Nurses need 'right attitudes', says minister

7 September 2010 | By Charlotte Santry

Care services minister Paul Burstow has called on nurse managers to ensure staff have the “right attitudes” to meet the aspirations of the white paper.

In an exclusive interview with Nursing Times, Mr Burstow said that treating patients with dignity had little to do with staff numbers and was more closely related to the culture on wards.

He said: “It’s not just about creating x number of staff but staff with the right attitudes, empathy and understanding.

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“The government can do so much by providing the overall resources. We can’t shape the culture - that has to be led by clinical leaders, by managers and by practitioners themselves being clear what their ethos is and translating that into practice.

“That will be very important in the new white paper direction of travel.”

He was speaking as the Department of Health celebrated the appointment of 22,200 dignity champions, who work to ensure patients have a good experience of health and social care.

These include staff, counsellors, volunteers, service users, carers and members of the public.

Asked why such an approach was necessary, Mr Burstow, a Liberal Democrat, said a culture of “targets and tick boxes” had disempowered frontline staff.

While dignity standards across the country were “variable”, he said there were examples of good practice, many of which were being instigated by nurses.

Readers' comments (28)

Anonymous | 7-Sep-2010 9:19 am
I agree that ward culture is influenced by the staff, particularly managers. But for Paul Burstow to say this has nothing to do with staff numbers is wrong, you do need an appropriate number of staff to deliver good care. However, if he meant that 'just numbers' has nothing to do with delivering high quality care, he is right, we need the right number of registered nurses and in some cases, less skill mix, but I suspect that isn't what he means.
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Steve Williams | 7-Sep-2010 12:37 pm
What an arrogant bar-steward this twonker is.

Remind me again... what School of Nursing did this Onanist train at? How dare he lecture front-line Nurses about

Hucking Fell - 22,200 dignity champions (all probably being paid more than the average staff nurse) appointed? Someone is having a laugh eh?

The new coalition government is still choosing to ignore the gigantic elephant in the corner of the ward that's screaming “More front-line nurses and a decent living wage!” (Yeah I know elephants don't usually talk but this one does!”)

He wants more “staff with the right attitudes, empathy and understanding” - how is he going to check the progress? Give the nurses more paperwork to tick off? Or more “champions” to 'tick-off' the nurses – in both senses?

Once again another prime example of clueless ministers leading equally clueless NHS middle managers!

Perhaps the NHS will employ some more expensive 'expert' consultants to advise them how to spell the word “dignity” for starters!

See what an absolute 'Richard the Third' the guy is? He says “That will be very important in the new white paper direction of travel.” “Direction of travel?” What the feck does that mean? He rates a Type 8 on the Bristol Stool Scale in my opinion!
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Anonymous | 7-Sep-2010 12:41 pm
Being constantly restructured, regraded, transformed and over worked - expected to do more and more with the resources we have - with little encouragement or support form the NHS management structure demoralises staff and does unfortunately affect staff attituded to working environments and to the patients. Some of the recent issues with mid staffs and other hospitals is about supporting staff and providing the right atmosphere to engenger a culture of care throught a supportive learing environment - staff cuts prevent education and imprtantly clinical supervision from happeninghappening
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Steve Williams | 7-Sep-2010 12:44 pm
Sorry. I missed a couple of words in the second sentence there. My acidic indignant rant should have read...

“How dare he lecture front-line Nurses about nursing with dignity!”

BTW, is it “frontline” or “front-line?” My spellink-chucker throws a wobbly when I use “frontline” but I'm sure that's an acceptable word. Anyone care to advise a terminally bewildered posting practitioner?
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Anonymous | 7-Sep-2010 1:32 pm
In response to Mr Willliams

First of all a dignity champion is an unpaid position. Any-one from lay people to students to senior consultants can sign up to be one.

I strongly suggest that before you start blowiing off on a subject that you make sure you have the facts on it first.

The white paper is aimed at championing excellence in the NHS and yet there are nurses such as yourself that are dismissing the steps being taken without understanding what they are.

It appears that your 'acidic indignant rant' was shortsighted and illinformed. Perhaps Mr Burstow had a point after all!
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Steve Williams | 7-Sep-2010 3:22 pm
Sorry. I missed a couple of words in the second sentence there. My acidic indignant rant should have read...

