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'Seventh C stands for covering up the real issues, not CPD'

Minutes of the “What Are We Going To Do About Nursing?” Marketing Focus Group. Private and Confidential.

Gordon: Thank you for coming, help yourself to biscuits. We need to come up with something to sort of relaunch nursing that looks a bit modern, will facilitate the use of diagrams, is catchy and - easy on the Hobnobs, Bob - doesn’t cost anything.

Arabella: Are we thinking slogan or something a bit more visible… new hats?

Bob: Ohh, what about old hats? We want people to stop thinking about what nurses are like now: expensive, educated and, according to the polls, “not very nice to my nan”, and remember what they were like in 1952 - demure, starched, angelic. Give them pre-coronation hats and we’re sorted.

Flotilla: Can’t do it, Bob - infection control and not enough starch. Anyway, we need something that characterises the ideal nurse, the modern nurse, we need qualities, we need catchy…

Arabella: Have we considered rhyming?

Flotilla: Not with nursing it doesn’t; bursting, immersing, reversing, cursing….

Arabella: Well, it could be a word everyone associates with nursing like….

Bob: Tired, oppressed, poorly represented, embattled, varicose veined…. My mum was a nurse.

Gordon: Well, we have had this idea from the CNO’s office. She couldn’t be here today because we told her we were meeting somewhere else. The 6Cs they call it - care, compassion, communication… er care….

Bob: You’ve said that one.

Gordon: I know, er, care, compassion, communication….

Flotilla: Is consternation one?

Gordon: Its not on the list….

Bob: Why C? Why not K? We could have kindness if we went with K and knowledge.

Gordon: Yeah, but there aren’t 6 Ks, are there? Not unless you include killjoy, kickable, kitten-like and kinesis.

Flotilla: D! D is good. Delightfulness, Determination… er… Danceability….

Gordon: We’re wedded to C so we can say compassion and that feels quite important.

Arabella: Will saying that be enough?

Gordon: We hope so. Communication, care, courage, compassion… not custard….

Bob: I like E. Elegant, excitability, excellent, E-coli-fighting….

Arabella: What is this for, again, Gordon?

Gordon: There will be posters and lots of people in quite key positions are committed to saying at least four of the six Cs to each other at lots of meetings and conferences.

Bob: Will it actually help?

Gordon: Well, we’re going to call it a vision to start off with, so that doesn’t matter too much at this point.

Arabella: Who’s paying for the posters?

Gordon: Well, after the Francis report, I got a memo from the Department of Health. They feel they could focus most of the debate on things like inspections, management checks and systems and processes. When it filters down to people, you know, what happened to make good nurses become disengaged, they reckon there will be some righteous outrage, a bit of name-calling and that will be it. However, they did come up with £300 for posters and erm… biscuits.

Bob: Nothing for extra nurses or better CPD, then?

Arabella: Is CPD one of the 6 Cs?

Gordon: No,, I don’t believe it is.

Gordon: Then no, Bob, nothing for that.

Bob: CPD funding really would help….

Gordon: Courage, Bob, courage. It is cheaper than CPD, more vague. If people don’t show courage, we get to call them cowards, very First World War. Stop it with the CPD Bob. It’s the wrong kind of C.

Readers' comments (27)

  • michael stone

    My brain is very slow at present - I had to look up CPD to work out what it was standing for.

    My worry, is that an F might be involved (flannel, as in 'load of old') and an O (as on obfuscation).

    But I might be a bit cynical - the Francis report was really clear about where the problems that caused Mid Staffs rested, and it was essentially hierarchical structures, the people in the pyramid almost totally ignoring concerns and feedback from anyone lower down, and a general lack of openness about problems which were 'hidden in plain view'.

    It should, logically, lead to the 'culture change' Francis wants - but I'm still cynical !!!

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  • Did you say biscuits?

    don't tell Tinkerbell or s/he will be after you!

    Too right about the starch. the laundry cut back following the strike towards the end of the 70s, can't remember the exact date, and we had to go and raid the x-ray dept. for film which we scrubbed clean and cut into semi-circles to hold our hats up. thank goodness for nurses' resourcefulness (-:>

    As for the 'Six C's, maybe there is a 7th which says they are a Curse rather than a Vision.

    was Lansley's disproportionate bill at the DH for biscuits paid for before he left by the way?

