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Content ArticleNHS community services are an essential part of national ambitions to support people to manage their conditions, prevent ill health and deliver care closer to home. Community nurses are central to the care delivered for many people, across a broad range of conditions and needs But how do we quantify the difference that a community nurse makes? How do we demonstrate the economic value of community nursing? These were the questions addressed at a roundtable hosted by the HFMA in 2021, with a mixed group of directors of nursing, directors of finance and subject matter experts. This briefing describes the key points raised at the roundtable and an overview of the challenges identified. It also includes other sources of information identified by the HFMA where they add to the understanding of the topic. The briefing does not present a solution to understanding the economic value of community nursing, rather it is a starting point to scope the challenge ahead.
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Content ArticleThis study in the International Journal of Nursing Studies looked at the role of primary care nurses in coaching patients in shared decision making about their treatment. It evaluated an approach to support nurses in coaching patients, which was found to have a positive impact overall. Nurses became more aware of their own attitudes and learning needs and reported more in-depth discussions with patients. However, nurses struggled to integrate the approach in routine care and highlighted the need to receive support from their practice to implement the new approach.
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News ArticleHundreds of nurses, paramedics, health and care workers have been disciplined over allegations of sexual assault, including incidents involving child sexual abuse, The Independent can reveal. It comes as the government begins a year-long inquiry into the sexual abuse of dead patients by “morgue monster” David Fuller. Charities claim the true scale of the issue is likely to be hidden by “vast underreporting” while safeguarding experts say there is no “uniformity” in how NHS trusts handle such cases. The Health and Care Professions Council (HCPC), which regulates just under 300,000 workers including paramedics, occupational therapists, psychologists and physiotherapists, has taken action on 154 occasions following 293 investigations carried out into allegations of sexual assault or abuse since 2012, according to figures obtained by The Independent. Fifty-three clinicians were struck off, 20 were cautioned and a further 29 were either suspended, had restrictions placed on their practice or agreed to be removed from registration. More than half of the actions followed allegations of sexual abuse of a child patient. Separate data from Nursing and Midwifery Council (NMC), which has more than 700,000 registered nurses and midwives. shows action was taken 113 times in the past four years against nurses and midwives who did not maintain professional boundaries; in more than 80 per cent of those cases, the clinician was struck off. Read full story Source: The Independent, 21 January 2022
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News Article
Concern over ‘disgraceful’ nurse staffing levels planned for mini Nightingales
Patient Safety Learning posted a news article in News
NHS leaders have raised concerns over the “new mini Nightingales” as hospitals draw up plans for use with “minimal” nursing levels, The Independent has learned. In December the NHS announced it would be launching eight “surge” hubs dubbed “mini Nightingales” to help hospitals manage increased admissions amid the Omicron wave. These facilities would be able to admit about 100 patients and have been set up as temporary sites across eight NHS hospitals. Details around the safety requirements and required staffing levels have yet to be published, however several NHS sources have said some hubs are planning to use a “low” ratio of 1:15 nurses to patients within the units. One trust chief has called the staffing models a “disgrace” and says the hospitals should never be used. Senior sources have questioned the safety of using a 1:15 ratio, although they said the risk would depend on how ill the patients being sent to the units are and whether there would be sufficient health care assistant support. However, sources have said the staffing models have yet to be finalised and so could change. Read full story Source: The Independent, 20 January 2022 -
Content Article"To healthcare workers in the COVID era, holidays mean death, and we knew Omicron was coming before it had a name. The wave caused by this variant has barely begun, rapidly gathering steam, and we are exhausted, attempting to pull from reserves badly drained by earlier surges." Kathryn Ivey, a critical care nurse at a medical center in Nashville, Tennessee, confronts the Omicron surge filling her hospital.