“How dare he lecture front-line Nurses about nursing with dignity!”

BTW, is it “frontline” or “front-line?” My spellink-chucker throws a wobbly when I use “frontline” but I'm sure that's an acceptable word. Anyone care to advise a terminally bewildered posting practitioner?
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Isla Dowds | 7-Sep-2010 6:07 pm
First of all, Mr Burstow, it's a bit of a cheek to be proclaiming the appointment of 'Dignity Champions' when this was a Labour government initiative - maybe you didn'tknow that.... secondly, it's a heck of a lot easier to be empathetic and understanding when you have an adequate workforce and are not run off your feet because cuts have left you on minimum - or worse - levels of staffing.
Reality check please.

I must also say, Steve Williams ( and numerous others,including various types of clinican and of course, politicians) that I am pretty fed up with NHS manager bashing. Like nurses, there are fabulous ones,ok ones, mediocre ones, and not very goot at all ones. Oh yes. So maybe you would like to stop tarring us all with the same brush becuase many of us not only work hard and try to do a good job alongside clinical colleagues, we also care every bit as much about patients as you - and we'd like a teensy weensy bit of the respect you would like for yourself.
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mike | 7-Sep-2010 6:13 pm
You cheeky, patronising, arrogant bastard Burstow!

(And I make no apologies for any language!)

You want attitude boy? Come and say that to my face after I've done a twelve hour shift with no help or support, too many patients and not enough staff!
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mike | 7-Sep-2010 6:25 pm
Isla, I see your point about managers, but to be fair I also see Steves point (and agree with it) that at the same time staff Nurse numbers are being cut on the wards and we are being asked to deal with more and more patients with increasing acute co morbidities, we are also seeing vast numbers of clipboard wielding managers who from our point of view do nothing useful from behind their desks, and simply create more work that takes us away from our patients (ie audits). But like I said, it is the staff Nurse numbers every shift that are the problem. (Just to reiterate a point, not so long ago I was on a night duty of a 35 bed ward ON MY OWN with only a HCA and an agency HCA to back me up, then when the lone Staff Nurse next door rang in sick, I was expected to cover that ward too! That would have been 1 staff Nurse to 70 acute patients!!!!! You can imagine the articulate and reasoned response I gave to that. Needless to say I refused. And yes I did put in incident forms. The next day the day shifts were only a little better staff wise, yet there were 4 dark blues in for both wards and apparently not one of them came onto the floor. You want respect? Not in those circumstances.)
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k g | 7-Sep-2010 9:21 pm
Like someone said " if you want to die from ignorance, join the CONservative party..." Mr Paul Berstow, has sold his DIGNITY and SELF-RESPECT to the CON party. You cannot expect anything from people like him but only Ignorance and Arrogance
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Anonymous | 7-Sep-2010 9:21 pm
Like someone said " if you want to die from ignorance, join the CONservative party..." Mr Paul Berstow, has sold his DIGNITY and SELF-RESPECT to the CON party. You cannot expect anything from people like him but only Ignorance and Arrogance
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Steve Williams | 8-Sep-2010 11:31 am
This gentle missive is primarily directed? @ ?Anonymous? | ?7-Sep-2010? ?1:32? ?pm,? ?Isla Dowds? ?,? ?and all of you nurses who are too blind/enamoured with your line-management to see the truth.?

Maybe...? ?just maybe,? ?if you read this missive and follow the provided references you might get a better understanding of the reality that going on at the moment? – ?and how? (?or not?) ?I use the term? “?Middle Management?” ?and whether it applies to your personal employment situation personally.? ?Ahem....? ?Some of you are claimin to be? “?Middle Management?” ?when really you are just? “?Nurse Managers?” ?and that's a whole other kettle of worm....

Please bear with me for a while....

So you think that the? ?,? “?NHS middle management?” ?somehow doesn't deserve all the bad rap it gets?? (?barf?!) Read on....

"If it looks like a duck,? ?and it walks like a duck,? ?and it quacks like a duck...? ?it's reasonable to assume it's a duck?!!"?

Infrequently it may be a magnificent swan? (?or even a goose that lays the golden egg?) – ?which is a nursing bonus? ?-? ?but for the most part it is safe to assume it's a duck? (?only one vowel away from dick?!)

