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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)

  • On top of stafford we now have Tameside in manchester. Appalling systemic failure of management in running these hospitals.

    Self inspection of standards by hospitals, misleading health inspectors, fabrication of figures.

    A Govt to blame for huge budget cuts to trusts resulting in too few nurses, beds, doctors.

    The buck stops with the govt. We have a growing population and a NHS that is chronically underfunded. Regardless of what the govt says about record spending it is not enough.

    Do we want an NHS. Tax payers aren't prepared to pay more to fund it. The population of this country have to understand that if they want an NHS fit for purpose it must come from tax increases. If they are not prepared to pay more they will get the NHS they deserve.

    The govt has to increase taxes to pay for it or commence health insurance payments to fund it. IT IS A MESS.

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  • Yes Anonymous 8 -March-2010 8:56, I agree with most of your points.
    But perhaps taxpayers would be prepared to pay higher National Insurance, if it meant improved healthcare.

    The Government has a responsibility to get rid of the corrupt and incompetent managers that are draining the service dry.

    Allowing a £400.000 pay off to the departing Chief Executive of Mid Staffordshire, while front line staff burn themselves out trying to provide good care, in an under funded service, is simply not acceptable.

    Corrupt managers have squandered millions of pounds over the years excluding and sacking courageous whistleblowing nurses, who tried to stop malpractice like Mid Staffs. One courageous nurse was wrongly sent to prison, and would still be there if a barrister had not taken up the case (free of charge) and proved her innocence.

    Then we have Ann Keen a junior health minister robbing taxpayers money to the tune of £195,000. For details Google; Ann Keen expenses. Of course she is not alone, there are many other snouts in the trough.

    This would not happen if Human Resource Staff and Unions did their jobs. If any union officials read this comment, perhaps they will explain why they are failing their members ( and pandering to corrupt managers).

    The above are just a few examples to show that the money is there, and being squandered.

    Further information on the CAUSE (Campaign Against Unecessary Suspension and Exclusion in the NHS) website.

    So, the solution is accountability before deciding if higher taxation is really necessary.

    Kathleen White (Edinburgh)

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  • Julie Fagan, I hadn't tigged the invested interest in some rcn reps of having a vested interest in keeping quiet rather than representing members when they work at the same place. I assumed a rep would be independant and impartial. The process of an investigation you describe sounds utterly horrendous and trauma inducing. Thankyou for highlighting it.

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  • I think the description of being immune to pain an awful assertion to make. I can understand becoming numbed but not immune. Immune would imply serious mental health disorder

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  • I have to agree with kathleen White, I worked at a large hospital in Burton-On-Trent.

    I was asked if I wanted to do a course on patient assessment. I didn't need it to do my job, but thought it would be an extra string to my bow.

    The course had been very poorly thought out, and on one occasion I wrote to the course director complaining about a part of the course. After that, I never passed another component of that course. The amount of writing was immense, and 9 out of 13 of the course participants deferred due to amount of work.

    I asked my manager if I could defer, and she told me "NO! You're no good to me as a role model if you defer!" This left me between a rock and a hard place. I tried to complete the work, writing 25,000 words in just under 3 months (at level 3).

    I failed the coursework, and when asked to re-submit, I told them I didn't want to continue, and I would take the fail, as I had not been given chance to complete the work properly, and would have to re-write most of the work I had completed. They didn't care about my manager telling me I couldn't defer, and my manager then blatantly lied that she said no such thing.

    They said I was to be perfromance managed, as the course work brought my practice into question (I didn't NEED the course to do my job). All of the competencies that had been signed off and passed by my manager/mentor were to be reassessed by an consultant anaesthetist from ITU! As all of this had been instigated by the course director, who also happened to be the deputy director of nursing, so I knew that I had no chance of success, so I left the trust.

    I spoke to UNISON, who refused point blank to help me. HR immediately sided with management and swept everything under the carpet.

    I have now moved to another trust, who hopefully value their staff.

    I have learnt one thing: NEVER trust your manager or HR department, and NEVER complain about a course. They will come after you, and you have NO power, and NO backing from the unions.

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  • I am an RGN/RMN and have done agency work at Stafford General, Russells Hall, Walsall manor, Wolverhampton New Cross, Princess Royal and many other trusts and nursing homes. The patient to nurse ratio is too high with 1:13 in most hospitals for surgical and medical wards. When you have drug rounds, ward rounds, social worker referrals, discharge planning, medication ordering, IVs, blood transfusions, watching aggressive, confused and wandering patients to stop them disappearing from the ward or falling (Yes it will be all your fault you lazy cow), those who are incontinent and immobile and needing 2 houly turns, hoisting, mouthcare, Ivfluids administering and prescribing and resiting of cannulas, bedbaths, comforting and informing and reassuring relatives during the usually 5 hour visiting times, wound dressings, arranging appointments, serving meals and clearing rubbish and linen bags, making beds, answering phone calls and ringing porters and chasing up scans and blood results, TTOs, monitoring vital signs, admissions, record-keeping etc... what with only 1 nurse and 1 floating HCA I am sure quality care can be achieved. Forget your break do a 13 hour shift with no break you are not human you know. You usually have to stay behind finishing your notes with no extra pay and the break is still deducted despite no other qualified nurse arranged to take over your patients so you can actually leave the ward without fear of being blamed for negligence. The UK needs to decrease the number of directors, deputy directors, assistant directors, clinical governance teams and increase the nurses on the shop floor.

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