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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)

  • 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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