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'Red tabards keep patients safe and should not be undermined'


Patients like red tabards so why has there been such fury over them, asks Steve Hams

Having been in the middle of a media storm this week about the apparent “fury” caused by nurses at the Queen Elizabeth the Queen Mother Hospital in Kent wearing red tabards with “do not disturb” on them during drug rounds, I couldn’t help but wonder what on earth has happened to the public’s perception of nursing.

Several people who commented on the tabards criticised nurses, which was unjust and undermines our patients’ confidence in a caring profession. Nursing is a challenging, pressured and tough job, but the rewards are truly incredible; each and every day I hear and see magical moments where nurses really do make a difference.

Our frontline nurses have, like those all over the country, been developing innovative ways to improve safety as well as patient experiences and outcomes - it’s disheartening when the tabloids berate our profession and call us “hopeless” if we can’t do more than one thing at a time or say we are too important and too lazy to help our patients. This isn’t what I see day in, day out from my colleagues - I see compassionate, committed and dedicated nurses trying to provide the very best for their patients.

“Despite the furore, we have discovered patients like the red tabards; it tells them the most important aspects of their care are being delivered to the highest possible safety standards”

Our introduction of the red tabards is related to a broader range of measures to improve safety, reliability, patient experience, staff satisfaction and efficiency of medicine management; it has never been about inhibiting the unique relationship nurses have with their patients. Implementation of the tabards is, in some areas, to support the Productive Ward philosophy of Releasing Time to Care and cutting waste in processes that prevent us from being with our patients, but the fear of giving a patient the wrong drug or an incorrect dose never goes away - ask any nurse who has made a medication error or a patient who has been on the receiving end of one and I am confident they would support use of the red tabards.

Our own observations as part of implementing the Productive Wards Medicine Module show nurses are interrupted by other ward staff and visitors up to 10 times while doing a drug round. Introducing the tabards in other trusts has seen a 70% drop in the number of interruptions, fewer drug errors and reduced delays in getting patients their drugs. The trial and implementation of red tabards is a simple and effective way to keep patients (and nurses) safe. We must do much more to inspire, motivate and encourage nurses to work with patients and their carers to come up with the innovative ideas to really transform patient care.

One commentator suggested Florence Nightingale wouldn’t be impressed with our tabards - on the contrary, if she was alive today and working in an acute hospital, I am sure she would have been at the forefront of this and many other innovations. She may not be so impressed with how some sections of our own profession denigrate nurses and nursing though. We need to support each other, not put each other down - the job is challenging enough.

Despite the furore, we have discovered patients like the red tabards; it tells them the most important aspects of their care are being delivered to the highest possible safety standards. Coming to the end of our trial and having listened to the wide-ranging commentary over the past few days, we will remove the phrase “do not disturb” to make it clear we have never been more committed to doing the very best for our patients, to keep them safe and to care with compassion.

I am proud to be a nurse and privileged to work with inspiring, committed and talented people who do their utmost to keep their patients safe and nurse with professionalism and compassion.

Steve Hams is deputy chief nurse and head of quality at East Kent Hospitals University NHS Foundation Trust


Readers' comments (5)

  • The problem is twofold.

    First and foremost there is a distinct problem with the image of Nursing. There is extremely little understanding of exactly what it is that we do, how educated, qualified and skilled we are, or what important role we play in healthcare, this is not helped by the constant negative stereotypes such as the naughty nurse etc. The sheer lack of understanding of our role is epitomised by this tabards issue, the amount of ill informed opinions I have heard about Nurses, not least of which from patients rights groups who should know better, makes my blood boil!

    Second of all, partly because of the first point, our profession has very little status or respect by the general public or the powers that be, because we are seen as week, disparate and an easy target. So for the governments part, they can just walk all over us and patient care safe in the knowledge that we will do sod all, and from the publics point of view, they are so ill informed about our role and so used to us as an easy target, that they blame us for all the current problems that they see with the NHS. There is no care anymore? That has to be the Nurses fault, never mind that there is only one Nurse for 50 patients! The wards are filthy? Nurses fault again! Never mind that the trust has outsourced all the cleaning staff and will not pay for enough teams to do the job properly!

    As I have said before, it is about time that this changes. Until it does, we will always be the easy scapegoats, we will always be in the eyes of the public the same uneducated handmaidens as we were portrayed as in the 60s.

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  • I don't understand the attitudes of the public and their patient protection orgs. They complain the hind legs off the donkey about poor nursing care and when an initiative which demonstrates that nurses are very concerned about high quality care and patient safety and the reduction in drug errors due to constant interruptions is put forward they complain about that too, so the poor old donkey is left with no legs to stand on! This seems to be a proverbial case of having your cake or eating it! Perhaps they would be kind enough to inform us what they really want from us and come up with some better ideas of their own!

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  • From my experience of administering medication on the wards on late shifts, I found that this time is also visiting time and meal time for the patients.
    All the staff are extremely busy, especially if due to the timing of different shifts, break time for 1 or 2 nurses and/or carers is also due.
    I have to stop several times during drug administration to listen to a relative or friend ask after their love ones.
    To be honest if I were the patient waiting for my medication, I will want the nurse to be safe and concentrating on the administration of the medicine , just like I would want my surgeon to be concentrating on the surgery.
    What we need is to closely look at duty operations and review. I am sure that during this review, one would also find that we need more nurses.

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  • many medications need to be administered with meals but I can't understand why this coincides with visiting time as well! wherever I have worked visiting is always meals are finished except for a few patients who may benefit from help from their visitors with eating.

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  • I can't help but think that the complaints came from visitors who couldn't speak to the first nurse they fixed their sights on to because they had a tabbard saying "do not disturb"

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