It’s time to start looking after nurses to boost care
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When I was a student we used to ask patients to do the milky drinks rounds in the evenings.
Those were the days - when patients stayed in hospital until their stitches came out and we worked in predictable peaks and troughs with the occasional crisis. Life was less complicated 30 years ago. Patients trusted their nurses and there was never an expectation that anyone would complain.
The challenges faced by nurses today are so much more complex. Even if you had a patient well enough to do the hot drinks, they would probably not be allowed to help for health and safety reasons. The pace of change is rapid and it feels as if nursing has failed to keep up and engage the implications of this change.
We need to have that tricky conversation about what nursing is, what is driving its development and whether a direction is right for patients’ care. An example might be 12-hour shifts. They save money and might be good for staff arranging child care or social lives, but are they good for patient safety?
Marie Manthey, the advocate of primary nursing, gave some great advice that I always used when considering any change in practice: “Patients matter most but staff matter too.”
The new CNO of England, Jane Cummings, has laid out her vision for nursing and underpinned it with values: care, compassion, courage, commitment and communication. It is easy to be cynical but I think she has captured, in those five words, what nursing is.
She has started a dialogue about what nursing is and it is up to the profession, at all levels, to engage and take up the debate. This appears to be a real opportunity to talk about what nursing really means and define a philosophy for the future.
Imagine every nursing team across England sitting down for an hour and using the ‘five Cs’ to carve out their philosophy of care. An hour to write down what nursing means to them on their ward, unit or department and how they can achieve their goals. There is power in being able to articulate why your work is important, why it should be valued and to celebrate what you do well. It also helps to clarify when concerns should be raised and where change needs to happen.
Nursing has to change at grass roots level - anything else is merely cosmetic. So let’s stop talking audit and dashboards for a minute and think about what nursing should be. What is the value of empathy, compassion and care? How can nurses provide the best care all day, every day? What are the limits of nurses’ roles? What do patients actually need and want from nurses? When do nurses make a difference?
Being clear about what drives and motivates you and feeding this into the national debate is vital for patient care. With clear vision we can recapture public respect, but more importantly, their confidence in what we do.
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Readers' comments (30)
Anonymous | 13-Aug-2012 0:27 am
Sitting round a table for an hour eating sandwiches, drinking coffee and breathing a lot of hot air about this philosophy and that philosophy is exactly where the NHS is going wrong and all the money is wasted! Whatever happened to people knowing what job they were there to do and just getting on with it!!
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Anonymous | 13-Aug-2012 2:51 am
Hear, Hear...anonymous 0.27am 13.8.12,
Too much talk and not enough action which is what is wrong with nurses these days.
A simple philosophy...doesn't take much brain power either.
Nursing is doing what a patient is unable to do for themselves during illness or enabling a peaceful and dignified death.
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Anonymous | 13-Aug-2012 9:06 am
2.51 am
is that all?
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Anonymous | 13-Aug-2012 9:58 am
whilst I agree with the sentiments expressed alll too often they are not put into practise. Where I work we get told they had no time for me in hospital (not always a nurses fault I admit).
We TRY to work in partnership with management and put talk into practise ideas. Put talk into action !!
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Anonymous | 13-Aug-2012 11:57 am
Nursing is all about looking after people who are not very well, it has got nothing to do with the old days when younger and able-bodied patients used to help out with the hot drinks - they also used to sit in bed smoking cigarettes, I think we have moved on a lot since then.
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Anonymous | 13-Aug-2012 12:20 pm
our patients served hot drinks from the trolley but they weren't allowed in the kitchen to make them because of the dangers of gas cookers and the steam pressure water boiler. this was in the mid 1970s on.
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Anonymous | 14-Aug-2012 9:49 am
I too was a student when the patients made the evening drinks. To many it was the final task to be undertaken before they could be deemed fit to go home.
Nursing is about helping those who cannot meet their needs on a daily basis wether thats due to an acute episode of illness or a chronic condition. To me it makes no difference if you need to use highly technical equipment or just the you and your 1:1 interaction with that person or their family if you make a difference then thats nursing however delivered.
The skill in nursing is the application of that unquantifiable knowledge, perception and people skills which cannot be measured only witnessed. No-one has been able to define the essence of nursing but we all know it exisits.
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Anonymous | 14-Aug-2012 11:45 am
Anonymous | 14-Aug-2012 9:49 am
ask Mr Cameron and Mr Lansley they know how it should be done as well as everybody else who is not a nurse!!!!!!!!!
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Anonymous | 14-Aug-2012 11:49 am
nursing =caring and being involved every minute unfortunately a lot of nurses are paid/presence not /effectively nursing interventions in their shift .with other words some are working more than others.Is a lot of laziness and a lot of just doing the writing and the papers and not bothering about what is with the patient.somebody asked me one day if i know the role of the sister on the ward. being honest and realistic the role of the sister is to be on holiday most of the time and to work part-time .some of the managing roles in healthcare have to be completely changed .being a nurse is not just a job is dedication and vocation is you have it or you do not .sorry is a lot to say ...
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Anonymous | 14-Aug-2012 11:51 am
Is anyone ever going to be brave enough to start up a debate about how little respect some patients show towards each other and staff - especially nurses.
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Anonymous | 14-Aug-2012 12:04 pm
Anonymous | 14-Aug-2012 11:51 am
Go ahead!
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doneraile mulvey | 14-Aug-2012 12:42 pm
Yes I remember when patients volunteered to make drinks and even make drinks for other patients on the ward.