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News ArticleA nurse who was struck off for refusing to admit a woman to a mental health unit before she killed herself said 'leave her, she will faint before she dies' before he kicked her out of the facility. Paddy McKee allegedly made the comment as Sally Mays, 22 - who had mental health issues - tried to strangle herself when she was refused admission. Ms Mays killed herself at home in Hull in July 2014 after being refused a place at Miranda House in Hull by McKee and another nurse. Despite her being a suicide risk, they would not give her a place at the hospital after a 14-minute assessment. Her parents Angela and Andy have fought for several years for improvements to be made and lessons to be learnt from her death. McKee was this month struck off following a Fitness to Practice hearing conducted by the Nursing and Midwifery Council. The report by the NMC was this week published and condemned McKee, saying 'he treated her in a way that lacked basic kindness and compassion'. The NMC found his actions to refuse Ms Mays' admission had contributed to her death. Read full story Source: Mail Online, 12 January 2022
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Content ArticleWith a global nursing workforce shortage upon us, governments and health system decision makers are becoming alarmed at the potential risk to service delivery if solutions are not found. However, nurses know that what constitutes the fundamental threat to a healthy healthcare system is not the hard work of nursing, but rather the demoralizing conditions under which many nurses strive to practise their profession. This commentary examines the context for some of those conditions and encourages a collective commitment to articulating our vision for the profession in a manner that is sufficiently forceful to be effective.
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News Article
Nurse ‘bullied’ for wearing cross wins unfair dismissal case
Patient Safety Learning posted a news article in News
A Christian nurse who claimed she was discriminated against for wearing a cross at work has won her case for unfair dismissal. Mary Onuoha, a theatre practitioner at Croydon University Hospital in London, said she was bullied and harassed for refusing to remove her necklace in 2018. But an employment tribunal has ruled Croydon Health Services NHS Trust discriminated against and harassed Ms Onuoha over her refusal to remove the jewellery. The trust told her the necklace was a safety risk and must not be outwardly visible. Ms Onuoha, supported by Christian Legal Centre, said she had worked at the hospital for 13 years before being asked to remove the symbol. The tribunal found the employer’s uniform policy arbitrary, with many staff allowed to wear necklaces and other religious symbols were permitted. Following the ruling, Christian Legal Centre chief executive Andrea Williams said the trust’s interpretation of uniform guidance had led to a campaign of harassment against a devoted, experienced, and highly professional nurse, who was in effect hounded out of the NHS. Ms Onuoha said she was investigated and suspended from clinical duties when she refused to remove the item and she was demoted to receptionist duties. In June 2020, she went off work with stress and said she felt she had no alternative but to resign. Read full story Source: Nursing Standard, 6 January 2022 -
Content ArticleThe brief focuses on the nursing workforce at a time when a global pandemic is raging across the world. The year just ended—2021— has seen unprecedented damage inflicted on health systems and on the nursing workforce. The year just begun—2022— marks no change in the continuing relentless pressure of the pandemic on individual nurses, and on the global nursing workforce. This brief was commissioned by the International Centre for Nurse Migration (ICNM). It provides a global snapshot assessment of how the COVID-19 pandemic is impacting on the nursing workforce, with a specific focus on how changing patterns of nurse supply and mobility will challenge the sustainability of the global nursing workforce. It also sets out the urgent action agenda and global workforce plan for 2022 and beyond which is required to support nurse workforce sustainability, and therefore improve health system responsiveness and resilience in the face of COVID-19.
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In this blog, Lotty Tizzard, Patient Safety Learning's Content and Engagement Manager, looks at some of the patient and staff safety issues surrounding insulin delivery. These issues have been identified by a new working group set up by the Safer Healthcare and Biosafety Network (SHBN), and she also highlights potential solutions the group will explore. The SHBN is an independent forum focused on improving healthcare worker and patient safety. It has established a working group on improving injection technique and delivering dual safety in diabetes care. The working group consists of clinicians, policy-makers, charities, manufacturers and patients who are concerned about high numbers of preventable safety incidents related to diabetes treatment. -
Content ArticleBy autumn 2021 there could be more people suffering from Long COVID in the UK than from dementia. How can healthcare services cope with this serious challenge – a condition which can include multi-organ damage, clotting problems, disordered immune response, and renal, liver and brain issues, yet remains little understood? Dr Elaine Maxwell of the National Institute for Health Research tells us how the NIHR’s Long COVID report uncovered a growing and complex problem, and discovered that the largest group of sufferers are working age women in healthcare – AKA nurses.
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Content ArticleThis study, published in BMJ Open, seeks to evaluate variation in Illinois hospital nurse staffing ratios. It attempts to determine how higher nurse workloads are associated with mortality and length of stay for patients, and cost outcomes for hospitals. In their conclusion, the authors suggest that if nurses in Illinois hospital medical–surgical units cared for no more than four patients each, thousands of deaths could be avoided, and patients would experience shorter lengths of stay, resulting in cost-savings for hospitals.
