WILL YOU JOIN US? - Royal College of Nursing
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WILL YOU JOIN US? MEET THE MEMBERS WHO ARE SHAPING OUR CAMPAIGN ON STAFFING FOR SAFE AND EFFECTIVE CARE IN ENGLAND JOIN THE UK’S BIGGEST ‘NURSING IS STEEPED HOW TO SPEAK UP INTERNATIONAL NURSING CELEBRATION IN STEREOTYPE’ ABOUT POOR NURSING RESEARCH THIS MAY PRACTICE CONFERENCE P4 GOOD NEWS P7 OPINION P10 FEATURE P16 EVENTS ISSUE NO. 373 MARCH 2019 RCN.ORG.UK/BULLETIN
2 NEWS
Imposed pay deal leaves
The RCN represents nurses
and nursing, promotes members short
excellence in practice and
shapes health policies. Imposition of a pay deal by the Department of Health in
Northern Ireland means some members on Agenda for
Editor: Kim Scott Change contracts may earn less from this month because
Email: bulletin@rcn.org.uk enhanced pension contributions will exceed their pay
Web: rcn.org.uk/bulletin increase. Staff on bands 5 and 8A are most likely to be hit.
Address: 20 Cavendish Square,
London W1G 0RN The RCN in Northern Ireland says the situation has arisen
Classified advertising because the pay deal was imposed without proper union
Tel: 020 8423 1333
Fax: 020 8423 4382 Keeping children consultation or full assessment of the implications.
Email: advertising@rcni.com safe online The RCN is preparing to ballot members on industrial
Acceptance of an advertisement action in response to the imposed deal.
does not constitute an The RCN is getting behind a new
endorsement of a product, campaign which calls on social Visit rcn.org.uk/northern-ireland-pay to find out the
service or company, either by media companies to do more to latest developments.
the RCN or RCN Publishing. protect children from online harm.
The campaign asks companies to
For RCN country and regional sign up to a statutory duty of care
contact details visit
and invest a slice of their profits
rcn.org.uk or call RCN Direct
in child protection and mental
on 0345 772 6100.
health research.
© Copyright 2019. RCN Publishing
Company Limited and Fiona Smith, RCN Professional
The Royal College of Nursing. Lead for Nursing Children and
Young People, said: “If duties
Printed on 100% recycled paper of care for children exist in the
manufactured in the UK. offline world, they should exist in
the online world too. Social media
firms need to understand that with
Shed load of savings hundreds of millions of pounds
of profit comes a responsibility to
ensure children are kept safe and
healthy on their platforms.”
Nursing cadet pilot
The RCN is supporting a new
pilot initiative seeking to widen
access to the nursing New principles for CPD
Make March xtra special profession. The nursing cadet
scheme, which is supported by The RCN has worked with other professional bodies and
This month, you can make savings on HRH the Prince of Wales, will unions to develop five principles for continuing professional
everything from household bills and be aimed at hard to reach development (CPD). They say that CPD should:
Mother’s Day gifts, to family days out young people, like young
and cheap cinema trips. carers. It will be trialled in • be each person’s responsibility and be supported
Wales starting this year, in by employers
Just visit RCN Xtra and start partnership with the Wales • benefit service users
saving today. Army Cadet Force. Once cadets • improve the quality of service delivery
have completed the scheme, • be balanced and relevant to each person’s employment
they’ll be offered a guaranteed • be recorded and show the effect on each person’s area
Xtra benefits. Xtra easy. interview for a nursing degree of practice.
Register now at rcn.org.uk/xtra programme in Wales.
Find out more at tinyurl.com/new-rcn-cpd
RCN.ORG.UK/BULLETIN RCN BULLETIN MARCH 2019
3
Nursing degree
applications down 30%
since bursary axed
Members set to debate
hard-hitting issues
Prostitution, child poverty and loneliness
are among the debates on the agenda for
this year’s RCN Congress in Liverpool.
Members attending the event in May will
vote on a number of important resolutions
aimed at improving health and life
chances for vulnerable groups. Proposed
resolutions include lobbying government
to decriminalise prostitution and end
period poverty. Reducing sepsis and the
abuse of nitrous oxide will also be debated,
as well as workplace issues like bullying
and clinical supervision arrangements.
RCN warns NHS Long Term deserves to succeed, but it cannot do so
RCN Congress 2019 takes place in Liverpool without the nurses to deliver it. These
from 19 to 23 May. To see the full agenda and Plan won’t succeed unless figures show we all need to work together
book your place, visit rcn.org.uk/congress decline in student nurse to address the workforce crisis, not only
applications is reversed through investment in nurse education
in England but through a workforce
Figures released by UCAS in February strategy that reflects the demands of the
Education grants show that despite a small increase on last population in each country. This needs
year, the number of people applying to to be underpinned by legislation that
Nursing staff can apply for the RCN study nursing in England has fallen by guarantees the right number of nurses and
Foundation Professional Bursary more than 13,000 since 2016, the last nursing support staff to provide safe and
Scheme from 1 March. year students received the bursary. The effective care.”
RCN is urging the Government to invest
The scheme offers grants of up to at least £1bn a year back into nurse higher The RCN’s Fund Our Future campaign
£5,000 per year to nursing staff for education in England to reverse the trend. calls on the Government to invest at least
career development and CPD activities The College has warned that if the decline £1bn per year back into nursing higher
in the following areas; primary care, in applications isn’t reversed, the NHS education in England to help stop the
long term/chronic conditions, history Long Term Plan, which was published in decline in student nurse numbers and
of nursing and occupational health. January, won’t have a chance to succeed. recruit the nursing staff needed to keep
patients safe. The College is calling for the
Applicants will be asked to explain With almost 41,000 nursing vacancies Government to allocate the money as part
how their course will improve patient in England, the College has said the fall of the Spending Review in spring.
care in their field. in student numbers further jeopardises
the future supply of nurses and puts safe Students in Wales, Scotland and Northern
The closing date for applications is patient care at risk. Ireland can still access the bursary.
