Seldom Heard Voices

August 27th, 2009

Patients would like greater involvement and a stronger sense of partnership with their nurse or midwife, a recent Commission workshop held in London learned.

The Commission wanted to hear everyone’s views about the future of nursing and midwifery. It held a Seldom Heard Voices workshop on 14 August to hear the views of individuals and communities whose views are often insufficiently represented in the development of services.

It is especially important for the Commission to listen to and understand the needs of these individuals and communities since many of them are most in need of nursing and midwifery care.

The workshop was attended by people with Alzheimer’s, older people, mental health service users, people from rural communities, different faith and minority groups, people with physical disabilities and those who, for cultural reasons, find their voices are often not heard.

The smaller group size of the workshop enabled all delegates to be comfortable expressing themselves and being heard.

Common themes that emerged were the need for nurses and midwives to show greater compassion and cultural sensitivity, to be more open when responding to questions from patients, to treat people holistically, and to enable patients to have greater involvement in their own treatment.

The Commission feels it is important to hear from as many individuals as possible to gather first-hand experiences but it also has received submissions from many organisations that speak on behalf of seldom-heard communities.

Image of nursing doesn’t reflect reality

August 26th, 2009

The public image of nursing fails to reflect the reality and should be updated, according to nurses at a leading West London hospital.

They also told Commission chair Ann Keen, on her recent visit to West Middlesex University Hospital, Isleworth, about the barriers to good practice. These included failure by some medical colleagues to recognise their advanced skills, such as prescribing.

The hospital’s director of nursing and midwifery, Yvonne Franks, convened a group of nursing clinicians and students in practice, management and education to exchange views with Ann about the future of the profession. A wide-ranging discussion covered the challenges facing nurses who wish to return to practice, and the implications of the transition to degree-level registration of all newly qualified nurses in England.

The group said nurses and doctors should be more closely involved in each other’s training, to help create better teamwork and promote mutual understanding of their roles.

Ann also visited the hospital’s operating department and heard theatre matron Janet Henry describe its success in implementing the Productive Theatre initiative – leading to improvements in patient safety, quality of care and cost-effectiveness.

The West Middlesex is in Ann’s parliamentary constituency of Brentford and Isleworth, and she worked there in the 1980s and early 1990s in nursing education. The trust’s chief executive, Dame Jacqueline Docherty, also has a background in nursing, and was previously executive director of nursing at King’s College Hospital NHS Foundation Trust, London.

Visiting Great Yarmouth nurses

August 26th, 2009

Ann Keen MP

Ann Keen MP, Commission Chair, writes:

On Thursday 4 August I had the pleasure of speaking to nurses working out of Northgate Hospital in Great Yarmouth. They showed me the great work they are doing in a range of areas, including sexual health, breastfeeding clinics and admission prevention.

I was deeply impressed by the innovation and commitment to improving services that they showed. What particularly struck me was how these nurses had been able to take control of services that they deliver and take them to the next level. This not only benefitted patients, but also the nurses themselves in the improved job satisfaction that they gained.

These initiatives are directly linked to the culture created locally by managers who were brave enough to give the nurses the support they needed to allow the free-thinking and managed risk-taking required to nurture innovation.

The feedback and suggestions I received on the future of nursing and midwifery were greatly appreciated. These were fed into the information-gathering stage of the Commission’s work. So, a big thank you to Amanda Cousins and her team for their work and hospitality!

US Initiative on the Future of Nursing

August 26th, 2009

Nursing in the United States is facing a crisis that, left unaddressed, will severely hinder health care reform efforts, says a new initiative on the future of American nursing.

In a move that in many ways echoes the Prime Minister’s Commission, the US Initiative on the Future of Nursing (IFN) was launched on July 14. It is supported by the Robert Wood Johnson Foundation – a leading philanthropic organization in the US – and hosted by the prestigious Institute of Medicine in Washington DC.

‘There simply are not enough nurses,’ says IFN committee chair Donna Shalala, former US Secretary for Health and Human Services. The shortage could reach at least half a million by 2025, as the population ages and the need for long-term care and chronic disease management increases.

The initiative will work over the next year to develop a blueprint for action, and identify how nurses can contribute to the design and implementation of health reform.

Dr Shalala says the workforce crisis requires swift and bold action to fix ongoing problems: insufficient faculty to educate the next generation of nurses, curricula that fail to address 21st-century clinical practice, and regulatory and reimbursement constraints that prevent the health care system from using nurses as effectively as possible. 

IFN has set out a ‘nursing prescription’ to guide President Obama and Congress as they seek to transform the US health system. It advocates policies to advance access, quality, prevention and cost reduction.

The PM’s Commission regularly shares ideas and experiences with the IFN, whose next meeting opens on September 14 with an open web cast session. Ann Keen, our Commission chair, has been invited to participate and you can hear the debate on the Internet.

Learn more about the IFN.

Valuing staff

August 17th, 2009

heather_lawrence-150x150Commissioner Heather Lawrence trained as a nurse before moving into nurse education, HR Management and running healthcare services. Since May 2000, she has been CEO at Chelsea and Westminster Healthcare NHS Trust, a London Teaching Hospital. The lessons learned during nurse training have influenced every aspect of her career:

Do your staff feel valued? As importantly, do you feel valued? We all want to feel valued and it is easy to achieve this if we remember some simple rules of personal behaviour and, of course, create an environment where this is possible.

For me, valuing staff starts with the recruitment process. Selection should be a two-way process – while we want to select the best candidates, the best candidates must also feel that they selected us. The next priority is induction and local orientation, followed by annual appraisal and PDPs. A question that I ask managers at interview is “how many of your staff know you?”

I am always asked how I know so many members of staff. It is quite simple. I believe it is important to be approachable, to say hello to people and to ask how they are. They nearly always tell you something interesting or useful. Effective two-way communication will also help staff feel valued.

A monthly team brief followed by a face-to-face cascade system, a daily news bulletin and a monthly newsletter all help. Individual staff members and teams can also be recognised through employee and team of the month awards.

When patients write to express their gratitude to a staff member, ward or department, I write to each member of staff to thank them – it is important to recognise the positive as well as the negative feedback.

In clinical areas where there is clear leadership, teamwork, good communication and face-to-face meetings – rather than relying on e-mail – staff feel more valued. Each of us can play our part by just asking people how they are and using those two simple words: ‘thank you’.

As we move into a period of less growth and higher cost improvement targets, it is essential that we have transparency with staff concerning the issues we face and that we work together to ensure all staff feel valued, even when we are asking for more productivity and more efficiency. If we do not, then patient care will suffer and staff will feel less valued.

Space-age learning

August 13th, 2009

Commissioners Audrey Emerton, Jane Salvage and Sue Bernhauser at the University of Huddersfield

Space-age approaches to nursing and midwifery education was the theme of a recent fact-finding Commission visit to a Yorkshire university.

Commissioner Audrey Emerton and support office joint lead Jane Salvage watched student nurses and midwives learning how to improve their care of patients in a clinical skills laboratory at the University of Huddersfield. Instead of practising on live people, the students work with lifelike manikins or models that simulate health problems such as a heart attack.

As they spring into action, the students quickly forget they are working with a dummy, and act as they would in real life. The manikin responds instantly to their interventions – leading to death or recovery! Innovative, sophisticated technology makes the manikins mimic real physiological responses. The students then review the whole episode with their tutor, and think about what worked and what they could have done differently.

This is just one of many methods used to help students learn how to practise safely and effectively, said Commissioner Sue Bernhauser, the university’s dean of human and health sciences. She and Lady Emerton also discussed the Commission’s work with lecturers and health service managers.