Letters
Send your views by email to [email protected], the letters editor @RogerEvansE1, post on the Nursing Standard Facebook page or visit www.nursing-standard.co.uk
Please keep letters to a maximum of 200 words, and include your full name and a daytime telephone number. Letters may be edited
Safe staffing levels will be achieved through legal mandate, not tool kits I admire Welsh Liberal Democrat leader Kirsty Williams for taking the initiative to submit a Safe Nurse Staffing Levels (Wales) Bill to the Health And Social Care Committee of the Welsh Assembly (News March 25). But it is a travesty that Welsh health minister Mark Drakeford, who opposes the bill in its current form, believes enforcing the use of an acuity tool that is being developed in Wales will achieve the same aims as the bill. Workforce tools such as The Safer Nursing Care Tool Kit should be used to determine safe staffing levels, but they are not a panacea and their use should not be mandated. Evidence shows that one nurse caring for more than eight patients is unsafe, so it was equally disappointing when health minister Dan Poulter disagreed to a safer staffing level of one nurse to seven patients when questioned on this recently in the House of Commons. The advice the ministers are being given by senior management and nurse leaders must be fundamentally flawed – they need to read the research from nursing academic Linda Aiken on flexibility with the use of ratios. Or is their reluctance to implement legislated staffing levels simply down to cost? If so, they are failing to recognise the national and international evidence that shows safe nurse staffing levels result in more cost-effective care and a stable, well-motivated workforce. We have a serious shortage of registered nurses in the UK. Unless we have safe staffing levels to ensure safe practice across the whole of the NHS, nurses will continue to leave the profession and students will not apply for nursing courses because they won’t want to flout the Nursing and
Midwifery Council Code of Conduct and compromise their registration. Susan Osborne is chair of the Safe Staffing Alliance
SAYING MORE NURSES LEAD TO SAFER CARE IS A COSTLY ASSUMPTION I read June Clark’s comments about defining safe care (Letters March 25), citing ‘evidence’ that, she claims, shows an allocation of one nurse to eight patients is essential for safe care. But, in a recent edition of the Journal of Advanced Nursing (Vol 71, No 4), the report of a major study conducted in Australia presents a challenge to such claims. The study was carried out in 58 inpatient units, with a total of 265,984 hospitalisations assessed. The authors’ conclusions did not ‘support the widely held assumption that improved nurse staffing levels are associated with decreased patient complication levels’, and said ‘adding more nurses is not a panacea for reducing complications to zero’. Quite a challenge.
Clearly, discussion about correlations between nurse-patient ratios and safe/unsafe nursing care needs strong, supportive evidence rather than well-meaning passionate rhetoric. I sincerely believe that the NHS is a gem in our civilization, but it continues to be an increasingly costly service that, realistically, cannot be governed with an open cheque book for much longer. Dr James P Smith, Fochabers Scotland
ONLY LEGISLATION AND MONITORING WILL IMPROVE FOOD STANDARDS The Department of Health (DH)’s new hospital food standards are inexcusably weak. We are told by the department that hospitals have a contractual obligation to meet the standards under their commissioning contracts (Analysis March 25), but the lack of legislation to back this up – along with the government’s failure to hand responsibility for monitoring and evaluating the standards to an independent body – means we cannot
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be sure that the standards are being met in practice, or that they will remain relevant over time. Some trusts are making much-needed improvements to their hospital food. But the radical transformation so desperately needed will only happen if the government fixes these problems for good by introducing tougher food standards, putting them down in law, and asking a trustworthy body to check that they are being met. The DH must up the ante if it wants to deliver real improvements to hospital food in England. Until it does, we need campaigns like Nursing Standard’s Eat Well, Nurse Well to help keep up the pressure for change. Alex Jackson is coordinator for Sustain’s campaign for better hospital food
NURSES SHOULD USE THE ELECTION TO MAKE THEIR OPINIONS HEARD Last week’s RCN hustings debate in London was a lively event. The NHS political football was given a good kicking as health ministers Dan Poulter and Norman Lamb, and shadow health secretary Andy Burnham, responded to blunt questions from nurses. All three were left in no doubt that nurses have had enough of their goodwill being exploited, and being made to feel grateful for having a job. Doing more, earning less and working longer must be replaced with a new government mantra: ‘Improve, value and invest.’ As May 7 rapidly approaches, I would ask all nurses and other health professionals to please cast your vote, and make your voice heard. Gordon Lees, via email
TRAINING AND EXPERIENCE WILL HELP PREVENT PATIENT SUICIDE A cold shiver went down my spine when I saw the news item linking patient suicide with inexperienced staff (News March 25), the details of which made for sobering reading. When a patient has been assessed as being a suicide risk, the need to observe them to keep them safe becomes a
crucial nursing duty. Experienced nurses know this is vital not only to prevent suicide in the short term, but also to engage with the patient in order to develop some insight into why that person feels life is not worth living any more, and what needs to change. Professor Louis Appleby, who directed a confidential inquiry into UK suicides by patients under observation, suggests that suicide under observation should be a ‘never event’. I wholeheartedly agree. But for this to become reality, observation has to be carried out by nurses with the right training, skills and experience; they need a thorough understanding of policies and procedures and to be competent to carry out the required intervention. Otherwise, they are placing the patient and themselves in serious jeopardy. Zeba Arif, via email
REUNION CALL FOR JOHN RADCLIFFE SCHOOL-JOINERS OF 1976 Terri Coates and Anne Parks (now Asprey) are trying to find colleagues who started at Oxford’s John Radcliffe School of Nursing on January 1 1976. If that is you, or if you know anyone who did, please make contact with us as we would love to organise a reunion to mark 40 years of nursing. 1976 seems like only yesterday; where did the time go?! Please contact me at: [email protected] Anne Asprey, via email
CORRECTION An error crept in to our story about the global search for the new leader of the RCN: ‘College seeks ‘exceptional nurse leader’ to fill chief executive post (News, March 25). The article stated Chief Executive and General Secretary Dr Peter Carter would be leaving his post in October and that two council members will join council chair Michael Brown and two external advisers on the recruitment panel. In fact Dr Carter will leave this summer and there are three council members joining Mr Brown on the panel. We apologise for the mistake.
