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News ArticleThe Royal College of Midwives (RCM) has not met thresholds required to strike in its vote, it announced today, but physiotherapy staff are set to strike at more than 100 trusts in their first ever action ballot over pay. The trade union announced this afternoon that its ballot had not reached the turnout required to take strike action. 88& of those who voted said they supported strike action, but only about 47% of eligible members voted. Law requires a turnout of at least 50%, the RCM said. It comes as nurses prepare to take industrial action on 15 and 20 December, over pay and safety concerns, with ambulance staff across the GMB Union, Unison and Unite set to walk out on 21 December (and GMB also on 28 December). Read full story (paywalled) Source: HSJ, 13 December 2022
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News ArticleLucy Letby used a plunger to force milk and air into one of the babies she is accused of attempting to murder, a medical expert has told a court. The alleged attack caused the infant’s stomach to distend to such a degree that she then projectile vomited a “massive” amount of milk so violently that the material left her cot and splashed over a chair several feet away. Staff at the Countess of Chester Hospital managed to save Baby G’s life but the incident was so catastrophic that it caused the child severe brain damage. Seven years later she still suffers from quadriplegic cerebral palsy. Dr Dewi Evans, a consultant paediatrician called in by the prosecution, said the use of a plunger on the end of a syringe was the only explanation for the baby’s sudden collapse in the early hours of 7 September 7 2015. Letby, 32, of Hereford, is accused of murdering seven children in the neonatal unit of the hospital in Cheshire, and of ten attempted murders, between June 2015 and June 2016. She denies all the charges. Read full story (paywalled) Source: The Times, 13 December 2022
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Content Article
Roy Lilley eLetter - Helpless (12 December 2022)
Patient-Safety-Learning posted an article in Safe staffing levels
Writer and commentator Roy Lilley writes a daily email about what's happening on the ground in the NHS, and how this relates to policy decisions and guidance. Roy describes his eLetters as "a combination of opinion, my take on issues of the day and a news digest of things that I think are important or interesting." In this email, Roy shares several recent accounts sent to him by doctors and other healthcare professionals working in NHS hospitals. They describe dangerous staff ratios, overcrowding and medication shortages. The common theme is dangerously long working hours that could impact on patient safety. Sign up to receive Roy Lilley's daily eLetter. -
EventuntilInterested in sustainability and a Greener NHS? Join the Nursing and Midwifery Sustainability Network and help improve health now and for future generations. Nurses, midwives and care staff have a unique role to play in supporting the NHS’ net zero goal. They are already making tangible changes to tackle climate change while improving care. And together, we can achieve even more. That’s why NHS England is launching a Nursing and Midwifery Sustainability Network. The network will create a space and opportunity to share ideas, successes, and innovative practices and it will help us to address barriers and discuss challenges in order for our professions to make a real impact. Nurse, midwives and care staff prove every day that that they are adept at identifying issues and creating solutions – skills that are immensely valuable in reducing the NHS carbon footprint and delivering the NHS’ net zero goal. Come along to the online launch event and first network meeting to find out more about the network and how you can get involved. Open to all nurses and midwives working within the NHS in England, please sign up using your NHS email. Further information
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News Article
Our job is to keep people out of A&E
Patient Safety Learning posted a news article in News
As the pressures of winter and the Covid treatment backlog grow, the NHS is struggling. In Manchester, one organisation is pioneering a new way to care for people that tries to reduce the burden on the health service. It's the first call-out of the day for nurse Manju and pharmacist Kara in north Manchester. They are on their way to see Steven, who has been diagnosed with Parkinson's disease and had a fall the previous night. This might have led to a call-out for an ambulance crew and a visit to A&E. But instead the Manchester Local Care Organisation (LCO) stepped in. Once at Steven's house, Manju makes sure he hasn't been harmed by his fall, while Kara checks his medication. Manju notes that Steven's tablets could have contributed to his fall. Manju asks Steven how he copes going up and down the stairs. "I'm OK, just about," he says. But when he has a go at coming down the stairs, Manju spots he could use an extra grab rail and says she will sort one out. This intervention by the team has not only avoided Steven ending up in A&E, but also ensures he can continue to live independently in his own home. That's a key part of the LCO mission, according to Lana McEwan, one of the team leaders in north Manchester. "We would consider ourselves to be an admission-avoidance service, so we're trying to prevent ambulances being called in the first instance. "When an ambulance has been called, we're taking referrals directly from the ambulance service and responding within a one or two-hour response depending on need, and that's an alternative to A&E." Local neighbourhood teams are made up of nurses, social workers, pharmacists and doctors, all working together to keep people out of hospital. Read full story Source: BBC News, 9 December 2022 -
Content ArticleThis report from the International Council of Nurses is intended to give an overview of the continuing challenges faced by nurses, highlight the potential medium- to long-term impacts on the nursing workforce, and inform policy responses that need to be taken to retain and strengthen the nursing workforce.
