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District nurses setting 'rubbish' example on public health


District nurses often set a “rubbish” example to patients about healthy lifestyles, according to the head of community services in Leicester.

Paul Miller, managing director of Leicester City Community Health Service Business Unit – formerly part of NHS Leicester City but now integrated with Leicestershire Partnership Trust – was speaking at the NHS Confederation annual conference in Manchester.

His organisation is pioneering a programme to improve the occupational health of its staff, but said he had a “cynical view” when it came to them acting as public health advocates in the community.

He said:  “My problem is that too many staff are rubbish when it comes healthy lifestyles. You only have to look at some of our district nurses.

“My golly, how would you expect one of them to go and tell some of our patients about how to be healthy. It is quite clear that many staff take no notice whatsoever of the fact they need to look after themselves – eat properly, exercise, all of that.”

He added: “I think it’s a mountain to climb quite frankly.

“We’re out there promoting healthy lifestyles, but actually a lot of our staff are not doing what they’ve been trained to do and actually ignoring their professional knowledge, completely and utterly.

“I find that most distressing. Some of our staff I wouldn’t want to be advocates of health lifestyles quite frankly. That’s the cynical view.”

NHS Gloucestershire chief executive Jan Stubbings also said mangers had to set a good example themselves, explaining that she had lost five stone through dieting because discussing how to tackle obesity with colleagues had become “embarrassing”.

“Can you actually stand in front of the public as a chief exec being 18 stone? No you can’t,” she said.

She added that her PCT had, in agreement with unions, had made it a contractual obligation for staff not to smoke in their uniforms while also increasing  travel pay rates for cycling to and from work locations.    

She said: “We agreed with the unions that it would be written into contracts that none of the staff can smoke in uniform. It’s a district nursing issue, they might have a fag between patients [rather than in front of them] but they still reek of it.”

Mr Miller described the Leicester programme as a “fairly pragmatic response to try and improve the health and wellbeing of our staff”.

Among a range of initiatives, the programme includes a supportive managerial programme, staff stress assessments, and a twice weekly after work exercise group.

He said the supportive manager behaviour training was “one of the key features” of the programme. It is due to be rolled out beyond the community services unit into the rest of the partnership trust in August.

He said: “It’s not management development and it’s not your usual management by objectives training. It’s just about how you are going to be a decent, courteous, nice person who takes an interest in what they staff are doing.”

Mr Miller said the next stage was to fully evaluate the programme but there were indicators that it had made an impact on staff wellbeing.

He said: “Our sickness rate at the moment is just under 3.8 per cent and we’ve worked hard to get it under 4 per cent. In last set of figures we were the lowest in the East Midlands area

“It’s a huge productivity boost,” he added.

But Queen’s Nursing Institute director Rosemary Cook said: “It is very sad to hear a managing director talking about his staff in public like this. Professional staff like nurses would not deride their patients in such a demeaning way, and you might expect an NHS employer to act with more respect for its employees.

“Our Nursing No 1 campaign of a few years ago, which encouraged nurses to look after themselves as well as their patients, uncovered a complex set of issues which affect nurses’ lifestyles, including stress at work and a lack of time and support to eat, drink and exercise healthily. Perhaps the new occupational programme at Leicester City CHS business unit will help to address these issues.”

Royal College of Nursing public health adviser Jan Maw added: “Working as a nurse in the NHS is a stressful and demanding job and it is essential that employers provide advice and support to staff in order to help improve their health and wellbeing.”


Readers' comments (7)

  • @ Paul Miller, ok maybe some of us are not as healthy as we should be but who do you think you are........
    "Among a range of initiatives, the programme includes a supportive managerial programme, staff stress assessments, and a twice weekly after work exercise group" good idea but we have a social life or is it paid??????
    More often then not I go in early to finish of paperwork and work later I know some of me colleagues stay on for a few hours........

    As for eating healthy we often do not get a proper break so we eat on the run........or skip it completely

    work a few weeks with your teams and then speak again.


    Stressed and angry

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  • So we are not all as healthy as we should be and maybe some of us carry some extra weight.

