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'The very best chief nurses I meet are honest about challenges'

  • 4 Comments

If I could prescribe anything for the health service and nursing, it would be a nice big dose of honesty.

We all know that finances are dire in the NHS, that there aren’t enough nurses to provide care and that therefore things are going to be unpredictable and tough for at least the next few years.

Some leaders are honest about sharing that (NHS Improvement chief executive Jim Mackey and NHS England chief executive Simon Stevens have been famously frank about the financial challenges facing the service) but some leaders tend to shy away from being blunt about what is going on.

It’s almost as if some senior people think saying it confirms it is happening and compounds the situation.

”You probably don’t think hearing it makes it come true. You know it is already true”

Well if you’re working on a ward that is constantly short staffed, if you’re a district nurse unable to visit all your case load, or you’ve got a huge waiting list for your outpatients’ clinic, you probably don’t think hearing it makes it come true. You know it is already true.

And what you probably want is some sympathy, some empathy and some honesty. You probably think if you are working your backside off then you at least deserve that, and you’re right, you do.

The very best chief nurses that I meet are honest about the challenges of their staff but galvanise their teams into action. They lay out where the problems are and involve the whole team in finding the solution.

When they haven’t got enough staff to help with meals, they draft in volunteers or when they need to free up a ward sister’s time they provide some administrative support.

Nurses are incredibly pragmatic. You only have to look at the floods in Morecambe Bay and how chief nurse Sue Smith and her team dealt with providing care against that backdrop to know that. When the crisis comes, nurses are the best people to have on side.

”Why must we hide the nursing shortage like it’s the worst kept secret?”

So why can’t we see this from the very top of every organisation? Why must we hide the nursing shortage like it’s the worst kept secret? And how can we ever fix the problems if we aren’t honest about them?

A badly failing business never turns itself around unless it admits to where it’s going wrong. The world of nursing needs more than just a plaster stuck over the top of its wounds. Nurses need to be candid, clear and honest about what they need and how they will get around any issues they have.

It’s time to be frank. It’s time to be honest that in many places we will have to consider unpalatable moves just to keep patients safe and wards open. It’s time to say what we think and mean what we say. It is time for everyone to pull together and be open. That’s the only way things will ever change for the better.

  • 4 Comments

Readers' comments (4)

  • michael stone

    You did not mention, unless I missed it, 'politics'.

    http://www.bmj.com/content/353/bmj.i3237/rapid-responses

    And a 'yes' to:

    'And what you probably want is some sympathy, some empathy and some honesty. You probably think if you are working your backside off then you at least deserve that, and you’re right, you do.'

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  • Nursing is now a business and not the caring profession it is meant to be.Managers are no longer clinicians they are budget holders and looking at targets.Patient care comes last on the ladder.

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  • Nurses who raise concerns who later may or may not become whistleblowers are also only being honest and candid and upholding their duty of care as prescribed in their The Code of Conduct as per the NMC.....Sadly this aspect of nursing,whilst talked about a great deal all over by all largely awaits the theory of it being put into practice throughout the UK..........Unless of course a first class chief nurse is there to support these nurses without hesitation................. It can be done.........

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  • I like your editorial pieces Jenni. You regularly say what others think but will not say and I wonder if you were able to do so when in practice.

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