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  • tinkerbell

    of I'm so world weary of it all, this nursing malarkey. Nothing to do with the patients just the unrelenting, never ending, layers upon layers of old toot handed down to us to implement from those who have lost the plot or never had it in the first place. Mind boggling, mind blowing goobledygook with an MSc in how to send us all screaming for 'sanctuary'.

    I can no longer understand a word management speak.

    I have a far better understanding and connection with a dementia patient and they are supposedly severely cognitively impaired. At least they are emotionally honest.

    Who can blame me for wanting a 'C'ustard 'C'ream as a perk of the job.

    I'm not she/he or lady/boy.

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  • Dear Mr/Mrs Tinkerbell, Sir or Madam

    "...never ending, layers upon layers of old toot handed down to us to implement from those who have lost the plot or never had it in the first place."

    why don't you leave them to do their own work and just do yours. I am sure nursing patients with dementia gives you more than enough to do.

    IJust put your foot down, tell them what you are doing and where your duties lie and end, and say a very emphatic NO. Alternatively offer to do their work for them on condition that they come and give you a hand with yours. that should soon shut them up and sort them out.

    Qualified mental health personnel are supposed to be expert at negotiating, setting limits and showing people where the barriers lie between self and others and how not to cross them!

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  • michael stone

    tinkerbell | 23-Feb-2013 5:44 pm

    Tink, I can't remember if it is one of the 6 Cs - but you mentioned 'connection', and Connection should be in there !

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  • DH Agent - as if ! | 24-Feb-2013 12:39 pm

    connection is very relevant but isn't this included in communication which is also connection.

    if we add too many more Cs to the list they will probably forget them all!

    Besides they wouldn't all fit onto the credit sized cards being issued and these have to be able to fit into uniform pockets so that nurses have a constant reminder just in case they forget!

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  • tinkerbell

    DH Agent - as if ! | 24-Feb-2013 12:39 pm

    No i cannot take credit for adding 'connection' although vitally important.

    My only additions were custard creams and cucumber.

    Not that i think the 6 'c' thingy is unimportant, it is vital, but i think most good nurses already have these without having to have them spelled out. It just happens. We do not need another check list.

    I understand that this is a way to reinforce what nursing values are about and how important it is to enter nursing with the right values and attitudes but some more practical support at this late hour might be required to help us all. A vision is one thing having the tools to do the job properly is another. The tools to do the job properly are feet on the ground not a pocketful of visions and fairy dust.

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  • Tinkerbell

    careful what you say or we might not get our free credit cards to put in our pockets to replace our fallible memories!

    joking apart you are totally correct in what you say.

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  • Like the new picture Mark, not entirely sure if immersing and nursing rhyme though!

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  • tinkerbell

    and the biggest C of all CORRUPTION!

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  • tinkerbell | 24-Feb-2013 5:43 pm

    how do you possibly imagine there is room for that on the card as well? It is an awfully long word and there are six others already. Besides we do not wish to overtax the memories of our managers when they come round to measure our achievements.

    I am really looking forward to getting one of these credit cards, do you think the terms and conditions will be generous?

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  • tinkerbell

    Anonymous | 24-Feb-2013 6:05 pm

    Hopefully tea and 'crumpets' for staff breaks will be included within the T&C's.

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  • The Seventh C should be considered a lucky one.


    the Visionary, who brought the 'Six C's' to nursing. This is guaranteed to leave her mark on the history of the profession.

    'Twas an error. the 7th C should actually have been a

    Complement of staff.

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  • The trust i work for loves it's acronym's and buzzy word play, in fact remembering them was part of my induction and woe betide anyone who forgot! What a shame then that only 8 months into my newly qualified position that I feel like making my own set of acronym's up that wouldnt impress those above me one bit. Management have one agenda these show people (our customers, the public) that they care...'show' mind, not actually dealing with the problem of short staffing, poor control of resources or frankly intimidating and out of touch management. I dont need yet another 'initiative' to tell me i flipping care...i know i do or i wouldnt have gone near the caring industry to start with. I can think of a few other words that start with 'c' but they wouldnt be printable ......Caramel crunch anyone?

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  • michael stone

    tinkerbell | 24-Feb-2013 1:43 pm

    'Not that i think the 6 'c' thingy is unimportant, it is vital, but i think most good nurses already have these without having to have them spelled out. It just happens. We do not need another check list.'

    Yes, so would I - that is why I keep rabbiting on about the issue being patient/nurse empowerment, instead of 'nursing values'.

