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Top nurse urges staff to follow 'moral compass' on poor standards

  • 25 Comments

One of the country’s leading nurses has called on staff to brave opposition from others and speak out if they witness something that is wrong or falls short of standards.

Liz Redfern, a former deputy chief nursing officer who joined the NHS as a cadet nurse in 1970, was speaking after receiving an honorary doctorate from the University of Brighton.

“Some of my proudest moments are when I have spoken up against poor practice whatever the consequences for me”

Liz Redfern

“There will have been times already that have made you uncomfortable when you have seen practice that fell short of your own personal standards,” she told an audience of newly-graduating nurses.

“You know what you are witnessing is wrong – either technically or morally – and sometimes you will have spoken out and sometimes not,” she said.

“I’ve had those moments too in my career – some of my proudest moments are when I have spoken up against poor practice whatever the consequences for me,” said Ms Redfern, who retired as chief nurse for NHS England South in March.

“Maintaining that internal moral compass in the face of opposition is not easy, but I would strongly commend it you as always being worth it,” she added.

It was “often a false assumption” to assume that it was someone else’s responsibility to sort out or make right, she noted.

She told the audience there was a continuing need “to be clear about our own personal standards and where we’ll stand up for something against the views of others, however strong”.

Ms Redfern received her doctorate in recognition of her major contribution to the NHS and to the education of nurses and other health professions.

She was made a CBE in 2009 and won the Lifetime Achievement Award at the Nursing Times Awards 2013.

Liz Redfern

Liz Redfern receives the 2013 Lifetime Achievement Award

Ms Redfern also used her speech to say that, while technology had changed, there was still a need “to recognise how vulnerable people feel when they enter our familiar world” – whether for the first time as an acute episode or as a “normal experience” like having a baby.

She said: “The ultimate tool in continuously improving the patient experience is you, your heart, your hands, your arms, your minds, your compassion and your common sense.

“Your ability to leave behind the grumpy feeling you had when you left home this morning behind and focus on the person you are caring for.”

  • In 2013 Nursing Times launched the Speak Out Safely campaign to encourage healthcare providers to develop cultures that actively encourage staff to raise the alarm when they see poor practice, and to protect them when they do so.

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  • 25 Comments

Readers' comments (25)

  • Wonderful, where has she been working, I am sure this is not the general consensus of opinion. I am no shrinking violet but in reality you have to be able to face the repercussions of your actions. I have spoken out regularly, as have my colleagues, when witnessing poor practice. This often results in a negative response and being labelled as a troublemaker.It's not as simple as implied.

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  • all very commendable what Liz Redfern suggests, however, I blew the whistle at one of the largest acute Trusts in the midlands a few years ago involving the care of about 88000 patients who thought they were on the surgical waiting list but werent, the Doh and 10 Downing St sorted the management out, but only to end up with me being bullied and harrassed by the Senior and Middle Managements, only to end up being retired off at the age of 36 due to extreme stress and anxiety. Where is my Honorary Doctorate eh?? And where is the grass roots support for the lower grades on the shop floor??!!

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  • In response to the last comment - I rest my case. Is is really worth it ???

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  • All nurses know when they should speak out but they also know what is at risk. They are subject to riducule, abuse, false allegations and the worse being reported to the NMC based on these false allegations backed uo by false witness reports.
    Nurses should be free of the heavy hand of the NMC who say they protect the public. If that is the casr then the NMC should be paid for from taxes.
    When nurses are free of the NMC yoke they will keep quiet and having suffered for speaking out I dont blame them

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  • I made a complaint to my matron about the behaviour of my ward manager. The matron held a ward meeting and asked for staff to raise their hands if they agreed with me. Many had the same grievances, but none backed me up. Even though some had said they would. So I had to suffer public humiliation. This Stalinist behaviour is quite common. It was meant to intimidate other potential complainers, and it succeeded.

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  • How do you get to be a "chief nurse" anyway?

    I was very lucky to get as far as being a Band 7 and there was no way on earth the management of my trust was letting me get any higher after all the time I spent arguing with them over inadequate staffing and the implications for patient care and the health of my colleagues.

    I also saw what happened to a colleague, a consultant psychiatrist, who argued with management...And a union rep...And...I could go on...Jobs lost, victimisation, over-looked for promotion, sidelined, frozen out...

    So, how exactly does one become a "chief nurse"?

