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Focus of nursing 'fundamentally wrong', says Mid Staffs chair

  • 27 Comments

Nurses should stop trying to defend the profession against charges of poor standards and accept responsibility for making things better, according to the chair of Mid Staffordshire Foundation Trust.

Sir Stephen Moss, a nurse by training, told Nursing Times there was something “fundamentally wrong” with the current focus of the nursing profession and revealed he is working with five other nurse leaders to find ways to “help both the profession and the wider NHS get things right”.

“We can have a really high standard of knowledge and a really high quality technical skills but unless nursing care is delivered with kindness and compassion we are still going to let patients down… I’m not convinced we’re investing enough time in kindness and compassion. It needs to have a stronger base in the curriculum,” he said.

Sir Stephen, who spent the bulk of his clinical practice in intensive care, would not reveal the names of the other five members of the group, saying all were all in sensitive positions. The group, some of whom are nursing directors, has met three times and will meet again in September. They hope to go public in the autumn.

“We are people that have come together for a common passion. We are not going to be the solution but we are people who have got a wide range of networks and can exert influence,” he said.

Sir Stephen joined the board of Mid Staffs in February 2009 as the trust was still struggling to come to terms with the appalling standards of care exposed by the Healthcare Commission’s report a year earlier.

He had previously spent 20 years as director of nursing at Nottingham’s Queen’s Medical Centre before taking on the role of chief executive for two years. He retired from the role in 2005.

Sir Stephen said although he would not advocate a return to the days when nurses did all their training on the ward, that system had a lot of value in the “strong presence” of teaching staff in clinical areas which helped instil values.

However, he said trusts also needed to take their responsibilities for educating nurses more seriously and make sure newly qualified nurses received support, guidance and adequate mentoring to help them develop.

“I’m proud to be a nurse and the last thing I want to see happen is that nursing is talked down because there are some excellent examples of good nursing. But we have to accept in light of all the recent reports [exposing poor care] and having lived through the last two years in Mid Staffs and having heard from the patients and families we are still letting people down.

“Our maturity as a profession will show through if we stop trying to defend ourselves and accept that we all have a responsibility.”

  • 27 Comments

Readers' comments (27)

  • I think most nurses would like to hold patients hands, sit and reassure them more. Unfortunately due to inadequate staffing on the wards and more and more paperwork there just isn't enough time. To be told we do not show kindness and compassion is an insult, the majority of nurses are ran ragged from coming onto shift to going home. Sir Moss should come and work on a ward and see the changes that have happened over the years and how much more demanding our role is.

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  • To anonymous above,
    I honestly think that you have missed the point.
    We, the nursing profession and that includes you, have got into this awful state of indequate staffing, more and more paperwork etc.. etc... by supporting weak leadership in the nursing profession.
    We ( and I mean me and every other nurse) have not challenged and stood our ground to protect high quality nursing leadership and nursing practice.
    Don't tell me that these Directors of Nursing did not apply for their jobs to constantly challenge; they applied for the career progression, the salary and the compliance to keep their salary.
    We have very few champions in nursing these days but lots of nurse leaders who are compliant with the managerial model of the NHS and complacent about really tackling the heart of the problem.
    No one inside the NHS really seems to want to stand up and be counted - they seem to rely on Dignity programmes and outside lobbying organisations such as A Dignifed Revolution to try and change.
    The whole nursing profession, and that includes the RCN AND the NMC as well as Nurse Directors, CNOs and individual nurses, need to stand up and demand a change in the system now.
    We are not the angels to the public now, we have lost our image and their confidence in our care. We need to act now and earn that confidence back.

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  • Anonymous | 9-Aug-2011 12:21 pm


    "We need to act now and earn that confidence back."

    there are a huge number of commentators who keep repeating this but who has any idea how this can be achieved?

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  • Isn't about time we stopped hiding behind the anonymous button. Possible the only way to earn confidence is to put our head above the parapet and say 'I will be responsible for starting the change in my area' and yes I can hear all the shouts and rapid fingers insulted that you haven't tried, that the RCN and NMC don't give whistle blowers safety etc etc Leadership isn't about better managers its about individual personal behaviour. Your choice.