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Content ArticleJane Bruce was discharged from hospital on 24 March 2020 and was receiving wound care from the community nursing team twice a week, after surgery on a fracture following a fall in November 2019. She initially appeared to be recovering until 29 April when her pain increased significantly, rendering her bed-bound, with the exudate from the wound significantly increased. She continued to deteriorate and presented to Leicester Royal Infirmary on 1 May with features consistent with sepsis, and subsequently died the following day. In her report, the Coroner highlights concerns about an absence of continuity in Ms Bruce’s wound care. She notes that she had been seen by several different nurses but due to lack of photographic evidence/accessible electronic records they did not have the relevant information to recognise the change in her condition.
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Content Article
COVID Nursing and PTSD (December 2021)
Patient Safety Learning posted an article in Blogs
In an article for the Patient Safety Journal, Cassandra Alexander, a nurse, shares what it is like on the front lines and the toll it has taken on her mental health—a deeply personal and painful story, yet a traumatic experience shared by many nurses around the United States. -
Content ArticleThis guidance document for healthcare professionals highlights language that can discourage a person with type 1 diabetes, and what kind of language can motivate them. The project produced by The Diabesties Foundation and Diabetes India, and was adopted from the Language Matters guidance produced by NHS England. The guidance is available to download in English, Hindi and Tamil.
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Content ArticleThe Royal College of Nursing (RCN) has created an information hub containing resources related to their campaign for safe staffing, including: principles for staffing for safe and effective care: accountability, numbers, strategy, plans, education. information about safe staffing law and the RCN's campaigning work across England, Northern Ireland, Scotland and Wales. RCN Nursing Workforce Standards. advice for nurses in dealing with unsustainable pressure at work.
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News ArticleA nurse who was sacked by a private hospital provider treating NHS patients which believed she had deliberately tried to sabotage its Care Quality Commission inspection has won a tribunal. An employment tribunal found Care UK’s dismissal of Lorna Jarrett carried “the taint of race discrimination” and said the company had provided no evidence of any malice on her part. Ms Jarret worked at the North East London Treatment Centre. The judgment said management at the facility were convinced Ms Jarrett had deliberately faxed confidential patient identifiable data to the inspectorate instead of the GP surgery they were supposed to be sent to. This incident occurred in the week of the centre’s CQC inspection. However, the tribunal ruled Care UK “did not explore any evidence that might support the claimant’s account and disbelieved her explanation”. It added: “Finding that she sent the fax deliberately and maliciously demands an explanation.” The tribunal judgment said it was Ms Jarrett’s case that “subconscious bias was in play” and found Care UK had not explained the “lack of any motive”. Employment judge Lewis said: “Whilst we accept that Mr O’Brien did not consciously discriminate against the claimant because of her race we find that the factors relied on, her demeanour, attitude, her supposed lack of remorse, are matters that demonstrate subconscious bias and are not free from the taint of race discrimination. We find that the respondent has failed to discharge the burden on it to explain the difference in treatment.” Read full story (paywalled) Source: HSJ, 15 December 2021
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News Article
How hiring district nurses may reduce pressure in the NHS
Patient Safety Learning posted a news article in News
Is hiring more district nurses the smartest way to tackle the NHS care crisis as overstretched staff claim they are quitting hospitals due to intolerable pressure? District nurses are the unsung backbone of the NHS – going in to people’s homes to perform everything from wound dressings to support at the end of life. Yet what was once a thriving district nurse workforce has, over the past decade, been decimated. An ever-increasing caseload, limited resources and far more complex and challenging health needs have left them burnt out and fed up. As a result, they’re leaving in droves – at a time when we need them more than ever. The number of people dying at home is up by one third since before the pandemic, and those who do make it into hospital for care are discharged faster than ever to free up beds, long before they’ve made a full recovery. Ministers have tabled some ambitious ideas to address the vital need for at-home care, including a wave of new community health hubs, or more video appointments. But none are a quick fix, nor are they proven to solve the problem. Recruiting more district nurses could help alleviate these pressures, say experts, as well as tackling what threatens to be a spiralling crisis in community care. But this might be harder than it sounds. Read full story Source: Mail Online, 13 November 2021 -