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News Article
Parents of man left to die in prison say care failures will haunt them for ever
Patient Safety Learning posted a news article in News
The parents of a 25-year-old man left to die in a cell by a negligent prison nurse given responsibility for 800 inmates have told how the conditions in which their son died will haunt them for ever. The case – the 27th death in just five years at HMP Nottingham – was said to illustrate the desperate state of Britain’s understaffed and increasingly dangerous prison system. Alex Braund was being held on remand awaiting trial when he fell ill in his cell with the first signs of pneumonia on 6 March 2020. Four days later, on the morning of 10 March, after a series of ill-fated attempts by Braund’s cellmate to get prison staff to take the situation seriously, the young man collapsed. Prison staff responded to an emergency bell rung by Braund’s cellmate at 6.55am, but they initially only looked through the cell hatch, taking five minutes to enter the cell in order to give CPR. Braund was subsequently taken to Queen’s medical centre in Nottingham, where he was pronounced dead at 11.44am of cardiac arrest caused by pneumonia. The jury at an inquest at Nottinghamshire coroner’s court found there had been a “continuous failure to provide adequate healthcare”, with a prison officer told by a nurse a few hours before Braund’s death that there was “nothing to be done at this time of night”. Questioning during the hearing revealed that the nurse, who has since lost her job and been reported to the nursing and midwifery council, had amended her records on the morning of Braund’s death. Read full story Source: The Guardian, 6 December 2022 -
News Article
Wales ‘displaying a dangerous and growing reliance’ on agency nurses
Patient-Safety-Learning posted a news article in News
The NHS in Wales could move to a model in which most or all nursing care is outsourced to private companies, if its increasing reliance on agency staff continues, a union report has claimed. According to the Royal College of Nursing, the Welsh health service risks moving to a situation where it no longer directly employs staff to provide patient care. NHS Wales spent between £133m and £140m on agency nursing during 2021-22, based on different freedom of information (FOI) requests and official figures, the RCN’s report suggested. RCN Wales said, “If this trend continues, Wales will move to a situation where NHS Wales no longer directly employs staff to provide patient care and instead moves to a model in which most or all nursing care is outsourced to private companies.” Read more Source: Nursing Times, 4 December 2022 -
Content ArticleThis study in the journal Dove Press aimed to explore the experience of patient safety culture among South Korean advanced practice nurses in hospital-based home healthcare. 20 nurses involved in home healthcare were recruited from twelve hospitals located in three different cities throughout South Korea. The authors concluded that there were significant aspects of patient safety culture in hospital-based home healthcare, allowing for good continuity of care for patients. These aspects include communicating with caregivers, building community partnerships, understanding unexpected home environments and enhancing the safety of nurses.
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Content ArticleLetter from Mike Prentice, NHS England’s national director for emergency, planning and incident response, to hospitals and other care providers ahead of talks with the Royal College of Nursing later this week on the industrial action from nurses. At that meeting they will try to agree what areas of care will be hit on Thursday 15 and Tuesday 20 December, and which will continue as normal because they are covered by “derogations” – agreed exemptions to the action.
