  • The words : 'if nurses spoke out when they identified poor care ,public confidence and nurse pride could be restored'.
    I feel nurses have been speaking out long enough but no one is listening. There come a time when people don't fight the good fight any more when all the energy is gone and NOTHING is done.
    We need more staff to improve care and we need good nurse managers who are able.

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  • This woman is only capable of talking in cliches. No vision, no plan, no use to patients or nurses.

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  • I think the oldest elephant in the room is staffing levels but other elephants are now squeezed in too; clinical supervision, education, bullying, to name a few. Jane Cummings must broaden her vision, insight and political courage to address them if she is to succeed in even the smallest way.
    It strikes me the 5 C's might be helpful?

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  • Anonymous | 24-Jul-2012 6:19 pm

    I think you may be right?!....I'll have to read it back again, but unless there is a 'grass roots revolution', then nothing will change. This kind of action will 'force' a change in the higher strata of nursing & health care that wouldn't come about normaly. How to co-ordinate it??- not sure....

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  • Mike Stone

    Your polite cynicism is well placed. This woman is just the latest in a series of "Talking Heads". I would love her to prove me wrong!

    The reality is, despite the grand job title, this woman as no power and any advice she offers the DOH will ignore !

    Power lies in the TRUSTS and with CEO's and their bean counters ! Many NHS Trust Directors of Nursing are no more than sycophants to the all powerful CEO and do little to improve standards of patient care.

    These Senior Trust "Nurses" have colluded in the dilution of skill mix and have the consequential decline in the standard of patient care.

    I look forward to the day when many of these "Senior Nurses", who it could be argued, are in breach of the NMC's Code of Practise face Fitness to Practise panels.

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  • DH Agent - as if ! | 24-Jul-2012 11:27 am

    "Never - I'm psychologically unsuited to nursing (if pushed, possibly pathology)."

    and commenting?




    "You've miss the point...."

    having seen your comments here for around 18 months, I most certainly have not missed the point!

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  • Here's one 'C' for you, COBBLERS!

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  • Well............... what more can you say? except has the profession lost respect for itself? do the majority of the public disrespect nurses? My experience is no and no. I am always proud to say I am a nurse. The majority of the public I deliver services to/ and for show appreciation and thanks when their needs are met. I wouldn't call having the confidence to challenge when you are unhappy with a service not respecting. But nursing faces a bigger uphill struggle for recognition once the GP's are fully in the commissioning driving seat and I would have liked to hear the CNO allude to robust strategies for ensuring nurses are positively engaged in strategic decision making around service delivery.

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  • If I hear one more

    Vision,
    Clinical Strategy,
    Mission Statement,
    Corporate Strategy,
    Value Statement,
    Corporate Objective,
    Quality Account,
    etc. etc. etc

    I`ll scream. AAAAHHHHHHHHH !!!!!!!!!!!!

    Give us a break and tell us something useful, PLEASE !!!!!!!!!!!!!!!!!!!!

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  • Tipperary Tim | 27-Jul-2012 11:19 am

    congratulations, you qualify for an MBA!

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  • Anonymous | 27-Jul-2012 11:22 am

    Tipperary Tim | 27-Jul-2012 11:19 am

    I just hope it has some practical application in nursing!

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  • Jenny Jones | 25-Jul-2012 5:58 am

    "The reality is, despite the grand job title, this woman as no power and any advice she offers the DOH will ignore !"

    I think this offers her a unique position - her power is not in spending power or in directing policies but that she's a mouthpiece for the nursing profession - allowing us to connect with the public and importantly voice our views. With a strong voice, nursing won't be the fall guy for failings in the NHS - failings predominantly due to poor staffing levels and management, as well as the problems highlighted at the NMC. None of which are due to systematic nursing failings, or problems with nurse training as so often portrayed by an increasingly hostile media.

    Can I also just say with regards to the article, have nurses truly lost the respect of the public? There wouldn't be the outrage, the scandal, at cases of poor care if nurses weren't respected. The issue of course being that this respect raises us up, and only gives us further to fall when individuals and wards let the profession down.

    Nursing morale, and pride in our work, has been dented - something that can't completely be healed with rhetoric. A strong lead will help, but nurses need power given back to them. They need to feel those at the top are representing them and that their views, their concerns, are being listened to (unlikely to happen soon with pensions, the NMC fee hikes, non-implementation of the patient:staff ratios... need I go on?)

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  • tinkerbell

    Tipperary Tim | 27-Jul-2012 11:19 am

    Same here. ARGHHHHHHHHHH

    whatever happened to the word 'HONESTY'.
    Let's have that instead of all this bullshite.

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  • Grant

    I hope you are right ! I sincerely look forward to the day that the profession finds the strength to speak with one voice!

    Yes, I do believe that the public has,to a great extent has lost confidence in the profession. The steady drip of "bad news" particularly associated with what is euphemistically called "basic care" has made individuals doubt that their relative(s) will be cared for appropriately and people are scared about what may happen to them should they require hospitalisation.

    I still believe that Trust Directors of Nursing are culpable for their overseeing the dilution of skill mix and their continued "blind eye" approach to the poor staffing levels many RN's have to cope with on a daily basis. I really look forward to seeing them pay the price for ignoring the NMC's Code of Practise.

    Perhaps Robert Francis QC when he publishes his report on the "management" involvement in the Stafford disaster he will sharpen up the need to make Senior Nurses truly accountable for the mess they create and maintain on the wards and departments of hospitals. I live in hope !


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  • tinkerbell

    It is deeds not words that have earned nurses respect. Nurses have earned respect by being commited and caring over many, many years. Those nurses that bring the nursing profession into disrepute are a minority who have no place in nursing.

    The publics daily encounter with kind, caring, committed staff is what promotes nursing respect, they are walking the walk and earning the respect and trust of their patients on a daily basis.

    The feedback from patient and staff experience should be acted on and hopefully this is where change can happen so that nurses can get on and do their job without hindrance but only if we have someone who can speak up for nurses and make a difference to what happens on the frontline.

    Action speaks louder than words.

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  • Juggling Dog

    Grant Byrne wrote:

    'I think this offers her a unique position - her power is not in spending power or in directing policies but that she's a mouthpiece for the nursing profession - allowing us to connect with the public and importantly voice our views.'

    above.

    I've just been moved, in the LCP one, to enquire why some posters have launched a vicious attack on mike stone, apparently for having the nerve to post on this site.

    Now, I'm all for nurses talking to the public, and the public talking to nurses, and everyone talking to everyone else - it is the only way to understand other people/professions. But, judging by the vitriole mike attracts, not all nurses are very interested in 2-way interactions !

    PS I don't extend this liberalism, to taking into account the views of cats, however.

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