Analysis
Fatigue A study of US nurses working 12-hour shifts, published in Chronobiology International in August 2012, found that nurses accrue a considerable sleep debt while working successive 12-hour shifts with accompanying fatigue and sleepiness. Dickon Weir-Hughes, independent consultant and former chief executive of the Nursing and Midwifery Council (NMC) and chief nurse of the Royal Marsden Hospital, London, says. ‘This is a fantastic study but the results are hardly a surprise. It was my personal experience of working unplanned double shifts in the 1980s and knowing how it negatively impacted my clinical performance that influenced me to resist and cease 12-hour shifts in organisations in which I worked as a director of nursing. ‘However, the sobering element for me was that it wasn’t the board who resisted my attempts, but a large number of nurses who wanted to work 12-to-13-hour shifts three times a week because it was more convenient for them and their home lives. ‘Sadly, the patient was never mentioned in those discussions. Given the evidence now before us, this is a serious professional and regulatory issue and it would be important for key players in these areas such as the Care Quality Commission, NMC, chief nursing officers and the RCN to come together and agree what should be done. This work must not be ignored.’
Chief nursing officer for Scotland leaves a legacy of improvement Ros Moore to step down after four years amid praise for her work in infection control and mental health, writes Beena Nadeem AFTER FOUR years in post, chief nursing officer (CNO) for Scotland Ros Moore is stepping down. Ms Moore, who leaves the job at the end of this year, has been credited with making significant improvements in the fields of nursing and midwifery. She has been praised for leading work in preventing healthcare-associated infections, namely slashing the rates of Clostridium difficile infection in patients more than 65 years old by 85% since 2007. It was also in this role that she established a review of nursing and midwifery education in Scotland, leading to the Setting the Direction strategy, published in February this year. This review spelled out the vision that by 2020 people are likely to live longer and healthier lives in their homes or within a home setting. Much of it focused on what Ms Moore strived for: a more person-centred approach and giving patients more say over their own outcomes. One of her self-confessed proudest achievements was working stridently to improve services for people with mental Mike Wilkinson
factor was a financial one and we all knew that quality of care and continuity would be affected,’ she says. ‘There was little resistance from the workforce, however, as you work 13 shifts in a four-week rota, which frees up valuable personal time.’ While the RN4CAST study did not look at what exactly causes the reported decline in patient safety and quality of care with long shifts, the researchers suggest that fatigue leads to loss of alertness, an increase in the number of errors and loss of efficiency.
Erin Dean is a freelance journalist
Find out more Read the report at tinyurl.com/mu4oe7l NURSING MANAGEMENT
Strong leader: Ros Moore hopes to retire from the sector
health problems. ‘I have taken pride in leading improvements in the care of people with dementia and their families in hospitals,’ she says. ‘I have been proud to lead the work of the Care, Support and Rights team, who are working on vital issues such as patients’ rights and participation, autism, carers and learning disabilities.’ She also described her work on learning disability practice, culminating in the review, Strengthening the Commitment, as another important career achievement. The UK-wide review was published in 2012, with 17 recommendations, which, she says, has ‘done much to raise the profile of disability nursing across the UK’. According to director of RCN Scotland Theresa Fyffe, Ms Moore has set her ‘own agenda, fronting important work on nursing pre-registration education and professionalism in nursing that will continue to shape nursing in Scotland for the foreseeable future’. New programme For now, Ms Moore, who hopes to retire from the sector, says she would welcome the next chief nurse to take up a new programme of work. ‘Taking the decision to step down was a hard one, as I have really enjoyed the role,’ she says. ‘But the time is right for me to move on and for a new CNO to be in place to take forward the profession over the coming years.’ Chair of Scottish Executive Nurse Directors Fiona McQueen says: ‘Ros was able to make a genuine connection with nurses on the front line. She wanted to understand what the problems are to help make sure that policy really did have a practical application.’ According to RCN general secretary Peter Carter, Ms Moore has developed a strong working relationship with the college during her time as CNO. He says: ‘This was underlined by her willingness to regularly attend our annual congress and talk openly to our members about nursing issues in Scotland, in a manner that is unusual for someone in that position. Her influence will be missed.’ Beena Nadeem is a freelance journalist November 2014 | Volume 21 | Number 7
Downloaded from RCNi.com by ${individualUser.displayName} on Jul 17, 2016. For personal use only. No other uses without permission. Copyright © 2016 RCNi Ltd. All rights reserved.
