Saturday, 16 March 2013

Correspondence with Stephen O'Brien MP

On Wednesday 13 March during Prime Minister's Question time in the British House of Commons I picked up on Twitter from Michael White that Stephen O'Brien MP had called for nurses to return to the bedside and get out of the classroom (The Prime Minister resisted); here is the text of an email I wrote to the MP:

Stephen O'Brien
Dear Mr O'Brien

I see from PMQ you have joined the 'back to the bedside' brigade. I trained under the pre-university system and we spent 50% of our time in classroom. I now teach in the University system where students still spend 50% of their time in the classroom.  I recall excellent ward sisters and charge nurses (I used to be one of the latter) who had authority and experience and a genuine interest in students. The NHS has changed beyond recognition and the ward sister/charge nurse is no longer in charge in the same way - this has been studied and reported and the role of the ward sister/charge nurse is widely acknowledged as key to the training of students and the setting of standards in the clinical areas.

Therefore, we've always been trained at the bedside; it's the matter of who trains us that is the issue, the ward sister/charge nurse is no longer effective and the hallowed job of clinical teacher no longer exists, the NHS decided to do away with them, not the universities.  There can be no return to the bedside as we've never been away; if you are suggesting more time at the beside, where are the role models and what will the students learn anyway? I have two daughters working as nurses in the NHS who keep me informed.

Finally, we must remove the rose tinted spectacles through which we view the past in nursing. I recall incidents and practices as an auxiliary and a student that were truly appalling and accepted as the norm.  Things are bad in some places; Mid-Staffs is not the whole NHS. There is frank prejudice against Univeristy educated nurses but it is really prejudice against a large section of the working population and a largely female one.  The view that, perhaps unconsciously, you are perpetuating is that 'university is ok for the likes of me', but not for them. If you did not go to university then I apologise for the insinuation.

I remain
A Conservative voter and your obedient servant

Roger Watson PhD RN FRCN FAAN
Editor-in-Chief, Journal of Advanced Nursing
Professor of Nursing, University of Hull, UK
Follow me on Twitter @rwatson1955
Mobile +447808480547
"The plural of anecdote is not data"
Sent from my iPad

Sandy Summers
Prof Linda Shields of James Cook University in Australia sent the email round her distribution list and there were many positive replies but I was especially struck by this one from Sandy Summers (who gave me permission to reproduce here) of the Truth About Nursing organisation in the USA:

We have the same sort of problem in the U.S. Conservatives who think in a very short-sighted way insist on replacing registered nurses with nursing assistants and other technicians, educated at a mere 1-3 months beyond secondary school. They take vital signs, empty bedpans and give bedbaths, all tasks which should belong to registered nurses. Can a tech discern the difference between healthy and ashen color? A normal respiration and dyspnea? A bedpan full of poop or digested blood? Hardly. Yet these data collection tasks are given to people who have not been educated on the human body and how it functions. If it's nursing care, nurses should be doing it. Nursing assistants can't be present in the Benner fashion if they have no idea how to make physiological, social or psychological assessments. They can stand there all day and attempt sympathy, but until they are educated as nurses, they might as well have blinders on and ear plugs in.

And when non-nurses deliver nursing care, among other things, patients go unfed, and not hydrated, as the media has been telling us for years happens commonly in the UK. So if you know nothing about nursing, let's blame nurses! It's easy!  But a lack of decent nursing care isn't caused by bad nurses or nurses with their noses stuck in books--bad and neglectful care is caused by accountants and executives who know nothing about the value of nursing. If they really cared about the patients that they say they care about, they would give nurses adequate staffing--no more than 4 patients on a med-surg floor, about 1.5 in the ICU… And no nursing assistants or techs should have any hands on, assessment or data collection role in patient care. Hahnemann Hospital in Philadelphia, Pennsylvania, U.S. last year went to an all-registered nurse staff. Here's what they said:

The percentage of nurses who said they could complete their work during their shift rose from 37 before the pilot to 74 after, reducing overtime payments. Fewer patients got bedsores or had trouble with blood thinners. The number of emergencies at the bedside was nearly halved - a sign, Halter believes, that nurses were identifying problems before they got out of hand. Fewer patients fell. Patient satisfaction rose, especially with pain control.

All hospitals should follow this example--world wide.

So let's all of us nurses pledge to the profession that next time one of these politicians starts blaming inadequate nursing care on nurses that we reach out to the media and tell the public--not just the politician who made the ignorant comment--tell the world that the real people to blame for inadequate nursing care are greedy, stingy, short-sighted and ignorant politicians and executives. Want good nursing care? Then give us registered nurses, and enough of them or you take the blame. We should start taking them to court for genocide, really, for the decisions they make to withhold nursing care is taking the lives of millions around the globe every year.

Sandy Summers, RN, MSN, MPH
Founder and Executive Director
The Truth About Nursing 
203 Churchwardens Rd.
Baltimore, Maryland 21212-2937  USA  
phone 1-410-323-1100
fax 1-410-510-1790

The Truth About Nursing is a 501(c)(3) non-profit organization that seeks to increase public understanding of the central, front-line role nurses play in modern health care. Our focus is to promote more accurate, balanced and frequent media portrayals of nurses and increase the media's use of nurses as expert sources. The Truth About Nursing's ultimate goal is to foster growth in the size and diversity of the nursing profession at a time of critical shortage, strengthen nursing practice, teaching and research, and improve the health care system.

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