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  • and leading from the bottom up as well as the bottom down?

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  • tinkerbell

    Catherine Cooley | 9-Aug-2011 12:47 pm

    Catherine, hear, hear. I will be the first follower, any ideas about how to go about it? All my emails to MP's, etc., get me nowhere but a reply to say they have been received.

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  • 'there just isn't enough time. To be told we do not show kindness and compassion is an insult'

    The statement was that it is needed - and that seems to be true. You agree but then state we don't have time. Perhaps these senior nurses are going to lead a fightback... If so I applaud them.

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  • tinkerbell | 9-Aug-2011 2:49 pm

    and my MP Anne Milton is a nurse!

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  • Hi Tinkerbell....thank you for joining me in giving your real name!! Magic wand would be useful if you have one. The reality is we need to look at our own area of practice and decide what we can do to make that small area the best it can be. The silly comments about responding to 'kindness and compassion' need to remember that the public watch the media and respond to them. We need a campaign to show the media the fantastic work that actually goes on....but would it sell papers??
    Todays appalling riots are fueled by a media who loves to show pictures of yobs jumping on police cars...what fun! for goodness sake...if people want to fight and riot they could join the real men fighting for freedom and justice in other countries....I digress!
    Let us try very hard to have some small way today of doing one thing that makes us feel proud to be a nurse...look at #riotcleanup they make me proud!

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  • The idea of having nurses who are now managers in uniform on the ward should be a must. Being aware is different from being in it. Nurses have extended their practice and taken on so many of the roles that were once the domain of the JHO and SHO that that managing that all important 'time' with the patient and their families is becoming more and more difficult.

    First step should be protecting the role of the SCN. Too much time is spent covering shifts preventing them from being visible and accessible for staff, patients and families. Speculate to accumulate the trust and confidence that is being lost

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  • All these comments are valid but as usual nurses are bickering about it and blaming one another for the problem - we need to stand as one and be a united front - i believe most nurses are caring and treat our patients and their families with compassion and kindness - like so many have stated already there are time constraints which i have for many years complained to management about - when met with clinical team managers in nhs tayside and their answer is to shut up stop complaining and get on with the job because if you dont you are seeing as not providing care! its been frustrating but unless changes happen at the top (reducing the amount of managers and pen pushers - allowing for more nurses on the floor) things cant change - every interaction i have with patients and their families is always one that i offer a listening ear, i am kind compassionate and caring BUT it is for a tiny amount of time that is due to staffing - NOT because i am not a good nurse. Support of NMC and RCN are needed here to make a plan to make a change.

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  • tinkerbell

    Catherine Cooley | 9-Aug-2011 3:30 pm

    Did seriously think twice about providing my real name. Unfortunately that might inhibit my comments and lead to them becoming very bland and generalised. Of course we are all hopefully trying to clean up our own backyards and make our units the best they can be to provide good patient care It matters not what your name or mine is if that's as far as we are going to take it. We need the unions and the NMC to give our voices media coverage and stop nurses being dismissed at every level in any consultation. Whether we post under our real names or anonomously is our choice too. Would be nice to have a magic wand though.

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  • I agree Tinkerbell, there is little difference in using a pseudonym or 'Anonymous' and if NT provides this opportunity there is nothing at all wrong with using it and one should not be judged for doing so. The only difficulty I can see with it is sometimes if debates get long, involved and sometimes heated it could be helpful to know who is who, and one sometimes gets caught in the crossfire with a resultant barrage of insults sometimes intended for another! However, it is also useful, as you say, to have this freedom to make comments one may not otherwise think safe or appropriate to make! I have toyed with the security of using a pseudonym to avoid such confusion as it should also offer the same degree of anonymity and protection, but I am never 100% convinced of this.

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  • tinkerbell

    don't we have to sign up with NT with our real names to comment with either anonymous or pseudo name anyway. Think they already have my real name. Isn't it just a safety measure NT provides us with to stop the NMC bashing on our doors for something they might deem 'unprofessional'. If it weren't for anoymous cover NT wouldn't get as many posts as they do and this site would be pretty dead.