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News Article
Urgent surgery ‘may be postponed’ by nurses’ strikes, say NHS bosses
Patient Safety Learning posted a news article in News
Hospitals may not be able to provide key elements of healthcare such as urgent surgery, chemotherapy and kidney dialysis during the forthcoming strikes by nurses, NHS bosses have said. Trusts may also have to stop discharging patients, postpone urgent diagnostic tests and temporarily withdraw services to people undergoing a mental health crisis. Executives have been warned that industrial action by nurses in their pay dispute with the government could mean that a range of important, and in some cases time-critical, services to seriously ill patients may have to be scaled back or suspended altogether. NHS England bosses have raised that possibility in a letter sent on Monday to hospitals and other care providers ahead of crunch talks with the Royal College of Nursing later this week. At that meeting they will try to agree what areas of care will be hit on Thursday 15 and Tuesday 20 December, and which will continue as normal because they are covered by “derogations” – agreed exemptions to the action. The letter sets out a list of 12 areas of care and some non-clinical activity in hospitals, such as food supply, which could be affected if agreement is not reached with the nurses’ union. Eight of those involve direct patient care, three involve support services in NHS trusts and the other involves “system leadership and management to oversee safe care” on strike days. NHS England’s letter sets out 10 other types of vital care, mainly involving life or death scenarios, headed “derogations not needed”, which they hope to agree with the RCN to go ahead as normal. These include A&E care, services in intensive care units and emergency operating theatres as well as maternity services, including the delivery of babies, psychiatric intensive care, time-critical organ transplants and palliative and end of life care. Meanwhile, the chief executive of NHS England has insisted patients will not have procedures cancelled at the last minute due to the nurses’ strikes, but warned some care would have to be delayed. Read full story Source: The Guardian, 28 November 2022 -
News Article
Nurses across UK to strike for first time on 15 and 20 December
Patient Safety Learning posted a news article in News
Nurses across the UK will go on strike for the first time over two days in the fortnight before Christmas after ministers rejected their pleas for formal talks over NHS pay. The Royal College of Nursing (RCN) said its members would stage national strikes – the first in its 106-year history – on 15 and 20 December. Senior sources said the industrial action was expected to last for 12 hours on both days – most likely between 8am and 8pm. The unprecedented national industrial action will seriously disrupt care and is likely to be the first in a series of strikes over the winter and into the spring by other NHS staff, including junior doctors and ambulance workers. On Friday, RCN general secretary, Pat Cullen, said the UK government had chosen strikes over listening to nursing staff, adding: “If you turn your back on nurses, you turn your back on patients.” The RCN said that despite a pay rise of about £1,400 awarded in the summer, experienced nurses were worse off by 20% in real terms due to successive below-inflation awards since 2010. It said the economic argument for paying nursing staff fairly was clear when billions of pounds were being spent on agency staff to plug workforce gaps. It added that in the last year, 25,000 nursing staff around the UK had left the Nursing and Midwifery Council register, with poor pay contributing to staff shortages across the country, which it warned were affecting patient safety. There are 47,000 unfilled NHS registered nurse posts in England alone. Read full story Source: The Guardian, 25 November 2022 -
News Article
Plea to blur line between doctors and nurses amid NHS staff crisis
Patient Safety Learning posted a news article in News
The NHS staffing crisis will be solved only if doctors and nurses get more flexible about their job descriptions and break down barriers between roles, according to Rishi Sunak’s health adviser. Bill Morgan argues that training times for doctors and nurses may have to be reduced, and suggests developing “sub-consultants” and entirely new medical professions, He wants ministers to create an Office for Budget Responsibility-style body to predict future workforce needs. The Treasury has held down the numbers of doctors and nurses Britain trains to prevent “supply-induced demand”, which encourages people to seek appointments that are not needed, Morgan argues. Chronic shortages of qualified staff are the biggest problem facing the health service, which has more than 130,000 vacancies. Morgan acknowledges that this means “some of the government’s key manifesto commitments will not be met”, citing the promise of 6,000 extra GPs. Sunak said this week that the government was “thinking creatively about what new roles and capabilities we need in the healthcare workforce of the future”. He urged the NHS to shed “conventional wisdom”. Read full story (paywalled) Source: The Times, 24 November 2022 -
Content ArticleThe number of children and young people admitted to children’s wards with an eating disorder has increased significantly since the start of the Covid-19 pandemic. In the most extreme cases, those with severe malnutrition may need to be fed via a nasogastric tube without their consent. Children’s nurses working on hospital wards may therefore care for children and young people who need to receive nasogastric tube feeding under physical restraint. This article offers an overview of eating disorders and their detrimental effects as well as practical advice for children’s nurses, supporting them to provide safe, compassionate and person-centred care to their patients.
