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'Nurses should lead the culture change'

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The appointment of Dame Eileen Sills to be the first national guardian for the freedom to speak up within the NHS is a significant one for nursing and for the health service.

It’s fantastic that a nurse has been chosen to head up this important piece of work, which is intended to change the culture of the NHS. And let’s face it, the culture needs to change.

Since the publication of the Francis Report into care failings at Mid Staffordshire, the NHS has been awash with patients and staff who claim to have raised concerns and been ignored or even vilified. Many of those staff were nurses, who, as the clinicians closest to patients and service users, see first-hand how organisational culture affects the quality of care provided. They can also see the impact of poor care, lack of resources and bad judgements.

”It’s fantastic that a nurse has been chosen to head up this important piece of work”

Our Nursing Times Speak Out Safely Campaign encourages nurses (and all healthcare staff ) to raise concerns about issues that affect patient safety. We want all staff to feel able to speak up when they see something that is – or might be – wrong, so it can be addressed and used as a learning opportunity, so that such mistakes can be avoided in the future.

Many may wonder how the chief nurse in charge of a large and well-respected trust with stable finances can understand the challenges facing those working in organisations that are in trouble.

But let’s not forget that before joining Guy’s and St Thomas’s, she was director of nursing at Whipps Cross. She has also championed nursing throughout her career, and helped to increase the profession’s influence on decision-making about healthcare provision, because she knows what a huge contribution it can make to patient care.

”The national guardian role requires someone with integrity and decisiveness to if it is achieve its aims”

The national guardian role requires someone with integrity and decisiveness to if it is achieve its aims. I wish Dame Eileen well in this new role and hope she has plans to change the way people approach accountability in the NHS. The service must put an end to the blame and shame reactions found in so many organisations when staff raise concerns.

 

● Check if your employer is signed up to the Nursing Times Speak Out Safely campaign here

  • 2 Comments

Readers' comments (2)

  • michael stone

    Spot on with the obviously correct:

    'Many of those staff were nurses, who, as the clinicians closest to patients and service users, see first-hand how organisational culture affects the quality of care provided. They can also see the impact of poor care, lack of resources and bad judgements.'

    BUT hasn't that always been true of nurses - surely nurses have always 'been the clinicians closest to the patient'.

    So why will nursing 'lead the way on cultural improvement' NOW ? Why haven't nurses always been doing that, in an ongoing and continuous way ? If nurses could control 'culture', how did 'bad culture' become established, for Francis to highlight ?

    Is it, perhaps, that culture tends to seep down from 'on high', and even if nurses at ward level can see flawed behaviour/culture, it is very difficult to push for culture change from the bottom ?

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  • michael stone

    Anybody who is interested in 'nurses leading the culture change' would probably be very interested in the rapid response written by David Oliver (18 February) to his own recent piece on the BMJ - the series of responses to his article can be found at:

    http://www.bmj.com/content/352/bmj.i978/rapid-responses

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