The proposed recruitment of 70 nurses at Walsall Hospitals Trust (WHT) is clearly a very welcome development. The fact that the trust is able to make such a commitment at a time when investment is required in other parts of the trust is commendable (e.g. A&E).
The National Institute for Health and Care Excellence (NICE) is currently consulting on draft guidance on safe staffing guidelines while the Department of Health has previously stated that “There are over 5,100 more nurses on our wards since 2010 and in response to the Francis Inquiry we have been tough on insisting on compassionate care in our hospitals.”
So, clearly, both organisations see nursing levels as being a key measure to delivering healthcare. Well, no surprises there, but it is the DoH’s statement that captures my reason for feeling a tad cynical about announcements about increased/appropriate nurse staffing levels. While these posts are definitely welcome in absolute terms, I fail to see how “…insisting on compassionate care in our hospitals” actually says anything meaningful. How will this be measured? How will it be achieved? How will we know that 70 new nurses at Walsall’s Manor hospital will be delivering on the ‘care’ word in healthcare – rather than just health ‘processing’?
I have personally seen nurses who have worked nightshifts in our local hospital and I cannot find a better word than ‘heroic’ to describe their efforts. I also know that if they had more time to ‘care’, they would. But I have also seen nurses who, in my humble opinion, should consider other careers; not because of any mistakes they made (and they did), but because of their lack of compassion. And that for me is simply unforgivable. And no, they were not agency workers.
So how can we ensure that existing and newly recruited nurses actually ‘care’? Well, some of them will, because for them it’s not just a job, it’s a vocation. It’s the rest that senior nurses should be made more responsible and accountable for. It might be an outdated notion, but I do believe that if a senior nurse were to have any doubts at all about the ‘caring’ element of their nursing staff’s work then they should have the power to deal with them, but also to be held accountable for them.
And this needs to be managed in a proactive way. It cannot be left just to the analysis of patient feedback forms or formal complaints. I would not be surprised if over 90% of patients and/or their families simply do not complain because of their condition, vulnerability and fear of any repercussions. Once discharged too, patients just want to forget their experience and get on with their lives.
Question: what are hospital trust boards doing about this? While senior nurses should be responsible and accountable, ultimate accountability is with the board. A nurse that does not ‘care’ should immediately translate to a board that does not ‘care’.
So yes, I absolutely welcome 70 new nurses at the Manor. And I also welcome NHS England’s Chief Nursing Officer statement that a “sophisticated approach” was needed in hospitals:
Each ward in each hospital around the country is different in size, number of patients, the type of patients and their needs.
It needs a sophisticated approach, using hard evidence and local professional judgement to determine what staffing is right to provide the best care for patients in every setting.
These Nice guidelines are a fundamental part of this sophisticated approach and I look forward to feedback from the public consultation.
– JANE CUMMINGS, NHS ENGLAND’S CHIEF NURSING OFFICER
But am I disappointed that the sophistication does not seem to include how compassion is ensured?
Yes, I am.