Nurses
lack support not compassion
Ministers and nurses clash over how to prevent a repeat of the Mid-Staffordshire scandal that led to 1,200 deaths .
Described as “ appalling and unnecessary suffering of hundreds of people ” by Robert Francis QC , the Stafford hospital inquiry listed failures at every level of the NHS . Reports of “ corporate bullying ” and “ insidious negative culture ” point to deep-seated problems that many who work in the National Health Service will sadly recognise . The result was unusually high mortality rates and shocking neglect with patients left lying in their own urine , or forced to drink from flower pots because no one gave them water .
As a former nurse who now represents patients injured by negligence , this is the worst case of widespread neglect I or my colleagues have ever come across . But it would be wrong to say the problems at its heart are entirely unique to the Mid-Staffordshire NHS Foundation . Research released by Unison in April found frontline NHS workers are so busy that they often don ’ t have time to help patients eat or drink , explain treatments or keep proper records . While the union has an interest in highlighting bad working conditions , I find it hard to believe there is no link between neglect and the loss of 2,000 nurses since 2010 .
Many of the Francis report ’ s recommendations are positive steps with the power to make fundamental improvements , but the tone of the Government ’ s response concerns me . While several good recommendations are being adopted , much focus has been put on training nurses to be more compassionate . With Jeremy Hunt now accusing the Royal College of Nursing of having “ missed what happened at Mid Staffs ”, the proposals are starting to look like an attempt to shift the blame onto nurses , rather than something capable of improving conditions on under-staffed wards .
All of us want to be looked after in a compassionate way when we are ill , but in my experience student nurses already have compassion . Low wages and exhausting shifts hold little attraction unless you ’ re passionate about looking after people . The real issue is what leads someone who is motivated by kindness to treat a patient with neglect .
Being exhausted , under-valued and under-supported with a staggeringly high ratio of patients to staff can make it difficult to provide the care that the public is entitled to . I found myself agreeing with Nursing Times editor Jenni Middleton when she wrote “ no amount of training can enable a nurse to be able to take two patients to the toilets at once , while feeding another , and helping someone else to have a drink . While another patient calls out for pain relief .”
The want of anything close to compassion evident in some of the cases at Stafford Hospital was truly shocking . Perhaps politicians had to create a headline-grabbing policy to address this but it can only work if the root causes are tackled .
One of the risks with the plans to instil compassion is that they may deter people capable of becoming wonderful nurses . Spending a year working as a healthcare assistant before beginning nursing training should , in theory , be a good way of understanding the caring role of frontline staff . Yet to be effective those who wash , clothe and feed patients must all be shown more respect . Experienced nurses must lead by example , which will only happen if time is freed up and they are supported themselves .
One thing with the power to spark real change is the duty of candour recommended by Mr Francis . This would legally require staff to tell patients when a mistake is made . Being honest with families upfront would allow lessons to be learned faster and drive up standards . In Staffordshire , trust management ignored patients ’ complaints while local GPs and MPs failed to speak up . If the very first complaints had been taken seriously a great deal of pain might have been avoided .
While Jeremy Hunt says legal duty of candour will apply to providers , it is not being extended to individuals . I wonder how trusts can be entirely candid when healthcare professionals don ’ t have to be . Yet even at trust level duty of candour may help foster a more open culture , which can only be a good thing . It has the potential to transform the way complaints are dealt with and reduce legal claims , as many patients simply want to see their concerns properly addressed .
The Secretary of State for Health says he wants the Francis report to become a “ catalyst for change ” not a byword for failure ”. It ’ s a bold ambition and duty of candour can only help , yet minimum staffing , communication , supervision and proper support are all essential . Clearly finances are tight , but austerity is no excuse for ignoring the correlation between understaffing and neglect .
By Katy Meade
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