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
Trusts in trouble need supportive help, not excessive intervention A recent King’s Fund report says that staff have a greater say in organisations that are run along the lines of a John Lewis ‘mutual’ model (News July 23). The report (tinyurl.com/k5ysb72) makes for interesting reading in that it also discusses the potentially disempowering effects of top-down regulatory intervention. When trusts are failing financially, the regulators require trusts to appoint an interim turnaround director, bring in external consultants and a contingency planning team, and a special administrator may be appointed to replace the board. The Care Quality Commission, Monitor and the NHS Trust Development Authority are all involved in trusts placed in special measures. These approaches have drawbacks. Excessive top-down intervention runs the risk of disempowering and disengaging the leaders and staff responsible for making the turnaround plan work. We need more supportive intervention, rather than adding to the pressures already felt by providers in difficulty. Far from being a ‘soft’ response to problems in the delivery of care, supportive intervention encourages the kinds of behaviours that underpin a culture of positive engagement. Naomi Lyth, by email
SAFE STAFFING DISCUSSIONS ALWAYS OVERLOOK COMMUNITY NURSING Whenever I read about crises in staffing numbers, it always seems to be about hospital nurses (News July 16). We have similar issues in the community, and it would be refreshing to see some attention given to the pressures on our services. Unlike hospital nurses, we community nurses do not have the
luxury of being able to say that our patch is full. If a referral comes in, we have to take it. When practice nurses are off sick, guess who gets to see their patients? And at weekends and on bank holidays, when practice nurses are enjoying a well-earned rest, guess who gets to see their patients? To add insult to injury, even when a member of staff is off sick, we are told that we cannot use bank to cover that absence, even if it is for several months. Community nurses work extra, unpaid hours every week. We have more and more paperwork added to our workload, but never any acknowledgement that this adds to the time of a visit. We would all love to be giving holistic, evidence-based care to our patients, but the sad truth is that sometimes the only way to get through a day is to be task-orientated. Is this
what our managers mean when they tell us to ‘work smarter’? Name and address supplied
THE RCN STANCE ON NURSES’ PAY SEES TO HAVE HIT STONY GROUND Your news story, ‘Welsh nurses offered £160 instead of 1 per cent pay rise’ (July 16) comes on the back of health secretary Jeremy Hunt’s rejection four months ago of the pay review body’s recommendation for a 1 per cent pay increase for nurses in England. The RCN stance appears to have hit stony ground. It is refraining from even contemplating industrial action, preferring to attempt to win over politicians to the concept of fair pay for nurses. Most MPs who were contacted by nurses about their rejected pay rise have responded and generally have been unsupportive. So the news that the Royal College of Midwives (RCM) is going to ballot
32 july 30 :: vol 28 48 :: 2014 STANDARD Downloaded fromnoRCNi.com by ${individualUser.displayName} on Dec 04, 2015. For personal use only. NoNURSING other uses without permission. Copyright © 2015 RCNi Ltd. All rights reserved.
its members on industrial action has been a breath of fresh air. It has certainly got Facebook buzzing. Midwives, nurses and ambulance workers are among more than 400,000 NHS workers in England being balloted on pay-related industrial action, including strikes. Unison, the RCM, the GMB and Unite made the announcements in a co-ordinated response to the pay deal put forward by the government in March. It is the first time in their history that midwives have been balloted. We are missing a trick. I would like to see off-duty nurses, retired nurses, other healthcare colleagues and members of the public stage a silent sit in – displaying our large ‘What if…?’ banners – in front of Downing Street. No shouting, no slogans, just a very quiet, dignified demonstration, day after day. Just a thought... Zeba Arif, by email
WE SHOULD BE PUSHING FOR A MUCH LARGER PAY RISE THAN 1 PER CENT I am pleased that there is going to be a ballot on industrial action over pay. But why has it taken so long to organise and why aren’t the RCN and the British Medical Association balloting their members? Health secretary Jeremy Hunt overturned the pay review body’s 1 per cent pay award in March. Four months down the line, have we lost the momentum to oppose the pay freeze? Who is going to go on strike for a 1 per cent pay rise? I would like to see NHS workers balloted on a pay rise of 10 per cent. Years of below-inflation pay rises and freezes have left us with a 10 per cent pay cut in real terms. I would also like a commitment to cost of living increases in pay in future years, and substantial increases for NHS staff on lower pay grades. Christine Clark, by email
FORCE-FEEDING PEOPLE IS WRONG AND NURSES SHOULD PLAY NO PART A male nurse at the American military base in Guantanamo, Cuba, has been