I trained in the Army, so I suppose many of the patients were young fit men and it gave them something to do.
We worked on the old nightingale wards, so you could keep a close eye on all the patients and the patient who was making the tea!
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Carol Ellison | 14-Aug-2012 1:09 pm
I am sorry the nurse (Anonymous 14th August 11.49) does not know what the role of the ward sister entails. However the ward sister is a nurse and has no doubt worked her way to the band 7 post so knows exactly what a nurses job entails. Taking responsibilty for all the patients and staff on the ward and managing all the resources probably takes so much time that she/ he does not have any time left to explain her/ his role to this nurse. If the sister works part time perhaps she / he has home commitments; that does not make her/ him a bad nurse or manager. If you have a grievance about other staff not 'pulling their weight' then talk to the sister about it, airing it online, whilst remaining 'anonymous' will not help you or the patients! Just remember though, record keeping, however tiresome, is a very important part of the nurses role, it is never 'just the writing'!
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judy mewburn | 14-Aug-2012 9:27 pm
Two nurses in this debate have been confident enough to give their names. All other comments have been anonymous . Do these nurses either not believe that what they are saying is relevant and useful or is this a sneaky way of complaining and not being caught out ?
Nurses . state what you feel is important to you , how you view patient care and what you feel is good practice.
You are certainly being viewed cynically by the general public, your patients and it is up to you to state your purpose , your views and mostly to prove these by your practice
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Anonymous | 14-Aug-2012 10:42 pm
judy mewburn | 14-Aug-2012 9:27 pm
and who might you be with 'a name'?
and are you not 'being viewed cynically...' etc. as you suggest others are.
has it not occurred to you that not all who comment here are nurses?
if you look at the end of the comments you will notice there are two options under 'Post as' one of which is 'Anonymously'. You might also wish to note that different people have different reasons of there own in choosing this option which is their right and nobody else's concern.
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Anonymous | 15-Aug-2012 3:07 am
After 34 years of nursing I am now on count down to retirement... will I miss my job...my career...definitely.... have I seen changes in nursing...far too many mention but what I have noticed with each change is that as the changes occur the nurses in that era feel that how they trained etc is the best way.....and that is right.... we have done circles...we have done somersaults in nursing but those that love it just stay and deal with what is thrown at us....
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Anonymous | 15-Aug-2012 10:50 am
Nursing and the way nurses behave has changed but so has the way many patients and relatives behave.
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Anonymous | 15-Aug-2012 12:44 pm
"Cup of cocoa a day may help memory in elderly: study
Drinking a cup of hot chocolate before bed may stave off memory problems in the elderly, research has suggested."
'cos the Telegraph says so.
it don't matter who makes it, the effects will be just the same!
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Anonymous | 15-Aug-2012 2:44 pm
I also remember when we used to give out cans of guinness along with the mikly drinks!
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Anonymous | 15-Aug-2012 3:45 pm
you are showing you age dear!
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Anonymous | 15-Aug-2012 4:43 pm
can't get some of the staff to make the hot drinks let alone the patients.
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Anonymous | 15-Aug-2012 5:39 pm
you would probably be suspended and put on trial by the NMC for even suggesting that a patient made their own drink or even fetched one now, let alone serve all the others.
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Anonymous | 15-Aug-2012 6:09 pm
anon 5.39 - sad but true.
I think it is also very sad that no-one has posted on the site about volunteer nurses needed for the Mercy Ships yet we happily rant on about nursing directors wearing uniforms, nurses cleaning beds and patients making hot drinks, all of which are pretty irrelevant in the big scheme of life.
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Anonymous | 15-Aug-2012 7:29 pm
Anonymous | 15-Aug-2012 6:09 pm
why haven't you posted on them as you seem to have the information which others may not have.
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Anonymous | 16-Aug-2012 9:18 am
I didn't need to post on it, I looked up their website after I read the article. What should I have posted about?
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Anonymous | 16-Aug-2012 9:27 am
Anonymous | 16-Aug-2012 9:18 am
it was in view of your comment above
"I think it is also very sad that no-one has posted on the site about volunteer nurses needed for the Mercy Ships ... "
but you don't appear to have commented on it either.
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Jenny Jones | 16-Aug-2012 11:12 am
Carol Ellison | 14-Aug-2012 1:09 pm
"I am sorry the nurse (Anonymous 14th August 11.49) does not know what the role of the ward sister entails."
Reads like a disenchanted care assistant type rant !
If its a Nurse please don't allow her/him to write any care plan for me !
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Anonymous | 16-Aug-2012 11:58 am
I have been a nurse for 31 years and am saddened by the decline in standards of care in hospital. It is not only in nursing though, no-one seems to have the dedication and commitment they once did (porters, cleaners, admin etc). Perhaps this is due to the tendering to private services of some departments, but whatever the reason I agree that a culture change is the only thing that will improve standards. This is acheivable but will need a consistent approach in both training existing staff and in recruiting suitable applicants for a care system that apppears to be becoming an embarrassment. This of course will need.....MONEY!!
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Anonymous | 17-Aug-2012 12:39 pm
My husband learnt the taste of beer back in the 1960s. after having his appendix removed as a young teenager. During the 'Guiness round' one of the staff suggested that he would not want one. The other male patients all disagreed and he was included in the round. I don't think his parents ever found out!
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Anonymous | 17-Aug-2012 1:00 pm
Anonymous | 17-Aug-2012 12:39 pm
could have encouraged a life of addiction!
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