News ArticleVacancies for nurses and midwives in Scotland have increased by almost 20% in just three months, new figures show. Official figures revealed that at the end of September the whole time equivalent (WTE) of 5,761.2 posts were unfilled across the NHS – a rise of 18.9% from the WTE total of 4,845.4 that was recorded at the end of June. The rise in vacancies comes at the same time as health service staffing reached a record high, with the NHS employing the equivalent of 154,307.8 full-time workers as of September 30 – 5.2% higher than a year ago. However, opposition leaders warned the health service, which is coming under ongoing pressure as a result of the coronavirus pandemic, is facing a “staffing crisis” this winter. Scottish Labour health spokeswoman and deputy leader Jackie Baillie said: “Across our NHS services are on the brink of collapse, and things will only get worse as the cold weather bites. “This staffing crisis at the heart of this catastrophe has unfolded entirely on Nicola Sturgeon’s watch and will jeopardise the ability of services to remobilise and cope with demand. “Looking at the state of services in Scotland, we can all only hope we don’t get sick this winter.” Read full story Source: The Independent, 8 December 2021
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News Article
Doctors and nurses vent anger as unvaccinated Covid cases delay vital operations
Patient Safety Learning posted a news article in News
The NHS has a backlog of 5.8 million waiting for surgery and specialists are increasingly frustrated at how the unvaccinated have left them unable to tackle it. Doctors and nurses have told of their anger and frustration at not being able to treat seriously ill patients as new figures show that more than 90% of Covid sufferers requiring the most specialist care are unvaccinated. While the success of the vaccination rollout has reduced the overall impact of COVID-19 on hospitals, intensive care clinicians from across England have spoken out over the continuing pressure they are under. Between 20% and 30% of critical care beds in England are occupied by Covid patients and three-quarters of those have not been vaccinated, according to the latest data up to July this year. Read full story (paywalled) Source: The Times, 4 December 2021 -
Content Article
Special investigation: The voice of nursing on mute (1 December 2021)
Sam posted an article in Whistle blowing
The Nursing Times has carried out an investigation into nurses’ experiences of speaking out in light of the Covid-19 pandemic, revealing disturbing findings about the current state of openness in the NHS. -
Content ArticleDespite recent discussions and campaigns to widen nursing’s appeal to people of diverse gender identities, it continues to be perceived as a largely female profession. In the context of an ageing workforce, and alongside recruitment and retention challenges, efforts should be directed at developing a more inclusive profession rather than focusing on why people other than women do not become nurses. To attract more men, transgender people and those who identify as nonbinary, as well as women, the approach to nursing recruitment needs to change. The profession must develop a more inclusive culture and examine and promote the advantages that gender diversity can bring to nursing. This article from Quinn et al. explores the lack of gender diversity in contemporary nursing, briefly examines the history of gender in nursing, and considers how the profession might evolve into a more gender-diverse and inclusive workforce.
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Content ArticleThis report from the Queen's Nursing Institute’s International Community Nursing Observatory (ICNO) describes the role of district nursing in ensuring continuity of care and preventing unnecessary hospital admissions. It highlights the advanced skills in assessment, diagnosis and patient management of District Nurse Team Leaders - skills that could be used to provide safe and effective care for people at home.
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News ArticleDying patients are going without care in their own homes because of a collapse in community nursing services, new data shared with The Independent reveals. Across England a third of district nurses say they are now being forced to delay visits to end of life care patients because of surging demand and a lack of staff. This is up from just 2% in 2015. The situation means some patients may have to wait for essential care and pain medication to keep them comfortable. Other care being delayed includes patients with pressure ulcers, wounds which need treating and patients needing blocked catheters replaced. More than half of district nurses said they no longer have the capacity to do patient assessments and psychological care, in an investigation into the service. Professor Alison Leary, director of the International Community Nursing Observatory, said her study showed the country was “sleepwalking into a disaster,” with patients at real risk of harm. She said the situation was now so bad that nurses were being driven out of their jobs by what she called the “moral distress” they were suffering at not being able to provide the care they knew they should. “People are at the end of their tether. District nurses are reporting having to defer work much more often than they did two years ago. What they are telling us is that the workload is too high. This is care that people don’t have time to do.” Read full story Source: The Independent, 29 November 2021
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Content ArticleIncident reporting is an important aspect of clinical care. It highlights safety issues that need addressing and supports clinicians in learning how to keep our patients safe from avoidable harm. Sian Rodger, patient education and health coaching lead at London Spinal Cord Injury Centre shares with the Nursing Times how nurses are learning from incident reporting at her trust.
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