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Content ArticleIn this episode of 'Better Never Stops', Virginia Mason Institute Senior Partner Melissa Lin interviews Dana Nelson-Peterson, Vice President of Nursing Operations at Virginia Mason Franciscan Health, who shares what happens when you trust a management system and improvement process to solve your toughest challenges. Dana shares her story of leading a critical part of Virginia Mason’s Covid response.
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Content ArticleThis 15-minute training video by the Parkinson's Excellence Network pulls together the key symptoms and issues that can impact on a person with Parkinson's and their care when admitted to a hospital ward. it aims to help ward staff understand the key issues when caring for people with Parkinson's.
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Content ArticleNHS chiefs and regulators have written to hospital bosses admitting winter could be so bad NHS staff may have to "depart from established procedures" to care for patients. Letter says regulators will take the challenging situations into context...
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Content ArticleTeamwork is critical in delivering quality medical care, and failures in team communication and coordination are substantial contributors to medical errors. This study in JAMA Internal Medicine aimed to determine the effectiveness of increased familiarity between medical resident doctors and nurses on team performance, psychological safety and communication. The authors found that increased familiarity between nurses and residents promoted rapid improvement of nursing perception of team relationships and, over time, led to higher team performance on complex cognitive tasks in medical simulations. They argue that medical systems should consider increasing team familiarity as a way to improve doctor-nursing teamwork and patient care.
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News Article
US nurse who called emergency services on own hospital speaks out
Patient Safety Learning posted a news article in News
A nurse in the USA who called emergency services in response to staffing issues at Silverdale, Washington-based St. Michael Medical Center spoke out about her decision and the events leading up to the call. Kelsay Irby has been an emergency department charge nurse at the hospital for less than a year. On the 8 October, the night Ms Irby called emergency services for help, the ED was operating at less than 50% of its ideal staffing grid. Among the nearly 50 people in the hospital's waiting room were patients with cardiac or respiratory issues and children with high fevers — "all patients that made us very nervous to have in the lobby, unmonitored for extended periods of time," Ms. Irby said. The ED had one first-look nurse on the clock who was trying to keep up with patients checking in and could not supervise those waiting for care. After exhausting all other available options, Ms. Irby said she called emergency services' nonemergent line and asked the dispatcher if any crews were available to help ED staff. Ms. Irby was connected with a local fire chief who sent an emergency services crew to the hospital to monitor patients in the lobby, retake their vitals and do roll calls to ensure the ED team's patient list was accurate. Ms. Irby's actions made national headlines in the US as a dramatic example of the staffing issues hospitals nationwide are facing. "I didn’t recognize the impact of what I was doing that night," Ms. Irby wrote. "I was simply working my way down the list of possible sources of help for my coworkers and ultimately our patients." Read full story Source: Becker's Hospital Review, 8 November 2022 -
Content ArticleDisruptive behaviours have been shown to have a significant negative impact on staff collaboration and clinical outcomes of patient care. Disruptive episodes are more likely to occur in high stress areas such as the Emergency Department (ED). Having the structure, process, and skills in place to effectively address this issue will lower the likelihood of preventable adverse events. This study assessed the status of disruptive behaviours and staff relationships in the ED setting. It concluded that disruptive behaviours in the ED have a significant impact on team dynamics, communication efficiency, information flow, and task accountability, all of which can adversely impact patient care. EDs need to recognise the significance of disruptive behaviours and implement appropriate policies and protocols to address this issue.
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News Article
Nurses’ strike: what’s at stake and how will it affect patients?
