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OPINION

Back our fight to get nurses onto boards

  • 14 Comments

This week we are proud to launch the Nursing Times A Seat on the Board campaign.

Back our fight to get nurses onto boardsOur goal is to ensure that the organisations involved in advising GP commissioning consortia recommend that at least one nurse is included on each consortium board to shape decisions about the procurement and provision of healthcare services.

Nurses are involved in a vast proportion of direct patient care so they have a unique perspective on the NHS. This insight means they must be involved in decisions about the services consortia offer to make sure the health service runs efficiently and effectively.

As the major providers of hands-on care in the health service, nurses know what patients and their families need. They understand all the social, environmental and financial factors that impact on them and what will offer the best outcomes.

Nurses are on the front line, and see what patients require and what is missing from the care pathway. A couple of months ago I was lucky enough to attend the Queen’s Nursing Institute’s Fund for Innovation awards, which celebrate nurses and their ability to spot gaps in healthcare provision. It is nurses who have ensured, for example, that patients in Warwickshire can use services by teaching them health related right vocabulary, and it is nurses who piloted a programme to improve the mental health of older men in Barking and Dagenham at risk of social isolation, depression and suicide.

The aim of our campaign is to ensure all those bodies that have started issuing guidelines to commissioning consortia – namely the British Medical Association, Royal College of GPs, NHS Alliance and the National Association of Primary Care Trusts – give clear instructions that there must be at least one nurse on every consortium board.

Nurses have previously been disenfranchised from commissioning, which is a shame because they have much to contribute. Failure to involve them would seriously affect patients’ experience. So sign our petition at www.nursingtimes.net/seatontheboard and make sure that nurses’ voices are heard and patients are given the best care.

  • 14 Comments

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Readers' comments (14)

  • It doesn't matter about whether any nurses have any seats on certain boards. What matters is WHO sits on these boards.

    It is more or less a given that such nurses have adopted a 'thrilled to be invited, better not rock the boat' stance to their attendance or have been so soft, pliable and weak that our voice has not been heard.

    The problem ultimately lies in two areas regarding our status, renumeration and influence.

    1. Out of the 88% of nurses that are women, many if not most will become mothers, wives etc and rightly so family comes first - but the apathy in improving the career prospects for us all suffer. Countlesss senior nurses at my own hospital display utter contempt for any real action/protests/petitions that might have an effect.
    Obviously the majority of nurses have no real interest, if they did; where's the evidence????
    2. It doesn't help that we want to constantly appeal to the vanity and weak demands of the public. they are not interested in the truth or the fact that inactivity not nutrition or lack of attention that causes things like pressure ulcers or the fact that malnutrtion in the elderly is entirely their choice and by the time we get them it is at the end of the road not the beginning, nor that we can't force feed them.

    It's not really about the time to deliver basic care. that's just guff to me because basic care is not nursing by any means.

    However our leaders constantly apologize for things that are out of our control and vowing to improve things for free usually with more paperwork and no money.

    I work in a dump of a hospital with a dire reputation. We have endless numbers of nurses who carry clipboards and agree to force me to transfer patients here and there because they closed ward after ward. But no senior nurses did anything to protest, they merely continued in the time old tradition of curtseying and thinking somebody else would do the thinking for them whilst they feathered their nests.

    Don't ever forget that many of you capitulated to this by a total lack of action, protest or even outwardly expressed disapproval.




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  • Absolutely agree with JJez, what we need is far less of the 'Dame' Christine Beasleys of our profession sitting on these boards, and far more REAL leaders, Clinical Nurses who are passionate about the profession and who will fight for it. Who will DEMAND to be heard, DEMAND better pay, better status and better working conditions, and unite the profession into a strong, cohesive whole. Only then will we be able to truly use our professional power and influence in our role as patient advocates.
    We need to make sure that those Nurses who do sit on these boards don't simply become more nodding dogs to the so called 'superiors' that surround them.

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  • I agree in principle with Jjjez comments, though I work at the other end in primary care. In my observation, quite a number of practice nurses are motivated but various attempts to stand up for better services, conditions etc is just blanked by many of the GPs who employ them.

    It is alright say speak up, but I have been dismissed twice, when employed less than the statutory 12mths for just suggesting change, being seen to make waves, and with a mortgage and children to support it isn't that easy to keep being proactive.

    In my view I need some structure and support via the Government to force some GPs to be fair, yet what do we see?
    We see the Government giving the medical professional even more power to abuse.

    OK, not all GPs are that bad, but in my experience since 1999 NONE in 8 practices have had all the tick boxes to both employ in a professional manner AND do the right thing by patient care. In my present job (the best of a bad bunch) I am even excluded from practice meetings and not told about plans for the practice so how on Earth can I expect to get a seat on a Board?

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  • Anonymous | 9-Dec-2010 5:22 pm I know exactly what you mean, but I have to say it isn't just GP's. Managers from everywhere from care homes to hospitals, primary or secondary are exactly the same. Good at dishing out rhetoric but completely ignorant when it comes to actually letting us change practice. Don't give up though. At least you can turn round and say we are trying at the end of the day, even though we can both understand why so many give up.