‘assigned to alternative duties’ after refusing to force-feed prisoners on hunger strike (News July 23). This is a brave act on the part of the nurse, who is likely to be ostracised for making such a stand and his military career may be blighted as a result. But the nurse is right to make a stand. Forcing any medical treatment on an individual deemed capable of consent is unethical. It constitutes an assault. If nurses and doctors compromise their ethical code in this way, it makes them accessories to torture. The people held in Guantanamo Bay have not been sectioned. They are adults who have the right to refuse medical treatment, however misguided that may be. Ann Gallagher, reader in nursing ethics at the University of Surrey, made some salient comments on your letters pages last year (May 22 2013). She wrote: ‘There is no professional justification to support the force feeding of prisoners. We should not seek healthcare solutions to a political problem.’ I draw your attention to a discussion in the New York Times on the ethics of force-feeding inmates and, in particular, Dr Gallagher’s article, ‘Patients, not politics, are nurses’ concern’ (tinyurl.com/cr4qvde). Paul Hegarty, by email
BARTS HOSPITAL OCTOBER 1989 SET IS PLANNING A 25TH REUNION We are planning a 25th anniversary reunion of the October 1989 set at Barts Hospital, London, and are looking to contact three members of the set. Can you help? I can be contacted at melanei@melanei. orangehome.co.uk Melanie Harwood, by email
REUNIONS Are you planning a reunion or trying to trace former colleagues? Email [email protected] with the details and we will post them at www.nursing-standard.co.uk
TWEETS OF THE WEEK Ask #nurses on a night shift how easy it is to get hot appealing nutritious food at 2am for staff or patients and relatives @e1ucidate
@David_Cameron, another nurse shift over, 4 hours o/t with no pay & u won’t give 1%, MPs get 11% and skive off 2 the cricket! @PortyGeoff
Irish nurses won pay rise in 1980s in 20 minutes – because they were united @LondonNurse2014
How can we – as nurses – strike? Our first priority is #patient #safety @shinybluedress
I feel something needs to be done! No one seems to be listening or caring for those who care! @fitcherry
Only effective action nurses take over pay and conditions is to quit profession. Industrial action better in long run #NScomment @TomBolger
Makes me cross. Can train anyone to do ‘tasks’ – complexities of professional nursing require formal education. @AusNurseEd
Another tip from a current student ‘there will be times when you feel like giving up. In that moment remember the times that inspire’ @nursingSUni
Follow Nursing Standard @NScomment and join the #NScomment chat on Thursdays at 12.30pm
NURSING STANDARD july 30 :: vol uses 28 no 48 :: permission. 2014 33 Downloaded from RCNi.com by ${individualUser.displayName} on Dec 04, 2015. For personal use only. No other 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
Trusts in trouble need supportive help, not excessive intervention A recent King’s Fund report says that staff have a greater say in organisations that are run along the lines of a John Lewis ‘mutual’ model (News July 23). The report (tinyurl.com/k5ysb72) makes for interesting reading in that it also discusses the potentially disempowering effects of top-down regulatory intervention. When trusts are failing financially, the regulators require trusts to appoint an interim turnaround director, bring in external consultants and a contingency planning team, and a special administrator may be appointed to replace the board. The Care Quality Commission, Monitor and the NHS Trust Development Authority are all involved in trusts placed in special measures. These approaches have drawbacks. Excessive top-down intervention runs the risk of disempowering and disengaging the leaders and staff responsible for making the turnaround plan work. We need more supportive intervention, rather than adding to the pressures already felt by providers in difficulty. Far from being a ‘soft’ response to problems in the delivery of care, supportive intervention encourages the kinds of behaviours that underpin a culture of positive engagement. Naomi Lyth, by email
SAFE STAFFING DISCUSSIONS ALWAYS OVERLOOK COMMUNITY NURSING Whenever I read about crises in staffing numbers, it always seems to be about hospital nurses (News July 16). We have similar issues in the community, and it would be refreshing to see some attention given to the pressures on our services. Unlike hospital nurses, we community nurses do not have the
luxury of being able to say that our patch is full. If a referral comes in, we have to take it. When practice nurses are off sick, guess who gets to see their patients? And at weekends and on bank holidays, when practice nurses are enjoying a well-earned rest, guess who gets to see their patients? To add insult to injury, even when a member of staff is off sick, we are told that we cannot use bank to cover that absence, even if it is for several months. Community nurses work extra, unpaid hours every week. We have more and more paperwork added to our workload, but never any acknowledgement that this adds to the time of a visit. We would all love to be giving holistic, evidence-based care to our patients, but the sad truth is that sometimes the only way to get through a day is to be task-orientated. Is this
what our managers mean when they tell us to ‘work smarter’? Name and address supplied
THE RCN STANCE ON NURSES’ PAY SEES TO HAVE HIT STONY GROUND Your news story, ‘Welsh nurses offered £160 instead of 1 per cent pay rise’ (July 16) comes on the back of health secretary Jeremy Hunt’s rejection four months ago of the pay review body’s recommendation for a 1 per cent pay increase for nurses in England. The RCN stance appears to have hit stony ground. It is refraining from even contemplating industrial action, preferring to attempt to win over politicians to the concept of fair pay for nurses. Most MPs who were contacted by nurses about their rejected pay rise have responded and generally have been unsupportive. So the news that the Royal College of Midwives (RCM) is going to ballot
32 july 30 :: vol 28 48 :: 2014 STANDARD Downloaded fromnoRCNi.com by ${individualUser.displayName} on Dec 04, 2015. For personal use only. NoNURSING other uses without permission. Copyright © 2015 RCNi Ltd. All rights reserved.
