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'Immune to the sound of pain' - Why the lessons of Mid Staffs must never be forgotten


The NHS is still reeling from the catastrophic care failures uncovered at Stafford Hospital. Beyond the Bedpan has one question - what now?

The frank conclusions of the Robert Francis Inquiry into care failings at Mid Staffordshire Hospitals Trust were felt far and wide this week.

Hospital managers bore the brunt of the criticism. Staff shortages and a lack of leadership led to chaos in the A&E department, with one doctor saying nurses were forced to work extra hours and “were desperately moving from place to place to try to give adequate care to patients”. The results were predictably dire: “If you are in that environment for long enough, you become immune to the sound of pain.”

Others pointed to a slavish commitment to the four-hour target, leading to 96 complaints about inappropriate discharge from patients who were effectively sent home before they were ready or well.

Nurses were not blameless. The attitude of some “left a lot to be desired”, the inquiry heard. Examples of patients being left in sheets soiled with urine or faeces make painful reading for all concerned.

The outrage and recriminations will continue. But the million dollar question (not to be confused with the departing chief exec’s £400,000 pay-off) is simple: how can we make sure this does not happen again?

The latest from a Nursing Times survey suggests that 20% of nurses think the serious care failures at Mid Staffs could happen where they work. Whether fair or not, nurses themselves will shoulder a lot of the responsibility for making sure they do not.

We may not be the problem, but we can be the solution. Nursing is the single most powerful force for improving patient care in the NHS. When things go wrong, will you do something about it?


Readers' comments (36)

  • Suzzanah hobley i agree with you 100%.

    I'm afraid our nursing unions are quite pathetic when it comes to supporting whistle blowing.

    They are also equally impotent when it comes to fighting for improved working conditions (eg staff/patient ratios).

    I left the RCN years ago. Totally useless self serving organisation.

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  • I am a student nurse working in the lothians, i have been on various placements and the one similarity running through most is the shortage of staff and the basic lack of time nurses have to spend ' caring' for patients. I have had two placements in separate a ad e units and understand the idea that nurses do become hardened to patients cries of pain, but i think this needs to be put into perspective. Firstly the nurses in a&e are having to prioritise which patients need help and indeed pain relief first. Yes there are certainly nurses that are more hardend than others and there practice is poor but yet again it seems that nurses are carrying the brunt. I have seen MANY a doctor in a&e sit around while the nurses are administering meds, support patients and families, and give basic care.....why couldn't these doctors help their colleages if and when they have the time .

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  • i must also add from my above comment that i am a degree student in my third year and nearly fell off my chair when i was told that a compassion module would be included as research had shown that compassion was lacking in nursing. As old fashion as it sounds i actually CARE about people and enjoy caring for them, that it why i got into nursing. Quite simple. To suggest that degree nurses are less compassionate is just plain silly. Being compassionate is something that is embeded into your very fabric as a human being.

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  • We at CAUSE (Campaign Against Unnecessary Suspensions and Exclusions in the NHS) would add to all this that people who care and speak out in these malfunctioning trusts will be silenced by false allegations made against them and suspension. The suspensions will probably go on for months. The investigation hearing by the person who suspended or made the allegation(!) will ignore the person's defence.
    This person will be banned from any contact with work and colleagues and friends, making defence very difficult, if not impossible.
    There will follow a disciplinary hearing eventually and again the person's evidence will be ignored. Very possibly, further allegations will be added!
    In our small study of union help, two thirds of respondents found their union rep very unhelpful with some colluding with management. (There were some brilliant reps too who had given up all chance of promotion by their actions.)
    It is like a living nightmare for those caught up in it and the damage is immense. Many never return to work.
    It is misguided to claim that nurses don't speak out. They do but disappear into this effective silencing machine.
    The Department of Health could find out about it if they insisted that in future all trusts have to report their suspensions, and give details. So far they've refused and knowingly 'throw staff to the unaccountable lions'. Patients are losing their lives because of it and the many excellent caring nurses who have commented above, despair.
    CAUSE has been campaigning for 6 years now with no end in sight. We persist because of the trauma to colleagues and long for the day when it can no longer happen.
    Julie Fagan, founder member
    CAUSE (UK)
    Campaign Against Unnecessary Suspensions and Exclusions in the NHS (UK)
    Campaign Co-ordinators: Julie Fagan, Craig Longstaff, Andre Downer,
    Elsie Gayle (midwifery spokesperson), Dave Williams (Welsh spokesperson)
    and Kate Wynn (Scottish spokesperson)

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  • In my experience, its the HCA's, not the nurses, who are the least compassionate and sympathetic staff members out there!