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  • Anonymous | 9-Dec-2010 5:22 pm

    Do you not think it would make more sense to keep your head down and not rock the boat until you have been employed for more than the statutory 12 months. Once established you may then have a better chance of making changes.

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  • When Nurses become managers they try to meet the needs of managers - not nursing, the more senior they get, the worse it gets. I have had a clinical specialist position and I wasn't dismissed but it was clear no one wanted to listen to what was actually happening and no one mined massaging the truth. I guess those nurses just have an eye on their jobs and pensions, but largely they have lost perspective.

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  • Anonymous | 10-Dec-2010 2:44 pm, no you are absolutely wrong I'm afraid. Keep your head down, don't rock the boat, unfortunately that is the mantra of too many nurses! Bad practice is bad practice, wrong is wrong, and it is our duty to speak up against this regardless of wether it is day 1, year 1 or year 33 in the job.

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  • sjeffery@fmail.co.uk

    There are too few nurses rocking boats. The medical profession continues to dominate the political spectrum and there are dozens of doctor dominated pressure groups and regular joint letters to main stream press, yet very little from nursing.

    It is time for nurses to speak out.

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  • Exactly sjeffery! You don't see the government going after Doctors for job or pay cuts, and that is just because they are so vocal and therefore more powerful. The government knows they wouldn't stand a chance!

    Nurses in comparison are all too ready to bend over and take it. Can you imagine the power we would wield as a profession if we were as vocal and ready to take action as the Doctors are?

    Joint letters to the press? Hmm, that's a good idea actually? Anyone else a bit higher up the band system than me (or not as the case may be) care to join me in sending off a few to the broadsheets?

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  • Practice Nurses are out on their own and unfortunately have little managerial role within GP surgeries - but this is the design that was created. Nothing has gone wrong per se - moreso that this is the design they chose and they WANTED the Gp to have all the power.
    In this case it will take more than that. But yu can't simply fire a person for no reason. It's up to individuals to take the matter to industrial tribunals.
    Merely accepting defeat simply because you were trying to improve things is likely to work out in your favour rather than the GP's but it takes book smarts, moxy and less whimpering nun antics. You've got to be strong and stop constantly demoting yourself in your head.

    I accept in the community things are different and it is a black hole. But nurses are going to have to build up their own contacts and fight the battle on their own - there is NO-ONE WHO IS GOING TO DO THE THINKING OR HARD WORK FOR YOU!!!
    (it's in capitals because i want to emphasize that you are on our own)

    Meanwhile back in acute care, yes we do have a huge problem with managers that are unseen and unknown by staff making bizarre and unwholesome decisions they are often clueless about, but first let's think carefull about what it is to have this job

    A health service manager has objectives and their only function is to meet these objectives. It is not really for them to care, show concern or even be informed of the net result of what their objectives are, they must merely achieve them.
    In their career this is the crux of successful management - so yes! It does mean that they have no integrity that we can understand - but amongst themselves they have it in spades!!!!

    Unfortunately they aren't going to go away. We are stuck with them (thanks to everyone who thought the Conservatives were great in the 80's and 90's, obviously Labour thought they were so great, they copied their policies for another two terms!!).

    The most effeective way you can makje them aware of you is to always say (if you ever see them)

    'Who are you?' and 'I've never heard of you, how long have you been doing this job?'


    Lastly is the problem of being ignored which is of course one of the worst things about being a nurse - that everyone else thinks they're cleverer than you - though obviously they all do things to prove otherwise.

    Well sadly enough the rigid hierarchy beloved by nurses of yesteryear is the actual problem, followed on b the much self-quoted 'we can do it all' attitude some of the jolly motherly types like to portray.
    Those of you who have insisted you can cope with no staff, or not replaced new equipment or gone to Sisters meetings and contributed nothing are all to blame.
    Your silence and lack of interest is part of the reason why we're ignored - the forums you do get to speak in are silent because apparently at crunch time you all hav enothing to say.

    Nobody wants to complain as saving face seems more important than admitting that really the ward is at critical point, the staff are overworked and the machinery is half-working or dilapidated.

    So alot of the problems are self-inflicted for the following reasons.

    1. Nurses saving face/ staying silent/ apathy/reluctance to ever say anything

    2. Perpetuating certain nurse myths e.g. angels/nuns/lonely girls who have to spend time doing this before they get a husband

    3. Nurses assuming that they have a shared interest and goals with other health professionals (naive or what!?)

    4. Nurses effectively quashing their own spirited youngsters/passionate reformers with voices of disdain/apathy/ridicule/excuses whilst complaining endlessly

    5. Nursing and it's elite needlessly bending to the whims of others including patients rather than saying ugly/moral truths/ the correct way for patients to assert themselves. Nobody wants to comeo ff as a toal bitch by refusing to wash peoples feet, but love of god, they could try to do it first! I'm hardly giving them the car wash treatment myself - but it only takes a weeks worth of feet washing to find yourself pouring glasses of water form the table 0.2m away and lifting those 'heavy' blankets at the (2 mile distance) end of the bed.


    We all need to speak up, but it's more important to drop the petty squabbles about style and everything. After all the medical profession clearly isn't bothered with who is competent and who isnt. They have the good sense to ensure everyone sticks together regardless. This is what we need.

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