TWEETS OF THE WEEK Private providers motivation is profit Patients need care and support not being a source of money making! @wendyjpitt61
How does private sector demonstrate social conscience when aim of any business is profit? #NScomment @BunzBird
Can we honestly say the NHS values their staff? In many places they do not. Valued staff will = better care. @YFESue
Add a C, take a C away, disregard them altogether and write our own but at the very least, let’s determine our own values. #6Cs @6CsLive
Congratulations #India for making #HIV tests an essential part of antenatal services, ensuring mothers & babies are healthy. @MichelSidibe
”Fake it til you make it!” Best piece of advice from my circulating nurse I shadowed today on how to be a nurse @Nursingstress
My last working day @theRCN after almost 30 years coincides with RCN’s 99th birthday #RCN100 Mixed emotions joyous yet sad! #endofanera 4 me @RevdKevin
Follow Nursing Standard @NurseStandard and join the #NScomment chat on Thursdays at 12.30pm
NURSING april :: voluses 29 no 31 :: permission. 2015 35 DownloadedSTANDARD from RCNi.com by ${individualUser.displayName} on Nov 20, 2015. For personal use only. No1other without Copyright © 2015 RCNi Ltd. All rights reserved.
Send your views by email to [email protected], the letters editor @RogerEvansE1, post on the Nursing Standard Facebook page or visit www.nursing-standard.co.uk
Please keep letters to a maximum of 200 words, and include your full name and a daytime telephone number. Letters may be edited
Safe staffing levels will be achieved through legal mandate, not tool kits I admire Welsh Liberal Democrat leader Kirsty Williams for taking the initiative to submit a Safe Nurse Staffing Levels (Wales) Bill to the Health And Social Care Committee of the Welsh Assembly (News March 25). But it is a travesty that Welsh health minister Mark Drakeford, who opposes the bill in its current form, believes enforcing the use of an acuity tool that is being developed in Wales will achieve the same aims as the bill. Workforce tools such as The Safer Nursing Care Tool Kit should be used to determine safe staffing levels, but they are not a panacea and their use should not be mandated. Evidence shows that one nurse caring for more than eight patients is unsafe, so it was equally disappointing when health minister Dan Poulter disagreed to a safer staffing level of one nurse to seven patients when questioned on this recently in the House of Commons. The advice the ministers are being given by senior management and nurse leaders must be fundamentally flawed – they need to read the research from nursing academic Linda Aiken on flexibility with the use of ratios. Or is their reluctance to implement legislated staffing levels simply down to cost? If so, they are failing to recognise the national and international evidence that shows safe nurse staffing levels result in more cost-effective care and a stable, well-motivated workforce. We have a serious shortage of registered nurses in the UK. Unless we have safe staffing levels to ensure safe practice across the whole of the NHS, nurses will continue to leave the profession and students will not apply for nursing courses because they won’t want to flout the Nursing and
Midwifery Council Code of Conduct and compromise their registration. Susan Osborne is chair of the Safe Staffing Alliance
SAYING MORE NURSES LEAD TO SAFER CARE IS A COSTLY ASSUMPTION I read June Clark’s comments about defining safe care (Letters March 25), citing ‘evidence’ that, she claims, shows an allocation of one nurse to eight patients is essential for safe care. But, in a recent edition of the Journal of Advanced Nursing (Vol 71, No 4), the report of a major study conducted in Australia presents a challenge to such claims. The study was carried out in 58 inpatient units, with a total of 265,984 hospitalisations assessed. The authors’ conclusions did not ‘support the widely held assumption that improved nurse staffing levels are associated with decreased patient complication levels’, and said ‘adding more nurses is not a panacea for reducing complications to zero’. Quite a challenge.