    "It is quite clear that many staff take no notice whatsoever of the fact they need to look after themselves – eat properly, exercise, all of that.” Walk in our shoes, after all the NHS doesn't exactly allow for a healthy work/private life balance.

    It is quite clear that many staff take no notice whatsoever of the fact they need to look after themselves – eat properly, exercise, all of that.”

    Maybe is is time that people were allowed to see that we are not just nurses but human beings who everyone else are not perfect.

    Sorry for the rant but I am so angry about Mr Miller's attitude. Another reason why after 18 years as a nurse I am turning my back on it. It's bad enough that I am not allowed to nurse due to red tape and paper work but apparently because I carry some extra weight I am not fit to be a nurse.

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  • I agree with this, Nurses and HC workers in general should practice what they preach. I will site two examples I have personally seen, an extremely overweight nutritionist telling patients they should eat healthy and lose weight, and a smoking cessation Nurse reeking of smoke after a break before seeing a patient! I mean c'mon, how do you expect patients to take any advice seriously?

    Also I applaud any efforts to redress the quite frankly p*** poor work life balance and unhealthy work practices in our profession. I think a reduction in the workload and stress may be a better start however.

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  • To Paul Miller - what a cheek! So instead of looking at WHY nurses might be overweight and/or smokers, he is just condemning them out of hand for appearing to be "unhealthy". If he had read the newspapers recently, he would know that being overweight does not necessarily equate to being unhealthy. In fact a slim person can be equally at risk of CHD/stroke. I am overweight because I eat normally but my body too easily converts this to fat, despite the fact that I am not a couch potato. My GP told me I had raised cholesterol BUT he said I had more of the "good" stuff than the "bad". I have underactive thyroid which is a known risk factor for raised cholesterol. What do I do? Starve myself?!
    As an ex community nurse I recall not having breaks at the usual times because of the workload and the distance I had to travel between base and my patients' homes. There were times when I was offered sustenance from patients and yes I took it because I knew that it would be a long time before I could stop and eat my lunch! In one case, my stomach was grumbling so much that the patient could hear it. She insisted that I ate some chocolate. Stomach settled, patient happy, nurse able to get on and do her job. How long does Mr Miller go between meals?
    Once again, nurses are being held accountable for problems that are not of their own making. Overworked, underpaid, we are now told that we are too fat! I consider these comments to be offensive and discriminatory. I would whether the RCN would agree? I ask Mr Miller to apologise for his insulting comments. His comments DO NOT encourage me to rush out and buy a treadmill (unless he is going to pay for it!) they are more likely to make me go out and buy the biggest bar of chocolate I can find. Dark of course as it's full of antioxidants!

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  • SalusUni1

    I feel the same way user "Mike" does on this topic. Why would anyone want to take advice from people who do not even practice it themselves? I am glad to see that there is some initiative to correct this problem based on the article.

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  • My golly Mr Miller what an offensive unproffessional comment.Might Isuggest instead of insulting your loyal hardworking workforce you investigate the real causes of stress within the organisation.It is a wonder there are any overweight nurses as we rarely have time to eat .As with so many Trust initiatives it is all spin and no substance. Shame on you Sir.

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  • Jean, I hardly call it insulting, it is certainly not unprofessional. The fact is a huge portion of the workforce are NOT great role models for health, are they? In my opinion, it is generally the people within that category who start getting all huffy and offended at articles like this.

    I agree with you about the causes of some of our poor health as I said in my previous comment. I wholeheartedly admit that Nursing as a profession generally does it's utmost to ruin the health of it's workforce, high stress, long hours, quite frankly stupid work patterns and rotas, stress, poor working conditions, more stress and a bit more stress on top of that. I KNOW that. You know that. We all know that. That is why I said I applaud any efforts to change this, as the article suggested, although I agree there is little substance there and I don't think the article went far enough.

    HOWEVER, saying that, that in and of itself is no excuse. People should take personal responsibility for their own health, and Nurses especially so since we are the ones who are supposed to be promoting health, advising and treating patients. I do, and I work the same job, the same hours as most of you, so why can't others?

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