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  • My wife a band7 and myself a band 6 are mental health nurses with over 35 tears experience each. In the past couple of years in particular we have been left speechless and extremely stressed by the behaviour of junior staff and the reaction of senior staff. Several of the newly qualified staff we have think they know it all and do not like being corrected or told what to do. When they complain to the union or Matron they are supported and we are left with an impossible situation. If their work is not up to standard (usually because they cannot be bothered and do not see any importance in it) we have to treat them with kid gloves and "performance manage" the little darlings taking up valuable time which could be spent developing practise. My wife retires in Dec I retire in 22 months and we cant wait, until then I am keeping my head below the parapet

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  • Something the www.suspension-nhs.org team has noticed recently, is that trusts that wish to reduce staff, are making false allegations against the ‘speak outers’ and after the usual lengthy process, dismissing them for gross misconduct, thereby saving themselves redundancy payments.
    Just another sinister ploy by these bad apples that still exist in the NHS.
    The worst of it is that no one knows apart from the people directly involved. Shame on the Department of Health that they still refuse to have all suspensions notified to them with reasons and time scales. The DoH might then possibly notice that something might be amiss.
    Julie Fagan, founder member of CAUSE – Campaign Against Unnecessary Suspensions and Exclusions UK

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  • Is there a system in place where a nurse has abused her position in the Community. What I mean is, I know a Nurse who uses her status to cause problems for families but no one knows where to report this

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  • Anonymous | 7-Aug-2014 5:32 pm

    Every trust has a complaints procedure, details of which will be available on their website. If the employer is non-NHS, eg private or charity sector, they will still have a complaints procedure.

    Or a complaint could be made to the NMC.

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  • Julie Fagan | 7-Aug-2014 5:20 pm

    Some trusts are more subtle than that: my old employer would "re-structure" services and get shot of those who had most challenged management. When the "re-structuring" of my old service was announced I predicted who of the Band 7 nurses would lose their jobs, on the basis of who had most challenged management over many issues - unfortunately, as I was one of them, I was correct...

    A year sitting in limbo before I retired doesn't show up anywhere.

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  • David Dickinson

    My complaints about trust malpractices precipitated one then a second trust-wide internal inquiry. The first resulted in limited changes. My subsequent appeal against the limited findings and the consequent second major service wide report “The Seclusion Review” resulted in significant trust changes to long-standing locked seclusion practices across the forensic service and the introduction of behaviour pathway and positive programming principles. I received the written thanks of the trust CEO for "bringing the matter of seclusion to my attention". I was then disciplined and fired, not for legitimately accessing the clinical file of one seclusion victim but for accessing it for “too long”. Promptly referred to the NMC, its dispatched solicitor spent six months forensically examining my trust file and additionally charged that I had stopped the abuse against one severely learning disabled victim by revealing his identity to a select group of hospital managers and clinicians at the time but thus breaching the victims’ confidentiality. The NMC found the case proven. My urgent 24 page refutation of all findings was ignored including my compelling evidence that two senior trust managers had lied under NMC oath. I am subject to three years of conditional practice and evidence based personal development planning. At 58 my career and retirement plans are wrecked and my hitherto completely controlled epilepsy sufficiently deteriorated that since last year I can no longer drive. Exhaustion and depression are a constant concern. I can only work under zero hour contract arrangements where I can get it. Private sector service managers have been hugely supportive and even spoke up in support during the NMC hearing. Finally, the only proven example of confidentiality breaching in my case was the recorded admission during my appeal against dismissal hearing from the trust CEO that he had been given my private and confidential letter to the trust Chairman by the Chairman and without permission. The trust subsequently told the investigating NMC solicitor that the hearing recording and transcript had been “lost”. However, the deputy CEO under questioning later declared to the NMC hearing that it wasn't trust policy to provide appellants with transcripts, subsequently refuted by other former appellants.
    I would be interested to know how such offers of case submissions should be made.

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  • Dikod1 I'm potentially going to sound very naive but have you ever thought "f*#k it, let's see what the bbc/media/public think about it!"? Just thinking of Margaret Haywood.

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  • Dear Ms Redfern (as all these comments need to be addressed to her - so I hope the press picks up on these)
    You resided over a miserable 15 years of declining nursing practice because you did not lead or speak out effectively. That is why you have earned your awards and honorary doctorates. The past 15-20 years have been absolutely shameful. You were part of system that has destroyed real nursing.

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  • Shame on you Nursing Times. The history of nursing over the past 20 years shows that she was NOT a top nurse.

