Paul Vaughan, Regional Director, RCN West Midlands F IT FOR THE F UTURE : A MESSAGE FROM THE R OYAL C OLLEGE OF N URSING
P UBLIC I NQUIRY 2013 “We need a patient centred culture, no tolerance of non compliance with fundamental standards, openness and transparency, candour to patients, strong cultural leadership and caring, compassionate nursing, and useful and accurate information about services” Robert Francis (2013)
Changing population Length of stay: over 75/10 days, under 60/4 days 30% of all admissions to hospital frail elderly Last 10 years hospital admission up by 35%, bed numbers down by 10% People admitted to hospital at weekend increase risk of death
Hospital patients routinely treated in storerooms Nearly two-thirds of nurses in poll say patients treated in areas not designed for clinical care, from cupboards to kitchen. Guardian, Tuesday 9 March 2010
H UMAN FACTORS : S ILENCE KILLS Poor/no understanding of accountability Failure to connect ethical conscience to professional practice Lack of psychological safety Stress, burn out, depression leading to ‘detachment’ Hierarchies within and across professional groups Poor team relations – collection of individuals versus team Culture – gender issues Ineffective or poor leadership Disempowerment/fear Someone else’s job
W HAT DOES A PERSON DESERVE BY BEING A PERSON ? What do they deserve from you? If you describe someone as a person, what do they deserve?
RESPONSIBILITY Maintain standards Right skill mix Right resources Seek advice as required YOUR ROLE
S PEAKING UP FOR NURSING Someone handling patients roughly Poor Care Changing to e-learning model is not fit for purpose Education and training Lack of moving and handling equipment or poorly maintained equipment Resources Changes in staffing levels will not allow for call bells to be answered promptly or monitoring of patients effectively Staffing levels
When did it happen? Where did it happen? Who was involved? What happened? How did it happen? What evidence do you have?
RCN S TRATEGIC PLAN 2013-18 Use our knowledge and profile to demonstrate to the public how nursing contributes to safeguarding health and wellbeing Promoting excellence in Practice secure the future education of nursing staff in higher education and actively promote mandatory preceptorship and clinical supervision lobby for provision to keep nurses updated, addressing post-registration pathways and education and tackle workforce planning and staffing levels that have a negative effect on patient safety. Nursing development and education Draw on the best available evidence and expertise to contribute to change in health and social care policy Share intelligence and work collaboratively within the RCN and with other organisations Shaping health policies
RCN S TRATEGIC PLAN 2013-18 Increase the number and visibility of our accredited representatives Improve local member engagement in decision-making Enable nursing staff to engage with the RCN Recruit and retain health practitioner members Representing nurses and nursing Emphasise the benefits gained from our dual role as a professional organisation and trade union Actively listen to the voice of members and put them at the forefront of developing and delivering our work Support greater engagement with HCA’s and students Extend our work on environmental and corporate social responsibility An effective, value-for money organisation
HCA’s – regulation and training: Code of Conduct, Uniform, registration and common national standards for education and training Leadership: Supervisory role of ward and community nursing team leaders Paperwork and Administration: Many staff feeling that paperwork is taking precedence over providing care Safe Staffing Levels: In order to safeguard patient care, the RCN believes now is the time to set more clearly defined standards and that mandatory nurse staffing levels must be adopted by providers, regulators and commissioners of health services Principles of Nursing Practice: These eight principles tell us what everyone can expect from nursing practice, whether they are colleagues, patients, or the families or carers of patients Education: The RCN believes that the vast majority of our nursing students receive an excellent standard of education and we want to share this good practice across the UK Professional Attitudes and Behaviours: It’s key that we understand and promote good practice in terms of how patients are treated
Paul Vaughan, Regional Director, RCN West Midlands T HE V AUGHAN C HALLENGE ‘To survive and actually thrive in nursing, we will all need to pull together as a profession and begin by working together at the bedside and being great team players willing to support each other. Something magical happens when we give to others; wonderful things begin to come back to us in far greater ways than what we have originally given.’ Val Gokenback (2012)
T HE V AUGHAN C HALLENGE Reflect – what could you do differently? Now you have decided what you are going to do differently – WHO are you going to tell? Tell people at home what you are going to do! Tell people at work what you are going to be doing differently The Vaughan Challenge: When you go back to your workplace, give people permission to challenge you and ask for permission to challenge them
T HE BIG C ONVERSATION Francis Inquiry: what does it mean for you and your practice?
C OMPASSION Create Similarities Treat as you want to be treated Flip your perspective Be present Appreciate Compassion ‘Compassionate action involves working with ourselves as much as working with others’ Pema Chodron
TOP TIPS FOR DEVELOPING YOUR PRACTICE 22 CPD Communication Skills Assertiveness Skills Use of Information Look after yourself Develop your confidence Share good practice Be heard