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Nurses are too busy to improve their practice

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On The Pulse is a weekly round-up of what’s happening in nursing or an analysis of a key nursing issue, written by Nursing Times staff.

This week: editor, Jenni Middleton

Nursing Times spends a lot of its time championing nurses, standing up for the value they add, explaining how they do much more than pass sick bowls and stroke hands (though let’s not underestimate how those two things can be elevated above the task to form part of compassionate care that enhances the patient’s experience).

But that doesn’t mean that we don’t recognise the value all health professionals play in the care of patients.

If we are to truly realise the ambitions to integrate social and health care, and to make care delivered closer to home a reality, we must first integrate the professions properly.

Of course this is happening in many places, but it’s just not consistently so.

“That doesn’t mean that we don’t recognise the value all health professionals play”

On Tuesday, I chaired an event organised by Ben Thomas, professional advisor on mental health, learning disability and dementia for the Department of Health, as part of the Health Secretary’s “Global Patient Safety Summit”.

It was focusing on the work being done by nurses and allied health professionals in falls prevention and sepsis.

We heard from a patient, nurses, medics, a consultant psychiatrist, a speech and language therapist, physio and a paramedic.

None of them passed the buck, none of them said that the responsibility was another profession’s or someone else’s department.

These healthcare professionals wanted to do the best they could and to disseminate learning to other clinicians in the multi-disciplinary team to ensure the best people for the job did the job.

But while this is the stuff of conferences, is this consistently what is happening in the real world?

”The King’s Fund estimated the costs of falls in the NHS in 2013 to be at £2bn”

The King’s Fund estimated the costs of falls in the NHS in 2013 to be at £2bn and NICE says it is the largest cause of deaths in the over 65s. If multidisciplinary teams worked together and truly integrated care and shared learnings and specific expertise, they could save money as well as lives.

So why isn’t that happening? Could it be that staff are too busy to collaborate, too overworked to share and too under pressure to change their practice for the benefits and safety of patients?

That NHS culture is often more about blame and shame than celebrations and improvements.

The day after this event, on Wednesday, I chaired the Nursing Times Revalidation Conference – something that truly did focus on the revalidation process to celebrate and improve.

We heard from three pilot organisations, and all of them acknowledged that the feedback element of the revalidation process was most useful when it was constructive – so that nurses could reflect on what they could improve and do better.

They agreed that while their nursing staff had been cynical at first, and felt a little hard done by at being selected to go through the process, they soon become converts.

In particular, they felt that receiving feedback and thinking about what it meant for their practice had improved patient care.

But they also acknowledged it took time, and this needed to be protected to ensure learnings were truly identified.

Both the events I hosted this week prove that if we want clinicians to work effectively and improve their practice, we need to create a culture of time and respect for all. This will enable all healthcare professionals to offer time and respect to the people they care for.

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