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  • Interesting that no one appears to pick up on the comments put forward here - those comments reflect the absolute truth as to what actaully happens if you speak out. Internal moral compass, dont see the evidence of Ms Redfern demonstrating this.

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  • dicod1 As I said the threat of the NMC hanging over the heads of nurses should be stopped the NMC should be disbanded & an independant org run by government put in place. All cases going before the NMC over the last 5 months were guilty. It appears that the case is heard ar another hearing and passed to the full hearing fopr the virdict. THere are no witnesses just the 'proof' from vindictive managers. The NMC have kangaroo courts that would not be tolerated anywhere else.
    In many ways I believe the NMC are breaking the EU Human rights Act in relation to a fair trial, to be able to face the accusers and to present a case against them openly in public not behind closed doors by a sub committee

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  • I don't really believe in all this encouragement of titaltating against your colleagues. The job is stressful enough without worrying if a an IR1 is going to be made against you because of a genuine simple mistake. One of my colleagues recently had an IR1 made against her because she forgot to sign for a drug. It's not even as if she makes a habit of this. Then a few days later the nurse who did the IR1 made a more serious mistake. I always say what goes around comes around. No one is perfect and yet some people think they really are.

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  • the problem isn't about 'braving opposition from others' it is about the consequences such as job loss or worse. there is nothing wrong with confronting individuals or a colleague over poor care but the difficulties arise with the organisation and its managers if they are ignorant about and incapable of handling criticism, complaints or whistleblowing or whatever you want to call it effectively.

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  • So called Top Nurses should be ashamed of the total mess Nursing is in today.
    Follow their advice and you might just get yourself in more problems than you can cope with. These nurses need to stand up for positive real root changes to improve nursing and patient care, instead of just giving advice to make a name for themselves.
    All the top nurses I know in the hospital are either too scared to speak up or have become as hard as nails just don't care a damm as long as they are getting what they want. Just keep making all the right noises you guys and you will keep your jobs or get promoted.

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  • I agree with Liz speak out of the care of patients are not up to standard. But it is easier said that done I have done this a few timew and each time it has back fired on me. First time the GP tried everything to get me to leave. The second time I reported the doctor to GMC you never guess they did nothing and I was forced out being a whistleblower. I would do it again if I had to but I do agency nursing now and try and keep my head down until I want to retire 15mnths time and in a way I will be glad because of the way you are treated if you stand up for patients and yourself.

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  • surely if you speak up about patient care in an open, honest and constructive way and point out any difficulties why should this be a problem? aren't hc professionals able to take useful feedback? isn't this the way we all learn? you make a mistake, we all make mistakes but unless it is consequential and was a genuine mistake we can all learn and advance from it and if it is negligence more stringent measures need to be taken to redress it or ultimate removal from the job and register if this is not possible. surely most of the mistakes we make are not wilful? I have no problems reporting to colleagues or doctors if I make a mistake so why should they. whether the patient is informed or not depends upon its nature as sometimes it may worry the patient and cause more harm than good but if it was serious and they needed to know I would ensure they were told.

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  • This Ms Redfern isn't in the real world is she. She hasn't worked where I have and had to leave because of what she colloquially calls 'braving the opposition'. Braving the opposition for me was discovering my 2 direct managers and half of the GP partners were either on the psychopathic spectrum or, like the rest of the nurses, keeping their heads down because they were less 'brave' than I was. Maybe they weren't so naïve? Quietly I had a great deal of support but no-one was willing to risk their mental health and jobs to publicly support what I raised. Everyone had mouths to feed, mortgages to pay and a life outside of work. Yes you could get high and mighty and say what they did was not the right thing in terms of the code of conduct or get all morally judgemental...., however, what would be much more helpful and effective would be to create conditions where speaking up is received with positive consequence not traumatic/negative. This will not happen in a market driven situation.

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  • Probably already mentioned, I'd like to see 'top nurses' follow their 'moral compass' and actively do something about raising standards, and not just through delegation to others to do it.
    For that matter 'top' medics, 'top' execs' 'top' directors, and 'top' admin staff should do likewise, as befits their role and status.
    A chief exec / director can only pour one glass of water, give it to one patient and help them drink it, one at a time.
    To get 40x or more pay than another valued member of staff and not doing 40x more work or higher efficiency, makes people wonder. Maybe that glass is made from antibacterial silver and the water is imbued with lifesaving dehydrating properties...

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  • Oops predictive text...
    That's Water with Rehydrating properties for dehydrated people.
    Yes anyone can give some. No good watching some get thirsty and not doing something positive.

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