When? (?and if?) ?you take the time to fully read stories with headlines like this you may understand the reasons for my acidic verbosity and continual carping more fully...?

“AN INDEBTED HOSPITAL TRUST PAID ITS INTERIM CHIEF EXECUTIVE AS MUCH FOR THREE MONTHS?’ ?WORK AS IT WOULD HAVE COST TO EMPLOY EIGHT NURSES FOR A YEAR.? ?HE WAS PAID MORE FOR ONE DAY’S WORK THAN A NURSE EARNS IN A MONTH.?” ?htpp?”?//www.nursingtimes.ney/whats-ne-in-nursing/news-topics/helath-workforce/peter-carter-critisicises-shockinhly-high-consultant-pay/5017856.article

or...

?“?NHS WASTES? ?£487M IN JUST FIVE YEARS ON ADVICE FROM OUTSIDE CONSULTANTS?” ?htpp://www.dailymail.? ?co.uk/news/article-1257900/NHS-wastes-487m-just years-advice-outside-consultants.html

or...

?“‘?NHS DOESN'T CARE ABOUT COST OF MEDICINE?’?:? ?DRUGS FIRMS ACCUSED OF PROFITEERING BY RAISING PRICES BY ONE THOUSAND PER CENT?” ?http://www.dailymail.co.uk/news/article-1295610/NHS-doesnt-care-cost-medicine-Drugs-firms-accused-profiteering-raising-prices-ONE-THOUSAND-cent.html

or...

?“?IN B&Q THEY COST? ?20P.? ?SO WHY DOES THE NHS SPEND? ?£99? ?FOR A SCREW TO PUT IN YOUR HIP??” ?http://www.dailymail.co.uk/health/article-1307565/In-B-Q-cost-20p-So-does-NHS-spend-99-screw-hip.html

or...

?"?NHS SPENT A STAGGERING? ??313? ?MILLION ON MANAGEMENT CONSULTANTS IN LABOUR'E LAST YEARh? ?http://www.dailymail.co.uk/news/article-1304956/NHS-spends-staggering-313million-management-consultants.html

or....

?“?NHS CRISIS SHOULD BE TACKLED BY CUTTING WASTE RATHER THAN STAFF,? ?SAY EXPERTS.? “ ?http://www.dailymail.co.uk/news/article-1192133/NHS-crisis-tackled-cutting-waste-staff-say-experts.html?

or....?

“NHS JOBS FOR NURSES TO BE CUT BY? ?13,000? ?OFFICIAL FIGURES SHOW?” ?http://www.dailymail.co.uk/news/article-1246651/NHS-jobs-nurses-cut-13-000-official-figures-show.html

or...

?“?THE MIDDLE MANAGEMENT CLONES RUNNING GREAT BRITAIN TERRIFY ME?”

The meek shall not inherit the Earth.? ?They have left it far too long.? ?Anyway it's already been claimed.? ?By middle management.

They appear to be in charge of the Government,? ?the BBC,? ?the NHS and anything else you might care about.

The NHS is run by these nameless types who have presided over the subcontracting of cleaning to private companies.

They then blame doctors for being uppity and nurses for not keeping wards clean and appear with lists of figures about targets. You can never remember a single one of their names or faces.? ?That's how they like it.? ?http://www.dailymail.co.uk/debate/columnists/article-488731/The-middle-management-clones-running-Great-Britain-terrify-me.ht

These are merely a few recent examples of how? “?Middle-Management?” ?acts and? ?,? ?in all honesty I don't think that? ?Anonymous? | ?7-Sep-2010? ?1:32? ?pm,? ?or? ?Isla Dowds? ?de severe to be lumped into this nefarious association of self-serving financial leeches.

Read them and weep.? ?This is where OUR money is going.? ?It was going there under LABOUR and The Coalition? (?bereft of ideas and advised by the Home Office's unelected officials?) ?seem to ushering in OLD policies.

Personal cheap shots against me? (Flight Offcer (Rtd) ?Steve Williams RN RMN SRN SEN?) ?are most valid,? ?accepted and reflected upon.? ?I am too experienced? ?to be lectured by students training in the UK, Nurse Managrs managers carrying clipborads for a living or “Anonymous” who probably drives a truck for Birmingham Sanitation.