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  • tinkerbell

    Anonymous | 25-Feb-2013 9:51 am

    my pet hate, acronyms, can never remember them and some people make up their own up and somehow we are all meant to mysteriously know what they mean. Just to add more confusion to the lack of effective communication, unless an acronym is known by all it should not be used.

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  • tinkerbell

    And so the end is in sight of what was OUR NHS. At last we get to see their real intentions. Hope everyone has private healthcare in place for when this lot kicks off. OUR NHS has been stolen from us, without our permission, without our knowledge and behind closed doors.

    At the NHS rally i went to in London David Owen said 'you's lot really haven't got a clue what's going on behind the scenes'.

    Seems not, only it's worse than probably even he thought.

    'A new fight over NHS privatisation has just begun. Jeremy Hunt is trying to use new powers, hidden within last year's controversial NHS laws, to force local GPs to privatise more health services. [1] This is one of the things we were afraid might happen - and now our worst fears are being confirmed. We need to do all we can to stop it.

    Jeremy Hunt's new privatisation plot is contained within "NHS competition regulations". [2] Usually these kinds of rules get quickly rubber-stamped by Parliament. This time, we need to get MPs and Lords to stand up to Hunt and block his plans. [3]

    It’s a long shot, but we have a chance of stopping these changes because Hunt is breaking promises made to MPs when NHS laws were voted through last year. [4] If we generate a huge, public outcry to put pressure on the politicians who clung on to those promises last time the government attacked our NHS, we can convince them to stop these new laws.

    Sign the petition against Jeremy Hunt's new NHS privatisation plan here – we’ve got just a couple of days before we’ll need to deliver it:

    Hunt's new regulations (Statutory Instrument 257 under Section 75 of the Health & Social Care Act 2012) are like a catalogue of our worst fears. [5] GPs would have to open up every part of local health services to private companies, whether or not it’s what they or local people want. It would speed up the break up of the NHS, giving profit-hungry companies new rights to muscle in.

    Last year, the government promised it wouldn’t go as far as forcing privatisation on local health services. Lots of MPs and Lords said these promises convinced them to vote for the NHS law. Now, we need to go back to these same MPs and Lords, and tell them to find some backbone. If they really voted for the law because of those promises, now they’ve got no excuse not to put a stop to Hunt’s latest privatising move.

    Let’s build a petition to hand in to each of the MPs and Lords who believed the government’s promises on privatisation:

    All over the country, 38 Degrees members have been working together to convince their local NHS decision makers to do the right thing and limit privatisation in their area. Now, government is trying to take that power away from local doctors and the patients they serve.

    This is going to be tough. It could be the start of the second round of the fight to protect everything that’s precious about the NHS. But it’s the right thing to do, because we know that when private companies move in, all too often it doesn’t end well for patients.

    Sign the petition now:

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  • For what it's worth I don't really care which letter they go with, I don't mind what order they put the words in, I just want it all to be framed in terms of how it might be helpful for nurses.
    How will we helpfully rejuvenate tired staff, make compassion available rather than put it on a list of demands. Where is the educational strategy, the CPD support, the attention?
    Without a way of making it meaningful, of being constructive, its all just guff.
    In my view.

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  • Hello Tink. Dementia patients used to scare me. Partly because I don't know what I'd do if I lost my nearest and dearest like that (I don't know why, but it feels like the worst illness to get, for me) and because I'd never know what to do to help them. So I made myself do a shift on an EMI unit. I've got a NVQ 4. I'm rubbish mind you, bit clumsy, talk bollocks about spreadsheets now and then, can't help it, it's the management nematode we have inserted when we get on a band 8. Bloody amazing experience. I'm going back next weekend. I'm getting glimmers of an idea how to stop all this top down stuff and make it more frontline. I'm starting with asking our director of nursing if we could move to 3 or 4 hour shifts in services that are particularly intensive. I'm going to call it AFA Another F Acronym.

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  • michael stone

    Hi Nobody.

    A question.

    Elsewhere you mentioned an EoL group in your area, comprising GP, palliative nurses, etc.

    I've tried to discover if there is such a group in my area (I used your description of it) - LINK have no knowledge of any such group, and my PCT seems unaware of any such group, either (although the PCT 'expert' in the area, is on holiday at present).

    This begs the question, if your area has got such a group and mine has not - which is out-of-the-ordinary, having such a group, or not having one?

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