Patient Safety Learning posted a news article in News
Ministers have offered about 1 million NHS staff in England – everyone bar doctors and dentists – a pay rise of at least £1,400 for 2022-23. That represents a rise of between 4% and 5% for staff covered by the longstanding Agenda for Change negotiating framework. Health unions have rejected the £1,400. They want a rise that would at least match inflation – which is currently 10.1% – while the Royal College of Nursing (RCN) is seeking inflation plus 5%. Without inflation-proof rises, staff will suffer a real-terms cut in their take-home pay, unions say. “Our members will no longer tolerate a financial knife-edge at home and a raw deal at work”, said the RCN general secretary, Pat Cullen. Sara Gorton, head of health at Unison, added: “Inflation has already wiped out this year’s 72p-an-hour increase. The government must put pay right to spare the NHS, its staff and all those relying on its care from a dispute no one wants to see.” The RCN has balloted its members across the UK. The results, published on Wednesday, show that a majority of nurses in most but not all hospitals and other NHS services across the four home nations have rejected the government’s offer and decided to strike in pursuit of better pay. Wes Streeting, the shadow health secretary, has condemned as “unacceptable” the fact that strikes will disrupt services and affect patients’ care. While he has not criticised nurses or any health union, he has blamed ministers for not negotiating with the RCN to try to avert strike action. “I’m concerned, I think lots of people are concerned about the impact of disruption”, he told LBC’s Tonight with Andrew Marr on Monday. “That’s still a disruption to patients, which I think is unacceptable.” If he were the health secretary he would see patients as his “first and foremost” responsibility, he said. “That’s why I think the government have to get a grip on this and get the unions around the table because there is a deal there to be done.” Read full story Source: The Guardian, 9 November 2022 -
Content ArticleRacism is unacceptable and it has no place in health and care. But we know that it exists and that the impact on staff can be devastating. All registered professionals have responsibility under the Nursing and Midwifery Council (NMC) Code to challenge discriminatory behaviour, creating an environment where people are treated as individuals and with dignity and respect. This resource is firmly rooted in our professional Code and it is designed to support nurses, midwives and nursing associates, providing advice on the action you can take if you witness or experience racism. It also supports those in leadership roles to be inclusive leaders. This document provides practical examples of how, as nursing and midwifery professionals, you can recognise, and challenge racial discrimination, harassment, and abuse. It also highlights other useful resources and training materials that will support you to care with confidence. This document is a resource for individuals at all levels. This resource does not replace existing NHS England policies and procedures for speaking up and managing racism. It is a resource to support best practice in line with organisational policies and procedures.
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News Article
Nurses set to hold biggest-ever strike
Patient Safety Learning posted a news article in News
The biggest ever strike by nurses looks set to go ahead. The Royal College of Nursing is due to unveil the results of its ballot, which ended last week, in the next few days. The final results are being counted but RCN sources say a large majority of nurses have voted in favour of action in a dispute over pay. The RCN had recommended to its 300,000 members that they walk out. If strikes take place, they would affect non-urgent but not emergency care. The vote has involved a series of individual workplace-based ballots across the UK and if nurses do not back action at a local level it is possible some hospitals and services will not be involved. The government had appealed to nurses to "carefully consider" the impact on patients. But Pat Cullen, RCN general secretary and chief executive, said: "Huge numbers of staff - both experienced and newer recruits - are deciding they cannot see a future in a nursing profession that is not valued nor treated fairly. She added: "Our strike action will be as much for patients as it is for nurses. We have their support in doing this." Cabinet minister Oliver Dowden said the government had "well-oiled contingencies in place" for dealing with any strike action by nurses. Speaking on Sky News, Mr Dowden said essential services would be prioritised, "but of course there would be an impact as a result of a strike like that". Read full story Source: BBC News, 6 November 2022 -
Content ArticleIn 1999, the pivotal report “To Err is Human” by the Institute of Medicine led to sweeping changes in healthcare. This report outlined how blaming individuals does not change the underlying factors that contribute to medical errors. It also stated that blaming an individual does little to make the system safer – or prevent someone else from similar errors. It is unusual for a nurse to be charged criminally, when there is no intent to harm a patient. However, the recent trial in America of nurse RaDonda Vaught could set a precedent for future medical errors to be treated as criminal cases. The case may ensure that for every step that has been taken forward in patient safety, we have now taken two steps backwards. This article from Human Factors 101 looks at the case of RaDonda Vaught, the criminal trial and conviction, and discusses the impact this will have on healthcare.
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Content Article
Blog - Long Covid: A catalogue of shame (2 November 2022)
Patient-Safety-Learning posted an article in Blogs
In this blog, Roger Kline, Research Fellow at Middlesex University Business School, highlights the lack of support from the Government and NHS that healthcare staff with Long Covid face. He looks at the impact of the Government’s decision to scrap extended sick pay for NHS staff with Long Covid and argues that healthcare workers deserve better support. The blog includes accounts from 31 NHS nurses and midwives with Long Covid; some are having to use annual leave as they cannot work their full hours and some have been threatened with redundancy. Others describe their experiences of phased return to work and applying for the NHS Injury Allowance or ill health early retirement.
