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Attitude of some nurses 'left much to be desired', says Mid Staffs report


Nursing staff at Mid Staffs did not completely escape criticism in Robert Francis’ report on care failings at the foundation trust.

Despite mostly apportioning blame to managers rather than clinical staff, it found a culture at the trust where some staff provided unsatisfactory levels of care, and other staff tolerated this poor care.

“Although some members of staff were singled out for praise by patients, concerns were expressed about the lack of compassion and uncaring attitude exhibited by others towards vulnerable patients and the marked indifference they showed to visitors,” the report says.

Patients and their relatives told the inquiry of requests to use bedpans or go to the toilet that were ignored; patients being left on commodes for too long; and patients being left in sheets soiled with urine or faeces.

The report was told that the attitude of some nurses towards these problems “left much to be desired”.

Some families felt obliged or were left to take home soiled sheets or to change beds.

“Some staff were dismissive of the needs of patients and their families,” the report says.

The report says this evidence points towards a systematic failure of good care, and it says: “The causes of these instances of poor care included, in a small number of cases, staff who appeared uncaring. More often there were inadequate numbers of staff on duty to deal with the challenge of a population of elderly and confused patients.”

It adds: “It is difficult to believe that lapses on the scale that was evidenced could have occurred if there had been an adequately implemented system of nursing and ward management.”

The report also heard complaints about poor hygiene practice among staff, such as using a razor on more than one patient, and neglect of basics such as cleaning patients’ teeth.

The report says: “A wholly unacceptable standard was tolerated on some of the trust’s wards for a significant number of patients.”

Robert Francis’ report makes a number of recommendations that could affect nurses. They are:


The trust, in conjunction with the nursing school at Staffordshire University, the royal colleges, and the deanery, should review its training procedures to ensure that high-quality professional training and development is provided at all levels
Audit in all clinical departments should be improved, and staff must be required to participate in audit processes
Staff must be involved in the complaints process from investigation to when any action is taken
The board must give priority to ensuring that any member of staff raising a concern is supported and protected
The board should review the management and leadership of nursing staff
The management structure of the trust must be reviewed to ensure that clinical staff and their views are fully represented at all levels of the trust
The trust should review its record-keeping procedures in conjunction with clinical staff
All nursing staff should have training in the diagnosis and management of acute confusion
The trust must ensure that its nurses work to a published set of principles, focusing on safe patient care

Readers' comments (17)

  • Maybe nurses are just sick of dealing with ever increasing workload with ever decreasing staff numbers and support from management. Most nurses do not start their careers with a lack of compassion to patients. The lack of compassion and the general 'let's blame the nurses for everything' that comes from managers and the public beat it out of us!

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  • lack of nursing staff is what we are faced with day after day.We strive wholeheartedly not to let our patients down ,but sometimes we fall down and this gives us no satisfaction at all.
    On the whole it is not the nurses that are letting patients down but the management and the mangement culture within the hospital
    When is anyone within the DOH see what is going on,it is hardly rocket science to understand that lack of hands on staff = poor patient care and outcomes.
    I believe all those above ward level are guilty of lack of duty to patients and nurses and should now be held accountable for their lack of care -and soon.

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  • The report that has been shown is shocking but sadly within the health care service I don't see it as surprising. The government continually use the NHS as an election tool, to get more votes promising the best Health care service! Maybe if they went back to ground level and looked at patient-nurse ratio's and encouraged hospital managers to focus on that to provide the better high standards of care that we strive for, then patients would hopefully receive the care they are entiltled to. The health care service should be run exactely as that, not a business which is promoted to gain more business, when most people who are ill simply want to go to their local hospital/NHS to be cared for, near to their family and friends. The ever growing population can only worsen this already recognised problem of staff shortages, growing pressures inivitably resulting in low morale, and nurses which are seen to have the wrong attitude and do not care-maybe because their fighting to stop the sinking ship which has already sunk!!!

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  • Managment at each level dare not challenge the layer above them for fear of being called a failure. Targets are king and God help those who try to challenge them. You are led to believe that you can give your opinion but you know that your card will be "marked". All managment are "yes" people; the chief exects say what needs to be done and those below just say "Yes". One manager was heard to say "I'm not interested in quality, its quantity that matters". Gordon Brown's style of management rules ok!

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  • TO Anonmous 25 Feb-2010

    You have described a shocking situation concisely in one paragraph. Well done.

    I was bullied out of post when I raised concerns about bad practice, and Im not alone.

    This is happening UK wide on a regular basis.

    The bottom line is that the NHS is not a Learning Organization.

    He who makes no mistakes, makes nothing. He who makes the same mistake twice is a fool ( trad saying).

    The NHS is repeating the same mistakes over and over again.

    Does this mean that we are managed by fools?

    How long will this be allowed to continue?

    Kathleen White Edinburgh.

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  • The moment you stop thinking about the patient, you become a threat to the patient.

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  • People are becoming more uncaring and materialistic . We are taking in unsuitable people to be in healthcare. It is happening worldwide, not only in UK

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  • I work for a trust that constantly threatens us that " we have to be cost effective or they will commission service elsewhere" Its like working in a third world country, bare numbers of staff, constant criticism, working without a criteria, changing the, scarce, guidance we have for admission on a daily basis to suit the acute trust putting patients and staff at risk. I know staff have written quoting NMC but nothing gets done this is the reality of the NHS .

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  • sadly the comments in both the report and above could be said about the trust i work for. they are planning to cut 200 beds in the next few months. staff are being moved to different specialities. at present none of them know where. our cheif ex thinks that if we discahrge patients quicker then we need less beds. however we are all aware that this often leads to readmissions. am currently looking for another job as i do not want to be part of another mid staf fiasco.

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  • Yes, Anonymous 1 March-2010 5:10pm, the comments you refer to could be attributed to the majority oh UK NHS Trusts

    No doubt your chief executive does not understand the amount of resources involved in discharing patients, admitting new patients, and readmitting those who were not ready for discharge in the first place.

    But then, it is VERY DIFFICULT for him or her to understand such basics,when their bonuses, continuing fat salaries and fatter pensions, depend on them not understanding.

    Unless nurses support each other in blowing the whistle on malpractice, this culture of corruption and bullying will continue.
    Kathleen White

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