its members on industrial action has been a breath of fresh air. It has certainly got Facebook buzzing. Midwives, nurses and ambulance workers are among more than 400,000 NHS workers in England being balloted on pay-related industrial action, including strikes. Unison, the RCM, the GMB and Unite made the announcements in a co-ordinated response to the pay deal put forward by the government in March. It is the first time in their history that midwives have been balloted. We are missing a trick. I would like to see off-duty nurses, retired nurses, other healthcare colleagues and members of the public stage a silent sit in – displaying our large ‘What if…?’ banners – in front of Downing Street. No shouting, no slogans, just a very quiet, dignified demonstration, day after day. Just a thought... Zeba Arif, by email
WE SHOULD BE PUSHING FOR A MUCH LARGER PAY RISE THAN 1 PER CENT I am pleased that there is going to be a ballot on industrial action over pay. But why has it taken so long to organise and why aren’t the RCN and the British Medical Association balloting their members? Health secretary Jeremy Hunt overturned the pay review body’s 1 per cent pay award in March. Four months down the line, have we lost the momentum to oppose the pay freeze? Who is going to go on strike for a 1 per cent pay rise? I would like to see NHS workers balloted on a pay rise of 10 per cent. Years of below-inflation pay rises and freezes have left us with a 10 per cent pay cut in real terms. I would also like a commitment to cost of living increases in pay in future years, and substantial increases for NHS staff on lower pay grades. Christine Clark, by email
FORCE-FEEDING PEOPLE IS WRONG AND NURSES SHOULD PLAY NO PART A male nurse at the American military base in Guantanamo, Cuba, has been
‘assigned to alternative duties’ after refusing to force-feed prisoners on hunger strike (News July 23). This is a brave act on the part of the nurse, who is likely to be ostracised for making such a stand and his military career may be blighted as a result. But the nurse is right to make a stand. Forcing any medical treatment on an individual deemed capable of consent is unethical. It constitutes an assault. If nurses and doctors compromise their ethical code in this way, it makes them accessories to torture. The people held in Guantanamo Bay have not been sectioned. They are adults who have the right to refuse medical treatment, however misguided that may be. Ann Gallagher, reader in nursing ethics at the University of Surrey, made some salient comments on your letters pages last year (May 22 2013). She wrote: ‘There is no professional justification to support the force feeding of prisoners. We should not seek healthcare solutions to a political problem.’ I draw your attention to a discussion in the New York Times on the ethics of force-feeding inmates and, in particular, Dr Gallagher’s article, ‘Patients, not politics, are nurses’ concern’ (tinyurl.com/cr4qvde). Paul Hegarty, by email
BARTS HOSPITAL OCTOBER 1989 SET IS PLANNING A 25TH REUNION We are planning a 25th anniversary reunion of the October 1989 set at Barts Hospital, London, and are looking to contact three members of the set. Can you help? I can be contacted at melanei@melanei. orangehome.co.uk Melanie Harwood, by email
REUNIONS Are you planning a reunion or trying to trace former colleagues? Email [email protected] with the details and we will post them at www.nursing-standard.co.uk
TWEETS OF THE WEEK Ask #nurses on a night shift how easy it is to get hot appealing nutritious food at 2am for staff or patients and relatives @e1ucidate
@David_Cameron, another nurse shift over, 4 hours o/t with no pay & u won’t give 1%, MPs get 11% and skive off 2 the cricket! @PortyGeoff
Irish nurses won pay rise in 1980s in 20 minutes – because they were united @LondonNurse2014
How can we – as nurses – strike? Our first priority is #patient #safety @shinybluedress
I feel something needs to be done! No one seems to be listening or caring for those who care! @fitcherry
Only effective action nurses take over pay and conditions is to quit profession. Industrial action better in long run #NScomment @TomBolger
Makes me cross. Can train anyone to do ‘tasks’ – complexities of professional nursing require formal education. @AusNurseEd
Another tip from a current student ‘there will be times when you feel like giving up. In that moment remember the times that inspire’ @nursingSUni
Follow Nursing Standard @NScomment and join the #NScomment chat on Thursdays at 12.30pm
NURSING STANDARD july 30 :: vol uses 28 no 48 :: permission. 2014 33 Downloaded from RCNi.com by ${individualUser.displayName} on Dec 04, 2015. For personal use only. No other without Copyright © 2015 RCNi Ltd. All rights reserved.
