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esponsibility for their own actions and admit they had made a mistake”.
This was different from most professional groups she dealt with. We
wondered whether the nurses who were more willing to own up to
mistakes were more confident in their abilities to nurse effectively and
whether it was part of reflecting-in-action.
Laura sometimes felt squashed by what she saw as a political act in the
way information was used by some of the more senior managers to block
her requests for systemic change. She suspected this had more to do with
keeping the books balanced than always embracing the necessary
changes. She told me that senior staff would ask for more information from
her which she felt was actually “a stalling tactic, because you know we
have no money”. She implied it was code for ―not a high priority‖. She was
concerned about the impact of freezing certain posts that could lead to
mistakes being made at the clinical level. Laura was passionate about
making a difference to practice and recognised the
drip, drip effect of change is what makes a difference, not
always the major changes, you just have to keep plugging away.
(Interview 9/6/05)
She used a roll of wallpaper as a poster to display the root causes of the
incidents and the patterns she had identified as part of her scrutiny of the
incident forms. She asked senior managers to walk round the poster and
give her comments. She was relational in her practice and tried to work
collaboratively which was not the impression I gained from all of the risk
assessment managers I interviewed. After the interview I noted in my
diary:
I‟ve come away feeling energised! But I‟m left with a
tension between finance and humanity or as Fletcher (1999)
would call it relational practice and balancing the books. If the
culture in the Trust at the moment is all down to targets and
money then this must indirectly or directly devalue the staff?
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