The Big Conversation about the Quality of Nursing ... - CLAHRC-NDL

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The delegates were told of the 7 Principles of Public Office. This is relevant to all healthcare managers. It was acknowledged that it is hard for middle managers, who are accountable to both management and the profession, and there is a conflict between operational and professional practice and they often become risk averse. It comes down to leadership again. Passing problems upwards is hard, particularly when it is not good news. The absence of curiosity is a big issue. The audience heard how we face challenging times: the economic downturn, challenges of regulation, uncertainty in new government policy and difficultly in working across agencies. However, the real concern is identifying who can speak out on behalf of the patient. The power of the chief nurse is diminishing. What is needed is the management of the expectations of patients, carers, commissioners and regulators. Care needs to flexible and cost effective (such as the productive ward, and lean strategies), the organisational reputation must be good and the potential of the staff and service should be maximised. Leaders need to be empowered and secure a personal reputation. DameElizabeth Fradd highlighted the exemplar of Honda and the Power of Dreams http://dreams.honda.com. This shows us that staff in care need space to be creative and innovative. There are lessons to be learnt from the Improvement Project from the Department of Improvement and Innovation. It‟s often the small things that matter, the relevant things need to be selected and success should be celebrated. To conclude, Dame Elizabeth Fradd talked of the need to recognise failure and that everybody has a responsibility for patient care. Patient and public feedback is vital, do something about it and be seen to do something about it. The care environment is complex and any action is not easy but have a go and don‟t give up. Questions 1. Delegate: What about the influence of external factors on nursing? A nurse may not understand all the agenda, you get encouragement but then your ideas get dropped. Maybe you need to know how to recognise what you are not asking? People can misinterpret support. When policy moves on, nurses need a safety net. DEF: This is at the heart of what people experience. Supervision needs to be improved, people need someone to talk things through with. To understand the core business, appreciate the ripple effect of death etc, we are still learning. The RCN Political Leadership Programme is useful guidance for nurses. 18
2. Delegate: Are things worse? DEF: no, not worse. Healthcare has got better and it is now in the public domain. The doctor used to be God and the nurse was the angel. There has also been a huge amount of misreporting and nurses are an easy target. Good practice is never reported. 3. Service User: How can you train a nurse to be a bit more emotional? How can you guide the profession? DEF: The heart of the issue is in education for nurses. Anyone who does not feel should not be a nurse, we need careful selection. But nurses can behave unemotionally that supports people humanely as it helps deliver care. Good role modelling is important. EF learnt from working as a nanny for Glenda Jackson who had such humility; good leaders show humility, it is not about formal teaching. 4. Delegate: I work in education and you can‟t teach compassion but you can teach self- awareness and how to sense. DEF: Yes, it‟s about being guided, supervision, reflection. Conversation 1: What are we getting right? Examples Intentions are good and need recognising. Often people feel they can‟t complain about medical care because it‟s seen to be good. We should bring in real life stories about differing perceptions. People are good at listening. Communication is not as good as it could be, misunderstandings happen but how to capture this? People described leadership initiatives, a chief nurse spoke about changing times, listening to frontline staff that have the good ideas. The importance of clinical supervision, recognising when they are needed. Having a big thought and being able to hold it. We are good at exposing poor practice and being vocal. A table considered the difficulties in talking about the good. Patients are more important than benchmarks 19
Page 1 and 2: The Big Conversation Tit about the
Page 3 and 4: About the author Bridget Roe is a d
Page 5 and 6: Acknowledgements The author is grat
Page 7 and 8: Executive Summary Background This m
Page 9 and 10: which were complimented by groups s
Page 11 and 12: someone noted, develop an “NHS Sp
Page 13 and 14: Feedback Around 50% of delegates fi
Page 15 and 16: Report of the Day’s proceedings T
Page 17: 11. Variable quality of monitoring/
Page 21 and 22: often do not take responsibility an
Page 23 and 24: Delegates from learning disability
Page 25: About CLAHRC-NDL The Collaboration

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