'Give us better wages and more staff, then we'll see better results' - Nurses attack the PM's commission

20 February, 2010 | By Gabriel Fleming

The ill-advised ‘pledge’ in a leaked draft of the Prime Minister’s Commission on the future of nursing and Midwifery has got readers as angry as they’ve ever been. Beyond the Bedpan doesn’t blame them.

When the Prime Minister’s Commission on the Future of Nursing and Midwifery set out to put nurses ‘at the heart of world-class NHS’, few could have predicted this.

Nurses welcomed the move; a brave step that would embolden a forward-thinking profession to lead change in a patient-centred NHS.

But a leaked draft of the commissions’ recommendations seems to suggest otherwise. The draft suggests asking all nurses to sign a ‘pledge’ reiterating their commitment to high quality care, health service improvement and professional accountability.

Nurses as handmaidens

It calls on nurses to renew their commitment to the public and patients, and by so doing reverse the perception of nurses as “poorly educated handmaidens”.

Hang on, do the public really see poorly educated handmaidens when they look at nurses? The phrase allegedly came from a public consultation undertaken by the commission. It brings to mind a scene of Dickensian depravity - illiterate wenches shuffling down grimy hospital corridors, spat on by doctors and patients alike.

At best it is an unfortunate turn of phrase, and as a summary of public consensus it is inaccurate as well as offensive.

The commission seems to suggests that it is up to nurses to redress the balance, to sign a “pledge” reassuring the public that, far being servile idiots, they are in fact committed to the NMC code of conduct, married to the values of the NHS, and actively involved in improving the health of the population.

A pledge too far

Beyond the Bedpan would venture that most nurses already do all of these things, and that many individual nurses and professional groups are well-respected by the public. By asking nurses to right the wrongs of the NHS, is the commission suggesting that they are responsible for them? And will the pledge really mean anything to the public?

“Will I be expected to make this pledge daily before I start my shift?” asks one. “What will make a real difference is giving ward staff the power and resources to make quality care a reality. We understand what is required, but we are spoon-fed platitudes by politicians and scolded by management who deny us the necessary resources.”

Another reader accuses the government of “patriarchal bullying”, and “lack of connection with reality and their own policies”.

Most tellingly, a commenter wants to know: “Does anybody from the government read these articles? If they did they would realise how unhappy we nurses are. What is a pledge really going to achieve? Give us better wages, better conditions and more staff, then we will see better results.”

A fair point, well made. Beyond the Bedpan applauds the spirit of the commission, and it is important to note that the above is from a draft of the commission’s recommendations and does not yet constitute official government policy. The message, from Nursing Times readers at least, is that it never should.

Readers' comments (59)