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  • We all know Nursing isn't what it use to be! However Why are we all labelled with the same! Many of us despite our age, background, level of education etc still care. Nursing should be hands on, unfortunately due to our Managers we do have the added pressure of other tasks that need carrying out eg paperwork, audits,etc

    Managers Conclusion - delegate (for bonus & promotion)

    Nurses Conclusion - Suffer in silence cant pass the book (same band)

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  • Charlotte Peters Rock 28-Feb 2010, asks pertinent questions and says that nurses who do not support their whistleblowing colleagues are unprofessional. Correct, but the situation is far worse. Some, stay silent out of fear,but the majority line up with corrupt managers, human resource departments, and unions to discredit the courageous whistleblower, confident in the knowledge that they will be rewarded with promotion and favourable conditions.
    How do I know this?
    I blew the whistle in 2001. I sat through meetings where nursing and HR managers told blatent lies and refused to listen to facts. Following a reign of intimidating terror I was suspended.
    With the help ( or so I thought) of my RCN Professional Officer I submitted an Employment Tribunal case, and was provided with an expert lawyer.

    Imagine my shock and disbelief 6 months later, when the RCN withdrew the lawyer 48 working hours before the Employment Tribunal hearing.
    Why? The RCN decided that my case had little chance of winning and therefore could not commit resources!!.

    Surely this is when a member needs a lawyer more than ever.

    The lawyer handed over the file to me which contained a 13 page pregnotion statement made by my RCN rep. The statement contained very little fact and multipe false and damning allegations against me. None of the phantom allegations had ever been discussed with me.
    I hired an Independent Employment Consultant who assured me that my case was rock solid.

    The Trust paid me a large sum of money to settle out of tribunal ( along with a statement of good character). I did not want a settlement, but ET's do not look favourably on those who refuse settlements, so I had to accept.
    I then pursued the RCN complaints procedure. The RCN refused to hear the complaint because I missed th 14 day deadline.
    Yes,I missed the deadline because my marriage of 30 years was finishing. I explained the situation to the RCN, without success. The RCN used the deadline to avoid an investigation.
    Yes, nurses should always advocate for patients, but I hope that my story shows that it is not as easy to do as many people think.
    I lost my job, my marriage and my health within a very short period of time
    Unfortunately, I had not heard of CAUSE at hat time (see comment 3-March-2010 8:35, for details).
    By since joining CAUSE, I found that I was not the only target of those same bullies, who pay NHS money in settlements, but fail to learn anything in the process. The support and information that I got from Julie Fagan and Kate Wynn has helped me to continue practising with my head held high. I am now in touch with several other Lothian nurses who experienced even worse intimidation than me. The reason in each case was; being good at our work, and courageous enough to question poor practice. Incompetent managers feel very threatened by professionalism and expertise. They will continue hounding good nurses out of the NHS, as long as Human Resource and Union cronies facilitate this corruption.
    What happened in Mid Staffs is not at all unusual.
    We all have a responsibility to put a stop to it, without delay.
    Unions, what are you doing, apart from rhetorical hypocrisy?

    Kathleen White (Edinburgh)

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  • You cannot make a profit out of people being ill. This is where the nhs has fallen down, trying to turn it into a business. There will always be good nurses and there will always be bad nurses. It is only the good nurses that keep the NHS going. I have seen appalling bad practice and I have seen excellent practice. It is the good nurses who end up leaving because they are overwhelmed by some of their colleagues who couldn't give a toss other than earn a wage. It is a very sad endictment that managers do not appear to care. I have been a 'whistleblower' on serious bad practice and it was all swept under the carpet. I very nearly had a nervous breakdown and was labelled a 'troublemaker'. The nurses involved int he patient abuse all kept their jobs and some were promoted.

    I just thank God there are more good nurses than bad.

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  • Yes Anonymous 7-March 2010 10;28am, senior NHS managers are experts at sweeping concerns under the carpet,presiding over mock grievance procedures and labeling highly professional nurses as "trouble makers".

    Human Resource staff and most union representatives are only too happy to assist in this corruption, by rubber-stamping the demands of those who know little about healthcare. Of course it is difficult for these bullies to understand good leadership / management when their salaries, promotion and generous pensions depend on them not understanding.

    Kathleen White (Edinburgh).

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  • I agree with alot of above comments, especially the lack of hands on nursing.
    I trained in the days when they trained SEN's and what a godsend they where.
    Left the Staff nurses to do the paperwork and chat with Doctors, knowing that the SEN's would lead a team and also carry out hands on nursing.
    Maybe alot would say that was the bad old days.
    I myself think the end of SEN's was the beginning of the end of hands on nurses.

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