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


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.



Readers' comments (25)

  • 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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