Nurse Managers who are half my age with half my experience of the NHS...? ?I will listen? – ?with a wry smile.? I have seen it all before. Re-invent the wheel and then get Kudos and large wedge of money, plus a nominal title for it!

Nursing Middle managers? – ?Icarus.? ?You flew too high with wax wings.? ?The NHS will burn you and then you will fall to Earth? – ?hopefully you will not die.

Note that I do not necessarily think that? “?Nursing Middle Managers?” ?are the same sub-species as? the.seemingly effortulosly efflouent “?NHS Middle Managers?” (?although statistics have proved some there is some heavy interbreeding between the two sub-classes.

I hope this has cleared up a few misunderstandings between my definitions of? “?Nursing Middle Managers?” ?AND? “?NHS Middle Managers?” ?-? ?both of which I despise with a venom that was sent from HELL courtesy of a certain fallen angel called? “?Monsieur Diablos? !”

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mike | 8-Sep-2010 2:07 pm
Basically Steve are you saying theres a difference between the Nurse managers and the pathetic clipboard wielding, over titled suit wearing non job ***** execs and commissioners who get paid four times our salary at least to swan about doing **** all, none of whom have ever been clinical staff but are buisness 'managers'? lol. Absolutely agree mate.
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Anonymous | 8-Sep-2010 4:13 pm
In response to Mr Burstow, if it makes any difference whatsoever, I agree that the culture of wards can be independant of the resources available, however, what you are missing Mr Burstow is the relationship that does exist directly in response to a lack of appropriate and clinically required resources. There are at least 2 distinctly different issues here and to muddy them together demonstrates a great deal about you as a politician and your understanding of healthcare dynamics.
Until you are willing to resource, train and nurture people to hold these positions where your expectations match what the workforce can express, then you, like us currently, will be banging your head on a brick wall.
Up your game Mr Burstow, healthcare is not running a shop or a council.
You will only learn that if you are willing to ask questions AND listen to the answers from the whole team not just the PR (!) department.
If you are truly brave then commission an investigation (independant of management of course) into comparing resource input and quality of care at ward level, as it is now, and compare it with quality of care when resources are improved by say, 10% and then 25%
How brave are you Mr Burstow?
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Steve Williams | 8-Sep-2010 4:54 pm
Basically mike - you got it!
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valstewart | 8-Sep-2010 10:27 pm
steve - type 8 on the bristol stool chart LOL that was great!
Whole heartedly agree.

What beggars belief is why as a profession 90% of us seem to accept or at least tolerate this abuse.

I have been qualified since the mid 80s and this has been going on since then, probably before.
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tinkerbell | 9-Sep-2010 11:32 am
RIGHT! Are there a few good men & women from the above who will come with me to 10 downing street and put all this to David Cameron and his cronies. We need to let them know what really happens, I mean what REALLY happens on a ward on a day to day basis. What it is that the frontline staff are expected to do, why those of us who have been in the profession for many years are worn out, burnt out, fed up, & thoroughly pissed off, but still want to be there for the patients as best we can but are bogged down with red tape, paperwork,
and parasitical shiney arsed suits. Who better to tell them than us, those who are doing it, otherwise they may not know. One visit to a ward does not constitute an 'understanding' of all the things that drain a nurse trying to do their job on a day to day basis.
Anyone up for it. Lets stop moaning and take action. (I'm day off next Wednesday & Thursday.) But seriously I'm due to retire in 2 years but I still want there to be an NHS for the next generation of patients and staff and one that works better than it has in the past, that does actually put the patient first, rather than all this lip service and spin. Let's take some action! We can send a request, signed by all for a meeting with 'whoever' and get the message home and give them some food for thought. Tell them if they want to know how to improve the NHS they need to speak to the staff on the ground, not the managers anymore, and see what happens. Keep banging on the door until they have to come out and speak to US!
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tinkerbell | 9-Sep-2010 12:12 pm
I have just emailed Sir Gerry Robinson and asked if he can help us in organising a meeting with government also, as i know he is really interested in trying to make the NHS 'well' again. Will keep you posted.
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Anonymous | 9-Sep-2010 1:42 pm
Good on you Boots. I'm up for direct action.
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tinkerbell | 9-Sep-2010 2:24 pm
good that's 2 of us so far. My name is anne i am contactable on boots4daisy@yahoo.com Lets do it!
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