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'Nursing strategy success depends on everyone'


The profession needs to acknowledge that there are problems in nursing - but recognise that instances of poor care delivery that are so often reported by the media are the exceptions. That was the message at the Chief Nursing Officers’ Conference last week, where nearly 400 senior nursing leaders gathered in Manchester to applaud or constructively dissect the nursing strategy presented by CNO for England Jane Cummings and director of nursing for the Department of Health Viv Bennett.

Ms Cummings had been interrogated by the media during the first day of the conference, and eloquently and powerfully told them that those nurses who failed to care for their patients were betraying their excellent peers in the profession.

She is right. Every nurse is having to shoulder the shared guilt of the terrible failings of the few. This isn’t good for individual morale, or the standing and status of the profession as a whole.

This was a point picked up by health secretary Jeremy Hunt on the second day. He said although poor care was rare, it could not be brushed aside. It had happened, and the public needed reassurance that the government - and the profession - was sorting it out.

Nurses need support from the top to ensure their “courage” in speaking out about poor care will not be met with derision, bullying or even disciplinary action

NHS chief executive Sir David Nicholson, via video message, also suggested that those nurses neglecting their patients and their duty of care would be rooted out.

Unequivocally, then, the message comes right from the top that there shall be a zero tolerance approach to those who are wilfully flouting the values outlined by the 6Cs nursing vision of care, compassion, courage, commitment, competence and communication.

While the 6Cs met with universal approval at the event, let’s be clear that the profession should not live these values in isolation.

Indeed, many a GP, hospital consultant, physio or OT could benefit from adhering to them. While nursing must own those Cs, it is wrong to suggest the onus for providing compassionate care lies solely with nurses. It will also make it harder for them to live the 6Cs if they are the only health professionals aware of them.

The very best nurses need support from the top to ensure that their “courage” in speaking out about poor care will not be met with derision, bullying or even disciplinary action - as has been the case all too often. Nurses must live by the 6Cs, but their managers must understand them too, and offer every bit of support to ensure they can be achieved in real-life situations, not cast aside to save a few pounds or cut out when resources are tight. If nurses agree those values are to save the future NHS, let’s all show them some respect.

Jenni Middleton, editor Follow me on Twitter @nursingtimesed


Readers' comments (79)

  • Jane Cummings Report “Compassion in Practice” has so far been a disaster for nurses. It has resulted in some of the worst media coverage ever over the past week. She has given the press a stick to beat nurses by suggesting that nurses are lacking in care in compassion. I would suggest that Jane Cummings would fail her own five”Cs”. Certainly her communication has been a disaster. The RCN had to appear on Radio 4 on the day of her pronouncement and face very hostile questions. To their credit they did concentrate on lack of adequate staffing as being of utmost importance. In the same week as Ms Cummings made her speech the NHS watchdog, Dr Foster, released a report saying that hospitals were full to bursting point and staff were rushed of their feet. How can staff provide adequate care and compassion in such circumstances? Jane Cummings failed to mention this report in her speech, I wonder why? I would suggest that she and the government do not want to draw attention to the real causes of poor care and it much easier to scapegoat and demonise nurses. This is similar to the way they are demonising the poor and unemployed as being workshy and feckless,” lying in bed with their curtains closed whilst other people go to work”. So we now get the feckless, lazy, uncaring and un-compassionate nurses as being the cause of all the ills in the health service.
    I would urge Jane Cummings to read some of the reports below, although I would have thought she should have been aware of them already. It seems she has chosen to ignore them and concentrate to her simplistic five C formula. Much easier that looking at the real causes and no doubt much more acceptable to her masters in government.
    “Hospitals are 'full to bursting' and patient care is being put at risk, report warns”
    Hospitals are 'full to bursting' and patient care is being put at risk, report warns. Dr Foster, the NHS watchdog, found 12 trusts have 'worryingly high' death rates for 48 weeks of the year most hospitals are more than 90 per cent full, 'jeopardising patient care'. A third of beds are taken by patients who could be cared for elsewhere. He added: “With bed occupancy of 95 per cent to 100 per cent for much of the year for many of the hospitals, there are too often no beds available, staff are rushed off their feet, patients are not cared for properly, infection rates rise and mistakes occur.”
    “Hospitals on the edge? The time for action”
    A potential crisis in hospital care is widely reported in the media today, with BBC News reporting that standards of hospital care are slipping throughout England. The Daily Mail states that elderly patients are being shunted between beds “like parcels”.
    The headlines are based on a new report by the Royal College of Physicians (RCP) of London, which warns that acute hospital care is under pressure, leading to “unnecessary pain, indignity and distress”. Many stories lead with the frightening claim that NHS hospitals could be on the brink of “collapse” – a term that the RCP’s report does not use, but which is present in its accompanying press release.
    The title of the report is Hospitals on the edge? The time for action
    “NHS Choices-Thursday September 13 2012”
    “Short-staffing nurses leads to care not being done “ October/December 2006 -- When nurses are short-staffed, a research study:"Missed Nursing Care: A Qualitative Study"found that much of necessary patient care was just not being done. Beatrice Kalisch, Past-President of the Center, published her findings in theJournal of Nursing Care Quality. The qualitative, focus group study of RNs, LPNs and nursing assistants found that care was being missed in 9 major areas including surveillance, discharge planning, patient teaching, ambulation, turning, feedings, emotional support, hygiene and intake and output documentation. One RN in the study stated: "People want to give good care and it bothers all of us when we can't do it. You are pulled in 10 directions, and you can't give quality care to your patients. It really bothers me.” And another said: “We don't let ourselves think about [the care not being done]. It is the way we cope. Underneath we don't feel good about it

    “Adequately staffed nurses with good administrative support and good relations with physicians have more satisfied patients”
    February 2004 -- Patients were more than twice as likely to report high satisfaction with their care and nurses reported less burnout when nurses worked in conditions with adequate staff, good administrative support for nursing care, and good relations between themselves and physicians. It was a study of 820 nurses and 621 patients from 40 units in 20 US urban hospitals. See: Vahey DC, Aiken LH, Sloane DM, Clarke SP, Vargas D. (2004). Nurse burnout and patient satisfaction.Medical Care2004; 42(2):II-57-II-66.