Clearly, discussion about correlations between nurse-patient ratios and safe/unsafe nursing care needs strong, supportive evidence rather than well-meaning passionate rhetoric. I sincerely believe that the NHS is a gem in our civilization, but it continues to be an increasingly costly service that, realistically, cannot be governed with an open cheque book for much longer. Dr James P Smith, Fochabers Scotland
ONLY LEGISLATION AND MONITORING WILL IMPROVE FOOD STANDARDS The Department of Health (DH)’s new hospital food standards are inexcusably weak. We are told by the department that hospitals have a contractual obligation to meet the standards under their commissioning contracts (Analysis March 25), but the lack of legislation to back this up – along with the government’s failure to hand responsibility for monitoring and evaluating the standards to an independent body – means we cannot
34 april 1 :: vol 29 31 :: 2015 STANDARD Downloaded fromnoRCNi.com by ${individualUser.displayName} on Nov 20, 2015. For personal use only. NoNURSING other uses without permission. Copyright © 2015 RCNi Ltd. All rights reserved.
be sure that the standards are being met in practice, or that they will remain relevant over time. Some trusts are making much-needed improvements to their hospital food. But the radical transformation so desperately needed will only happen if the government fixes these problems for good by introducing tougher food standards, putting them down in law, and asking a trustworthy body to check that they are being met. The DH must up the ante if it wants to deliver real improvements to hospital food in England. Until it does, we need campaigns like Nursing Standard’s Eat Well, Nurse Well to help keep up the pressure for change. Alex Jackson is coordinator for Sustain’s campaign for better hospital food
NURSES SHOULD USE THE ELECTION TO MAKE THEIR OPINIONS HEARD Last week’s RCN hustings debate in London was a lively event. The NHS political football was given a good kicking as health ministers Dan Poulter and Norman Lamb, and shadow health secretary Andy Burnham, responded to blunt questions from nurses. All three were left in no doubt that nurses have had enough of their goodwill being exploited, and being made to feel grateful for having a job. Doing more, earning less and working longer must be replaced with a new government mantra: ‘Improve, value and invest.’ As May 7 rapidly approaches, I would ask all nurses and other health professionals to please cast your vote, and make your voice heard. Gordon Lees, via email
TRAINING AND EXPERIENCE WILL HELP PREVENT PATIENT SUICIDE A cold shiver went down my spine when I saw the news item linking patient suicide with inexperienced staff (News March 25), the details of which made for sobering reading. When a patient has been assessed as being a suicide risk, the need to observe them to keep them safe becomes a
crucial nursing duty. Experienced nurses know this is vital not only to prevent suicide in the short term, but also to engage with the patient in order to develop some insight into why that person feels life is not worth living any more, and what needs to change. Professor Louis Appleby, who directed a confidential inquiry into UK suicides by patients under observation, suggests that suicide under observation should be a ‘never event’. I wholeheartedly agree. But for this to become reality, observation has to be carried out by nurses with the right training, skills and experience; they need a thorough understanding of policies and procedures and to be competent to carry out the required intervention. Otherwise, they are placing the patient and themselves in serious jeopardy. Zeba Arif, via email
REUNION CALL FOR JOHN RADCLIFFE SCHOOL-JOINERS OF 1976 Terri Coates and Anne Parks (now Asprey) are trying to find colleagues who started at Oxford’s John Radcliffe School of Nursing on January 1 1976. If that is you, or if you know anyone who did, please make contact with us as we would love to organise a reunion to mark 40 years of nursing. 1976 seems like only yesterday; where did the time go?! Please contact me at: [email protected] Anne Asprey, via email
CORRECTION An error crept in to our story about the global search for the new leader of the RCN: ‘College seeks ‘exceptional nurse leader’ to fill chief executive post (News, March 25). The article stated Chief Executive and General Secretary Dr Peter Carter would be leaving his post in October and that two council members will join council chair Michael Brown and two external advisers on the recruitment panel. In fact Dr Carter will leave this summer and there are three council members joining Mr Brown on the panel. We apologise for the mistake.
TWEETS OF THE WEEK Private providers motivation is profit Patients need care and support not being a source of money making! @wendyjpitt61
How does private sector demonstrate social conscience when aim of any business is profit? #NScomment @BunzBird
Can we honestly say the NHS values their staff? In many places they do not. Valued staff will = better care. @YFESue
Add a C, take a C away, disregard them altogether and write our own but at the very least, let’s determine our own values. #6Cs @6CsLive
Congratulations #India for making #HIV tests an essential part of antenatal services, ensuring mothers & babies are healthy. @MichelSidibe
”Fake it til you make it!” Best piece of advice from my circulating nurse I shadowed today on how to be a nurse @Nursingstress
My last working day @theRCN after almost 30 years coincides with RCN’s 99th birthday #RCN100 Mixed emotions joyous yet sad! #endofanera 4 me @RevdKevin
Follow Nursing Standard @NurseStandard and join the #NScomment chat on Thursdays at 12.30pm
NURSING april :: voluses 29 no 31 :: permission. 2015 35 DownloadedSTANDARD from RCNi.com by ${individualUser.displayName} on Nov 20, 2015. For personal use only. No1other without Copyright © 2015 RCNi Ltd. All rights reserved.