Beth Young | 20-Feb-2010 7:33 am
time I spend of my own on nursing is my choice, i will not support enforced use of my free time which is unpaid and more than full time hours!
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Anonymous | 20-Feb-2010 9:27 am
i am a staff nurse who works on a 42 bedded ward and i go beyond my duty to make patients get the best care. however, at times we have only five or six staff on a shift. this is the problem it is not the fault of the nurses it is goverment problem with no money in the pot. the ward cannot use bank staff or pay overtime because the ward is so overspent. i am so mad that i have to stay back and finish my work and i dont get paid for it. i am so disillusioned in nursing.
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carley vaudrey | 20-Feb-2010 9:56 am
i am a student nurse and i completely agree with the above comment from 20-Feb-2010 9:27 am,
nurses should not have to take part in a 'pledge' we adhere to the NMC code of conduct. Yes there are lazy and uncaring nurses but this is merely a few and the rest are hard-working and kind and caring and i am sick of the government making it out overwise. Maybe these leaders who seem to know so much about nursing care should actually spend some time on a real ward where the nurses are rushed off their feet because they are understaffed before making any judgements on them.
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Anonymous | 20-Feb-2010 10:22 am
I am a staff nurse on an acute surgical ward for many years . my colleagues and I always have to stay behind to help, sometimes up to 45 minutes or one hour due to permanently shortage of staff. we do not get paid for this.We do not do this to give NHS a good name , we do this to help our patients and our colleagues whom we know would be in the same situation as we have been. This situation is here everyday , day in and day out. No amount of complaining or doing incident forms have made any difference.
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Enid Martland | 20-Feb-2010 10:37 am
No staff on the shop floor looking after patients,yet the trust can advertise 4 posts to train as specialist orthopaedic nurses at £38.000 per year each [we already have 2] for a hospital with 4 wards.Its positively obsene
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Anonymous | 20-Feb-2010 11:43 am
I find the idea of nurses having to make a 'pledge', to do what is in effect their job, very offensive. The presumption seems to be that we are not already adhering to our NMC code of conduct, and have taken these overworked and underpaid jobs just to make our patients lives a misery. I was so proud to have completed my nursing degree (the first member of my family to get one) and I worked harder than I ever have in my life to get it. Is this really the best they can come up with? If this is really what they think the public think of us then we should all give up now!
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Anonymous | 20-Feb-2010 12:34 pm
Maybe politicians should take a pledge not submit dubious expenses claims, people in glass houses and all that.
Says it all really when an ex politician says that they should be allowed to travel first class as you find "totally different type of people" in standard class.
I work in community mental health covering a huge patch in Lincolnshire,I can't remember when I last had a proper lunch break and when I do it's usually sat in my car in a lay by somewhere. as for staffing I reckon I know the lone working policy off by heart. Thankfully I can retire in 5 years.
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joanne barnett | 20-Feb-2010 1:31 pm
this is completely unacceptable. gloucestershire hospitals nhs is closing some 200 beds, some by the end of next month, the rest in the next few months. they are closing wards, splitting up good teams. is that going to improve moral or care of patients i think not. i am on one of the wards to shut our three specialities are being split onto three seperate wards. each speciality requires sound knowledge, putting them on general wards means that their levle of care will be poor. Mr Brown come to gloucester and talk to the staff affected, listen to patients....at present you are so out of touch.
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Abel | 20-Feb-2010 2:23 pm
They are using Nursing to score points for political purposes (ref. Election) the same way they do with other professional and social categories. Populism always works when dosed prudently with timing. Yet, we should not give up, even with the impression that the public is unhappy about nursing performance. To the contrary, we should fight back in developing our own agenda and taking the opportunity of the next election. Therefore, we need the following:
1. Being united in order not only to allow our movement to grow but also to prevent some individuals and corporate agencies to derail it with the guilt/responsibility argument;
2. Winning the hearts and minds of patients, their families and the communities, explaining them that Nurses are also victims of the NHS chronic mismanagement and, together, we can turn things for the better;
3. Creating a Nursing website that will raise money in order to start campaigning for the Nursing profession, focusing on the lack of safety in the health care system and proposing solutions and strategies to reduce occupational hazards and protect Patients and Nurses (e.g. Mandatory Ratio Nurse/Patients).
I have also a pledge:
1. All politicians should uphold the rule of law and the values enshrined in the ‘unwritten’ British constitution. They should be responsible for the quality of life for all their citizens and should act to tackle substandard living.
2. Politicians will try to make sure that people using government services and society receive the greatest benefit from public service resources. They should use their own time to develop services and adopt best manners.
3. Politicians should deliver fairness to all. They will undertake parliamentary debate and make laws to improve the daily life of their citizens.
4. Politicians should be fully involved in designing and delivering public services. Politicians should be role models for rectitude.
5. Politicians should take charge of delivering social justice. They will innovate, challenge accepted wisdom and look for new answers.
6. Politicians should be actively engaged in the shaping of public service policy, including funding, and new forms of management.
Abel sidhoum (RN)
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Anonymous | 20-Feb-2010 3:37 pm
krish

