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Exclusive: Peer criticises lack of nursing leadership at all levels

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Nursing leadership is lacking from the ward right up to the House of Lords, one of the profession’s most authoritative champions has claimed.

In an exclusive interview with Nursing Times, Baroness Audrey Emerton said the quality of nursing care often came down to the quality of leadership.

However, she feared nurses across the UK were not getting the training or support they needed to become leaders and middle management in particular was “weak”.

“I don’t think we have got our leadership training right at all”

Audrey Emerton

At the other end of the scale, the Baroness called for the profession to be better represented in the House of Lords, where she is currently the only peer with a nursing background.

She said: “We have 12 doctors and they are a much smaller profession than us. I would say that as an absolute minimum we need four nurses.

“With 670,000 nurses on the register there must be some who could come in,” she told Nursing Times.

Baroness Emerton has sat in the Houses of Parliament’s second chamber since 1997 when she was made a life peer. The House of Lords scrutinises government policy and can amend or block proposed changes in the law.

She said: “It would be helpful to have someone from a community/public health background, someone in the acute sector, someone from midwifery and particularly helpful to have someone in mental health because mental health really is in dire need.”

Baroness Emerton, who registered as a nurse in 1956, also called for a return to a more structured, national approach to boosting leadership skills at all levels.

Audrey Emerton

“I don’t think we have got our leadership training right at all,” she told Nursing Times.

“When I was nursing we had a national policy and national provision – first level training for ward sisters, middle management training for unit managers, senior management training for principal nursing officers and top management had business schools.

“Leadership is about being able to work in a multi-professional team and being able to hold your own and not give way,” she said.

“Now we do have some leadership scholars going through and they’re doing extremely well but it’s only a small number,” she added.

She said the NHS Leadership Academy, which runs a development programme for frontline nurses and midwives, could do more, including developing multi-professional training and ensuring nurses gained business and finance know-how alongside clinical skills.

“We need local nurse leaders going out to schools. We don’t do enough to say what a marvellous career it is”

Audrey Emerton

As Nursing Times launched its Proud to Nurse campaign, the peer also stressed the need for nurses at all levels to play a more active role in promoting nursing as a desirable profession.

“We need local nurse leaders going out to schools,” she said. “We don’t do enough to say what a marvellous career it is and many teachers don’t think it is the thing for their pupils.”

Baroness Emerton is also president of the Florence Nightingale Foundation, which offers leadership scholarships for nurses. Up to 28 scholarships are available during 2014-15.

Foundation chief executive Liz Robb warned it was becoming “increasingly difficult” to find nurses willing to take on some of the more challenging leadership roles.

Liz Robb

Liz Robb

“Often we promote people because of their clinical skill without any formalised training and then wonder why it’s difficult for them in a situation where they are dealing with conflict, complexity and budget of over a million pounds – effectively running a small business,” she said.

The Royal College of Nursing has just completed a review of the leadership support available to nurses.

Naomi Chapman, who leads the RCN’s Executive Nurse Network, acknowledged access to training was variable but also stressed the key role of employers.

“It’s one thing having the skills, it’s another being in an environment that enables you to use them,” she told Nursing Times.

“All leaders in healthcare need support, which includes a supportive environment where they have access to training and adequate staffing in order to work as a leader.”

Professor Jill Maben, director of the National Nursing Research Unit at King’s College London, said there was a need for “more visible leadership” from nurses and there were “not enough people speaking up and speaking out about nursing”.

Jill MabenJill Maben

But she added: “I think that is becoming increasingly difficult with nurses not necessarily able to speak out in the way they might wish because they have corporate images and trust reputations to protect.

“Baroness Emerton has been flying the flag for nursing in the Lords and doing it admirably,” she said.

“When she leaves there will be a real vacuum and a hole there for nursing because nobody will be speaking up on these issues in the way she has for our profession.”

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Readers' comments (4)

  • wow a sensible voice at last!

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  • Too much "uni" inspired carespeak and too little old fashion ward sister leadership where promotion was based on experience and competence, not the grade achieved in their foundation or preferably post grad degree which, far from demonstrating competence enables our clever colleague to convince us that they have some whilst seeking urgent promotion away from the nightmare scenario of the modern lawyer contrived practice place ..understaffed, over-tasked and over accountable for huge amounts of trivia the errors of which will see her career and prospects very quickly compromised.

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  • For what it's worth, I'm trying my hardest to join the House of Commons for the National Health Action Party in May 2015, fighting the Rt Hon Iain Duncan Smith for his seat.

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  • Audrey Emerton (who taught me!) makes key points about the need for better nurse leadership at all levels.
    Yes, it remains hard for employed nurses to speak up, but there are other ways to support nursing in a multiprofessional arena.
    For example, by getting involved in local Healthwatch. This gives an opportunity to examine patient feedback in the light of nursing experience.
    There is also the Scrutiny Function in which Healthwatch can comment on Hospitals' and other Providers' Quality Accounts. QAs are published for all to see - surely an incentive to improve quality and safety standards.

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