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  • very true. as far as signing up i can't remember whether we had to give a name or whether, as with some websites, it was just an email address.

    No matter now, however, i am convinced that anybody who wishes to know you are or wants to find out anything about you can do so and I prefer to be cautious.

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  • Who the hell does this pompous fool think he is? It is NOT Nurses who need to take responsibility for failing standards of care, it is the managers and the executives and government itself who are responsible for forcing us to work in substandard conditions, with unsafe and dangerous staffing levels! NURSES ARE NOT RESPONSIBLE FOR THAT!!!! It is about damn time the MANAGERS are held to account for this!!!

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  • tinkerbell

    Coping is not the same as caring. Give us the tools and we'll do the job. It's not rocket science. We don't need layers upon layers of managers, we need more staff on the shop floor. It always amazes me how much this is highlighted when i work a weekend without any management, apart from myself at my lowly level and we still manage to keep the boat afloat until monday when all the managers come back. No one ever asks from upper management 'how the hell did you manage without us?' There would only be any serious interest if something had gone horribly wrong. On the rare occasions when i have needed to contact a manager on call at the weekend i have often been told 'just do the best you can'. Well why didn't i think of that. Nice work if you can get it. I once went in for an early shift, no one turned up for the late, so i did that, then no one turned up for the night shift so i did that as well. There was not one manager prepared to come out and relieve me. Eventually managed to get home 24 hours later. Got a lovely letter saying how great i was for being such a trooper. Had to take the time back as time owing as they weren't going to pay me any overtime. Still think i'm owed a few hours for that particular panto though have never fully taken them back as they all get lost in the mist of time. I understand we now have a 'compliments department'. So if any relative pays us a compliment we have to cringingly ask them if they wouldn't mind putting it in writing so that we can 'evidence' the good care we are providing. Then when the letter comes in, we have to block out all the names so that we end up with nothing but the compliment and send it off to the 'compliments department'. (think the address is la la land). I understand the bit about confidentiality etc., but might as well just bang off a few letters myself at home and send in a truck load. No-one would know any different. What's the ******* point!

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  • tinkerbell | 10-Aug-2011 0:34 am

    do you remember the trust, I think it was in Cornwall, mentioned in the national newspapers where nurses had to record the boxes of chocolates they received with the size and estimate of the cost?

    I think there must have been a mode at that time to record tokens of appreciation of nurses. makes one wonder how managers with a serious job to do find the time for such unspeakable trivialities and childish games!

    as for managers who are paid for on call at the weekend just telling a senior nurse to do their best really does rather give the impression that they have no sense of responsibility and are rather superfluous. if they were replaced with front line staff how many could be engaged for the cost of their salary.

    How much longer is it going to take for the NHS and government to realise that patient care requires more front line staff rather than too many beings sitting in offices playing tiddlywinks 9 to 5, 5 days a week and how many more patients are going to suffer while these beings are still trying to work out this very simple fact?

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  • Although I may agree that staffing levels and added pressures have contributed to a changed climate on the wards I feel the biggest contributor to a lack of compassion and dignity for patients is the attitudes and treatment of staff by management. When staff are not treated with dignity and respect by management it takes a lot to continually go out on the ward and block that out. Perhaps this is a bad comparison but, if you treat a dog badly long enough (despite how loving and docile he/she was before) the dog in time becomes a completely different animal. Likewise if nurses are constantly badgered, conjoled, threatened and made to work longer hours with fewer and fewer resources the nurses become unhappy creatures. As professionals we try to put the nonsense and stressors behind us but I firmly believe compassion and respect for patients would greatly improve if it started from the top with how management treat staff. If you are treated with kindness and respect and not bullying tactics I feel it would naturally flow over to patient care.

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  • Patrice Wheeler | 10-Aug-2011 10:07 am

    does the bullying initiate from managers who are not trained professionals and have little understanding of the job and expect the impossible? Bullying and poor attitude can be pernicious, starting at the top and filtering right down the system before it becomes ingrained and its effects fully felt by which time it becomes very hard to diagnose and treat!

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