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


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.”


Readers' comments (27)

  • the NHS has one common goal and that is patients. why isn't everybody working together to achieve this goal? why are healthcare professionals not being provided with adequate resources to carry out their work effectively instead of being actively hindered by management who are constantly putting tangible and intangible obstacles in their way? why do managers not understand their role as support staff to healthcare professionals instead of creating a 'them us' divide which is becoming more and more destructive to the efficient running of the organisations and highly detrimental to patient care and sometimes a significant danger to the safety and well being of patients? why are the unable to listen to and take advice from the experts in their fields which is what management is all about?

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  • For 10 years I resisted, as a Chief Nursing Officer, constant demands for me to reduce the resource used by the Nursing Service.

    That is not to say that no changes where made in the manner in which care was delivered.

    Many changes were made during my tenure. However, any "savings" made where reinvested in the Nursing Service in order to address historic weaknesses.

    I was fortunate in having a Health Authority who were very supportive and the then General Manager and the Treasurer knew they would lose any attempt to publicly challenge my management of the Nursing Service.

    However, once the NHS Trust concept was implemented the Trust Chairman , CNO and Treasurer lost no time in making my post redundant under the guise of a "management reorganisation"

    In my view there are now few if any senior nurses who are prepared to defend their profession. Witness the constant dilution of skill mix and the appalling patient/staff ratios.

    These "Senior Nurses" who have abandoned the profession need bringing to account, many of them are in breach of their professional code of practise.

    This can be done - gather your evidence and present it to the NMC these people need removing from the register .

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  • JRT | 11-Aug-2011 8:31 am

    this looks like a very positive and constructive start, that is, unless it ends by merely banging heads against the NMC walls or befalling the same fate as whistleblowing. How many senior nurses sitting in offices, on board meetings or running around with clipboards all day still fulfill the NMC criteria for registration and those of their ethical code of conduct.

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  • If management ever bothered to carry out time and motion studies they would see that nurses are in fact doing much much more than should be expected of any human being and that they are doing it with a compassion and care for their patients that is above and beyond what could be expected in the circumstances. Why do people expect nurses to have a bottomless well of compassion and kindness when none is shown to us? Do they think that once we put our uniforms on, or our name badges on that we become sort sort super human, capable of working non stop without ever feeling tired or upset about what we are seeing and hearing and doing? It is this very attitude that is the root of the problem. The put up and shut up attitude. If we are treated like less than human it follows that we will start to act that way.
    The hierarchical system that has always existed in nursing is also to blame for the culture that exists within nursing, that of fearing to stand up to our "superiors" that of subjugation, that of fear of reprisals should we dare to speak out against our colleagues. To change nursing into the ideal that it should (and could be) the system within which we are forced to work has to change first.

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  • nursing was always excellent at managing itself
    until the government chipped in and brought in general management to the NHS.

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  • Its not difficult -------maybe you all will have to stop moaning and become more objective.

    Fill out your "untoward incident forms", be objective not emotive --------- detail patient /staff ratios and skill mix etc..

    Then send the forms to the most seni nurse in your organization and make sure you keep copies.

    If nothing changes get your staff representative to communicate with your most senior nurse saying that unless changes are made a charge will be laid against the individual with the NMC. The NMC WILL assist you in making out the charge.

    As individuals you must find the courage to come together as a team and fight for your profession and your patients.

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  • To JRT 11 August. I presume that you speak from experience?

    It is easy for managers to intimidate nurses whereas it is much harder for nurses to put the boot on the other foot and accuse a manger of wrongdoing. I know because I speak from experience. I am not a meak and mild young nurse. I am assertive, I have much life experience and yet I did not complain against what was effectively bullying from my then manager. Why? Because I was too busy getting on with my job! Also I thought I could handle the situation. I was wrong. And talking of teams, my then colleague did nothing to support me but was happy to use the situation to her own advantage. She always said yes to everything the manager wanted, as she was afraid of being made redundant.

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