9
Fatigue A study of US nurses working 12-hour shifts, published in Chronobiology International in August 2012, found that nurses accrue a considerable sleep debt while working successive 12-hour shifts with accompanying fatigue and sleepiness. Dickon Weir-Hughes, independent consultant and former chief executive of the Nursing and Midwifery Council (NMC) and chief nurse of the Royal Marsden Hospital, London, says. ‘This is a fantastic study but the results are hardly a surprise. It was my personal experience of working unplanned double shifts in the 1980s and knowing how it negatively impacted my clinical performance that influenced me to resist and cease 12-hour shifts in organisations in which I worked as a director of nursing. ‘However, the sobering element for me was that it wasn’t the board who resisted my attempts, but a large number of nurses who wanted to work 12-to-13-hour shifts three times a week because it was more convenient for them and their home lives. ‘Sadly, the patient was never mentioned in those discussions. Given the evidence now before us, this is a serious professional and regulatory issue and it would be important for key players in these areas such as the Care Quality Commission, NMC, chief nursing officers and the RCN to come together and agree what should be done. This work must not be ignored.’
Chief nursing officer for Scotland leaves a legacy of improvement Ros Moore to step down after four years amid praise for her work in infection control and mental health, writes Beena Nadeem AFTER FOUR years in post, chief nursing officer (CNO) for Scotland Ros Moore is stepping down. Ms Moore, who leaves the job at the end of this year, has been credited with making significant improvements in the fields of nursing and midwifery. She has been praised for leading work in preventing healthcare-associated infections, namely slashing the rates of Clostridium difficile infection in patients more than 65 years old by 85% since 2007. It was also in this role that she established a review of nursing and midwifery education in Scotland, leading to the Setting the Direction strategy, published in February this year. This review spelled out the vision that by 2020 people are likely to live longer and healthier lives in their homes or within a home setting. Much of it focused on what Ms Moore strived for: a more person-centred approach and giving patients more say over their own outcomes. One of her self-confessed proudest achievements was working stridently to improve services for people with mental Mike Wilkinson
factor was a financial one and we all knew that quality of care and continuity would be affected,’ she says. ‘There was little resistance from the workforce, however, as you work 13 shifts in a four-week rota, which frees up valuable personal time.’ While the RN4CAST study did not look at what exactly causes the reported decline in patient safety and quality of care with long shifts, the researchers suggest that fatigue leads to loss of alertness, an increase in the number of errors and loss of efficiency.
Erin Dean is a freelance journalist
Find out more Read the report at tinyurl.com/mu4oe7l NURSING MANAGEMENT
Strong leader: Ros Moore hopes to retire from the sector
health problems. ‘I have taken pride in leading improvements in the care of people with dementia and their families in hospitals,’ she says. ‘I have been proud to lead the work of the Care, Support and Rights team, who are working on vital issues such as patients’ rights and participation, autism, carers and learning disabilities.’ She also described her work on learning disability practice, culminating in the review, Strengthening the Commitment, as another important career achievement. The UK-wide review was published in 2012, with 17 recommendations, which, she says, has ‘done much to raise the profile of disability nursing across the UK’. According to director of RCN Scotland Theresa Fyffe, Ms Moore has set her ‘own agenda, fronting important work on nursing pre-registration education and professionalism in nursing that will continue to shape nursing in Scotland for the foreseeable future’. New programme For now, Ms Moore, who hopes to retire from the sector, says she would welcome the next chief nurse to take up a new programme of work. ‘Taking the decision to step down was a hard one, as I have really enjoyed the role,’ she says. ‘But the time is right for me to move on and for a new CNO to be in place to take forward the profession over the coming years.’ Chair of Scottish Executive Nurse Directors Fiona McQueen says: ‘Ros was able to make a genuine connection with nurses on the front line. She wanted to understand what the problems are to help make sure that policy really did have a practical application.’ According to RCN general secretary Peter Carter, Ms Moore has developed a strong working relationship with the college during her time as CNO. He says: ‘This was underlined by her willingness to regularly attend our annual congress and talk openly to our members about nursing issues in Scotland, in a manner that is unusual for someone in that position. Her influence will be missed.’ Beena Nadeem is a freelance journalist November 2014 | Volume 21 | Number 7
Downloaded from RCNi.com by ${individualUser.displayName} on Jul 17, 2016. For personal use only. No other uses without permission. Copyright © 2016 RCNi Ltd. All rights reserved.
9
