Working to rule is the most favoured method of industrial action among the 5,185 nurses and midwives who took part in Nursing Times’ exclusive survey.
Asked what duties they would refuse to do as part of formal industrial action, 59 per cent of respondents said they would refuse to work unpaid overtime and 53 per cent said they would insist on leaving the ward or clinic for breaks - something nurses in practice are often unable to do.
If working to rule consists of taking appropriate breaks and not working too many hours, organisations will have to deal with that
Just over half said they would refuse to carry out non-nursing duties such as cleaning and portering - another role nurses are frequently asked to do when workplaces are short staffed.
Four out of 10 said they would refuse to carry out administrative duties.
A nurse consultant from one London hospital told Nursing Times that it was acceptable to inconvenience a patient by working strictly to rule.
She said: “Patient safety obviously you would never compromise - if there’s a patient [who] needs taking to the other end of A&E and there’s no porter, you would do it. But if people say ‘I’m not doing any photocopying’, it might inconvenience [the patient] but it wouldn’t put anyone in danger.”
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She said nurses frequently showed “goodwill” by either not talking their breaks at the right time or forgoing them altogether. “It would cause considerable disruption if [that goodwill] was withdrawn,” she said.
The scale of potential disruption is heightened by the finding that only 15 per cent of respondents would rule out industrial action and one in five said they would refuse to work in “non-urgent” outpatient clinics.
King’s College Hospital Foundation Trust director of nursing Geraldine Walters said: “If working to rule consists of taking appropriate breaks and not working too many hours, organisations will have to deal with that.
“However, other actions, such as refusing to carry out administrative duties or outpatients [clinics] seem more designed to punish organisations.
“Unfortunately, in these instances, the only people who would really be inconvenienced at the end of the day would be the patients.”
Ms Walters admitted NHS employers did rely on the “good faith” of nurses to work beyond their contracts, but she said nurses were unlikely to be the only staff group that applied to.
Work to rule action will mean nurses withdraw their goodwill