I think we all nurses should enter in to politics we would do better job to then the present government. Recently one of the GP stood as MP and won the seat. It is time to form our party and show them how to run the government.
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Anonymous | 20-Feb-2010 4:03 pm
How dare the Government even suggest that we nurses adhere to a pledge. We all as nurses already adhere to our own body of practice, the NMC, and do so with pride. I most certainly believe that these politicians have no idea what life is like for us nurses. I work as a CPN in the community looking after mentally unwell peolpe, and am extremely passionate about what I do. My remarks are duplicated in all the other comments made about giving more than we should. We are nurses because we want to be, and love what we do, but at the end of the day....Do Not take us as Idiots either. We of course want to be recognized as valued individuals and receive a proper wage and respect for what we do from the politicians and we all work above and beyond our contracted hours...why? because our patients need us.
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Anonymous | 20-Feb-2010 4:08 pm
I previously used to work on an acute surgical unit and on several occassions myself and my colleagues would stay on 45mins to 90mins after our shifts finished due to permanent staffing shortages. I am now working in a different area but there are similar continuous staff shortages and even doctors seem to work hours after their shifts are over. Across the country there seems to be a complete shortage of staff, money and resources. Most nurses go beyound the call of duty to help prop up crippled services and gaps in staffing. All of this extra time is unpaid and currently saves the NHS a fortune, and yet the government seem to want even more, like wringing blood out of a stone. Invest more in front line services and less in expensive useless overpaid senior managers, external consultants and stupid ideas!!!
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louise armstead | 20-Feb-2010 11:16 pm
I am pleased they have read my comment and used it in this next article, which leads me to believe more than nurses read our comments, BUT this doesnt change anything we still must fight for more staff, better wages and conditions, we lag behind our fellow professionals collegues ie teachers police, making the pledge will change nothing to my working day, working extra hours, lack of lunch's and tea's going home totally exhausted. How much more can we nurses take before they break us, I have worked within the nhs for over 20yrs, the government have demanded more from us some for the good and some not so good, when are they going to listen to the staff who know how hard it is, instead of the pen pushers who have no idea. Please give us nurses what we need to make a difference for the better which ever party it may be. Hopefully I will see this before I retire.
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vera howarth | 21-Feb-2010 12:17 pm
does the government really not see nurses as they are.We gladly turn up for work day in and day out in the best interests of our patients.
We do not do it for the good of the egos of managers or polititians.
Nures are always targetted as the ones who have to bear the brunt of cutbacks and CIP.s, when less and less finance appears to be available to the wards.No overtime, cut out the bank nurses -how on earth can we be expected to cope let alone become a vehicle for improving the image of those who govern the NHS and our hospitals.
I would like to see an end to this top-heavy management culture.
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Anonymous | 21-Feb-2010 12:47 pm
i find it utterley offensive to be spoke of in this manner i work in a profession which i love and enjoy but cannot fulfill to my best ability because of politics policy and hypocrisy both at national and local level! To be reffered to as a handmaiden is outdated and highlights how in tune with the public these polititians actually are. Give us the staffing and bugets to actually provide a fully rounded service this would make me feel happier at my work and im sure would please the government and public alike.
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Anonymous | 21-Feb-2010 3:52 pm
How can hospital nurses make a pledge to do something that is impossible. We are human beings, NOT robots. We need time to do work, an appropriate working schedule, breaks and money to live. Nine times out of ten we do not get this! I am fed up with being a nurse and it is starting to have an impact on my work. There is something desperately wrong with the NHS and it will take more than a pledge to sort things out. Oh and by the way, no one will ever understand how it is unless they are working under those conditions, so there is no hope!
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Anonymous | 21-Feb-2010 4:51 pm
These comments have brought me to tears the same way I usually go to sleep at night. I feel sick to the stomach. I work through my breaks and work on average an hour a day over my shift to help the other nurses get back on track or to finish tasks due to the fact we are looking after 17 acutely ill patients with two staff nurses and one healthcare a majority of the time. With these numbers prioritising means neglecting tasks which may have an equal value of importance. Thus how can he say that this does not impact on quality and SAFETY OF CARE. Nurses want the best for patients also, so give us the means to do so. In the media an emphasis was placed on poor Dimentia care and suggested we all need better training. Yes this may help but when a Dimentia patient is placed on an acute surgical ward its staff we need not training, because they need time, company and stimulation, not to be sat in a corner as everyone is tied up with poorly patients! Its common sense. I am shocked and dissolusioned by the lack of respect for nurses and the head in the sand approach from managers and politians. Why is it assumed that we like to provide poor care? Who gets blamed for staffing issues? Nurses! We get the frustration and anger from relatives. Every day I have to self counsel because there is no support from management because their hands are tied and are too busy to worry about our welfare. The girls on the ward are so demorilised which does not breed excellence! These organisations pretend to understand with fake sympathy but we bang our heads against brick walls when fighting to highlight these issues. It worries me that the organisations in which we are governed care little in regards to staff health and stress and whether or not we are forced to work in unsafe environments. And yes most of the time it is UNSAFE and I am not gonna be afraid to say it because its the truth and I will fight to the end to PROTECT THE PUBLIC! I am sick of pretending everything is ok, it is like the world of nursing is brainwashed to be silent and subserviant. Our job is made impossible by contradictory policies. We are susposed to raise concern, but make sure you do it in a way that basically allows concerns to continue. If anyone feels my pain please say, its time we stood up for the public and for ourselves.
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Kelly Allin | 21-Feb-2010 4:58 pm
My comment above was also in response to Weir- DicKinsons interview! APALLING. If things carry on the NHS will loose all its good nurses and then they will have to spend some money instead of us bailing them out with free overtime!!!!!!
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Anonymous | 21-Feb-2010 5:25 pm
i agree with all of you. its appalling. and the pledge is a joke. what is the govenment playing at
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Abel | 22-Feb-2010 6:29 am
In order to start expressing your view and campaigning for more resources in the health care system with the aim of showing the Nursing weight in the ballot box at the next general election, I would suggest you to send an email to your local MP. http://www.parliament.uk/mpslordsandoffices/mps_and_lords/alms.cfm

Mine would be as follows:
No, for a pledge; yes, for delivering quality of care, providing safety for all and supporting the nursing workforce.

We need the following:
1. a mandatory ratio nurse/patients to be able to deliver the highest standard of care that patients deserve ( Safety and quality);
2. paid time off for continuous professional development regardless the type of training in order to allow quality study and life/work balance( future education and investment);
3. Independent nursing peer review of NMC powers and deliberations as to monitor and ensure that individuals are not victims of inherent failures and mismanagement of the healthcare system (fairness and social justice).

Remember! “Politicians' promises engage only the people who receive them”. Hence, having them in writing with timeline and deadline is of great importance.

If modern nursing was born in UK, then history is on your side.

Abel sidhoum (RN)
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