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  • My six-point comment on Cummings's formula


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  • Tinkerbell

    'The very best nurses need support from the top to ensure that their “courage” in speaking out about poor care will not be met with derision, bullying or even disciplinary action - as has been the case all too often'

    This is good news and a step in the right direction at last.

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  • tinkerbell | 11-Dec-2012 3:58 pm

    'The very best nurses need support from the top to ensure that their “courage” in speaking out about poor care will not be met with derision, bullying or even disciplinary action - as has been the case all too often'

    This is good news and a step in the right direction at last.

    It would be if it were true, but I'm afraid there is little chance of it happening under this government and Ms Cummings watch

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  • Does Jenni Middleton really believe what she has written? It is either wishful thinking or "their all in together"

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  • Tinkerbell

    Anonymous | 11-Dec-2012 4:48 pm

    What? Have i been duped into believing they might actually mean what they say? Must have let my guard down for a moment.

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  • Anonymous | 11-Dec-2012 4:52 pm

    it is journalism with which one earns one's bread and butter

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  • tinkerbell | 11-Dec-2012 3:58 pm

    It is your good heart and hopeful nature that means you still look at things with better eyes than some of us. Don't let it happen again!! You're going to end up looking like someone who cares. We can't be having any of that nonsense! But I have to agree with Anonymous | 11-Dec-2012 4:48 pm.

    There is nothing new in this 'nursing strategy'. Nothing new at all. Most nurses live by these six Cs and much more on every single shift they work. That is why the NHS has not collapsed completely.

    This 'strategy' is the vilest, most condescending load of claptrap I have heard in a long time. It seems to have fooled everyone but nurses themselves. Not one solution in sight.

    Anonymous | 11-Dec-2012 12:59 pm


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  • Tinkerbell

    mags | 11-Dec-2012 10:41 pm

    Yes but Mags you and many others posting here care passionately too, it encourages me to hear their dedication that we're not all badduns but does this mean that we can no longer believe a word the heirarchy say in relation to nursing. If that's the case i feel a weeping coming on. We're done for. I don't want to believe we're done for, all that's good and kind in our society which is reflected on a daily basis within what was OUR NHS. It's so vitally important that we don't lose compassionate care for ALL. No-one's asking for a medal just want them to stop this relentless assault on the majority of good staff.

    I am quite happy to take some action but there's no action going on. It is so frustrating that we feel so impotent in the face of this pasting when we could be a force to be reckoned with if we just had enough belief in our value to society as a compassionate society. Once our NHS is gone heaven help us all, it will be dog eat dog.

    I feel we don't need gimmicks or cards to remind us of 6 c's. It might be a reference point but caring nurses have been doing this without putting names to it all.

    I have seen and worked with some wonderful nurses and i have also seen and worked with some of the dregs but i feel so sad that nursing and good nurses are being dragged through the mud big time by a heartless government who have demonised nurses for their own money making agenda. Shame on them for the way they have tried to drag ALL nurses through the mud.

    Sometimes i find it hard to believe that it has come to this so you may be right I am looking for someone honest (hellooooo is there anybody there?) to believe in that might put nursing back on track and who really cares about what happens to the patients rather than them just being a pawn in a game.

    I am concerned because i now realise also that nurses aren't going to take the stand that is required to give this unelected government a bloody nose.We're just going to take it lying down or leave.

    Perhaps we are going to be destroyed and have to start again or just become a distant memory of the way things were and all the good thrown away with the bad but there was more good than bad.

    Must go can feel some swearing coming on.

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  • Nursing in this country is at an all time low.
    The two stupid, ambitious DJ'S and their boss has put a spot light on nursing in England.

    We are Receptionist, due to cut backs
    We are Porters, pushing beds to various places as not enough porters
    We are Physiotherapists as they are telling us we have to assess the patients moving first before they start moving the patients. They also are not doing enough chest physio so we end up putting on more nebulisers.
    We are tea ladies as the wards has done away with the House Keepers. Our health care assistants are taken away from us to do house keeping and filling out patients menu sheets so
    We are Health Care Assistants
    We are Cleaners as the cleaners' time cut to save money.
    We have to stop doing the medication and do the meals first as not enough staff. Medication is now given too late or too early.
    We have to stop our work every 5 minutes to answer the phone as relatives call 24/7.
    We are Ward Clerks as no ward clerk from 2:00 pm.
    We have little support from the ward sister/manager because they are stuck in the office doing paper work or pretending to do urgent paper work.
    We are not getting appraisals from the Ward Sister we are only called in the office to be told to do more or for a telling off.
    We are told that we cannot get our A/Leave as requested as no staff
    We are told we should not be fat and that we should smile more.
    Even the patients relatives give us work to do by leaving their chairs by the bed, we have to put their chairs away.
    We are managed by senior people who have't got a clue how to manage.

    God help us

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