31 May 2019. Visit
tinyurl.com/rcn-foundation-grants RCN Acting Chief Executive Dame Donna Find out more about the Fund Our Future
Kinnair said: “The Long Term Plan campaign at rcn.org.uk/fundourfuture
RCN BULLETIN MARCH 2019 RCN.ORG.UK/BULLETIN
4 GOOD NEWS
Member demands action on
staffing levels from NHS execs
RCN member Gay Lee has gone Chair of NHS England David Prior
straight to the top to raise insisted nurse staffing is a priority.
concerns about nurse numbers. “The workforce is absolutely
crucial to delivering the Long
Gay, who’s been nursing for 40 Term Plan,” he said.
years, says she felt compelled
to speak up at an NHS England “But what are you going do about
board meeting. She’d been it?,” stressed Gay. “It’s going to take
picketing outside as part of the three years and a massive amount
Keep our NHS Public campaign of work to get enough nurses.”
group but went in to observe the
discussion about the NHS Long Well done for speaking out so
Term Plan. She jumped in at the frankly, Gay. We share your
end when she felt execs had failed concerns. With almost 41,000
to address how they hope to have nurse vacancies in England, we
enough staff to deliver the aims of think there needs to be urgent
the plan. action to invest in growing the
nursing workforce.
“I’ve never seen the NHS in such
a bad state as it is now,” said Gay. We’re calling for £1bn to be
“It upsets me a lot. You’ve been invested in educating new nurses
very congratulatory and yet what and for laws on staffing for safe
I’ve not heard in this meeting and effective care in all four
is any real concern about the UK countries.
workforce that is going to do all
this wonderful work. We haven’t Find out how to get involved in
got enough staff…we have no our campaigns at
workforce strategy.” rcn.org.uk/campaigns
Order your pack for the UK’s biggest nursing celebration!
RCN Direct
comes of age Nurses’ Day is fast approaching
and this year we’re inviting you
More than 82,000 calls were
to join us for the UK’s biggest
made to RCN Direct last year
nursing celebration.
with nearly three-quarters of
queries resolved by staff at the
We know you’re facing many
advice hotline. The rest were
challenges. But we also know how
referred to other RCN
skilled and passionate you all are.
specialists for help.
So on 12 May we’d like to celebrate
It’s been 21 years since the the remarkable difference you
first call was made to RCN make by helping you hold parties
Direct on 1 March 1998. in your workplace.
Now in 2019 it’s easier than
ever for members to get the Order your free party pack, filled
information they need online. with materials to help you hold
Visit rcn.org.uk/get-help your own party, at rcn.org.uk/
nursesday from 6 March.
RCN.ORG.UK/BULLETIN RCN BULLETIN MARCH 2019
5
The big picture
It’s World Poetry Day on 21 March. To
mark this we’re sharing some of the poems
members have written about nursing that
capture the many experiences and emotions
nursing staff live through every day.
I am me
Look at my eyes, can’t you see?
I’m not just an illness, I am me.
Look past the appearance, my greying hair,
I’m still in there, I’m still here.
Picture by Look past the disease, the equipment around,
robcurrie.com
the doctors, the nurses, I still stand proud.
Laura and Stacy joined a march through Jersey last month to call for fair pay for public sector workers.
Members on the island will soon be balloted on taking strike action if mediation over a long-running Once a full life I lived in the past,
pay dispute fails. Visit tinyurl.com/rcn-jersey-strike to find out more. a career, a family, time goes by fast.
My children grew old, had kids of their own.
PATIENT PERSPECTIVE My husband passed on but I’m not alone.
Surrounded by loved ones, grandchildren
arrived,
Karen says the specialist advice
need to be aware of. Her compassion watching them grow filled me with pride.
she’s received from assistant and empathy are striking and she
practitioner Ellan Corner has always seems to know when I need to Memories made I’ll never forget,
been invaluable in caring for take a break from discussions. my life passing by with no regret.
her sister
She’s had to do a bit of hand-holding Remember this as you stand and stare,
I first met Ellan when my sister, who lately, helping me gain confidence, by I’m not just an illness, I’m a person
has a learning disability, had to have a explaining complicated issues clearly who’s scared.
cataract operation. Ellan came to our and leaving me with information to
home armed with eye patches and pads look at. Nothing is ever forced. Scared of what’s next, and how to let go.
to help explain visually to my sister Leaving my family and not watching
what would happen. When it came to She understands that when people them grow.
explaining how the drops and the eye have a learning disability things can
patch would work, she used me as a change very quickly – not all medical But most of all as I wither away,
guinea pig. She took photographs for professionals understand that. And remember the person I am today.
us to look at, reflect on, and talk about. she’s reliable. If she says she’ll get back
She was brilliant. to me with an answer, she always does. Not just an illness, not just what you see,
I am a person, I am me.
I’ve seen a lot more of Ellan in the last Ellan’s a compassionate and caring
few months as she’s now supporting me person with a big heart. You can’t Lyndsey Curtis-Dawson
as I face difficult decisions about my interview for that but that’s why she’s so
sister’s end of life care at home with us. good at what she does. To read more poems about
She’s addressed sensitive but important nursing by members, visit
practical issues, like what other carers Read more about Ellan’s work on page 13. rcn.org.uk/bulletin
ARE YOUR MEMBERSHIP DETAILS UP TO DATE? CHECK ONLINE AT RCN.ORG.UK/MYRCN OR CALL 0345 7726 100.
6 OPINION
THE VIEW
What you’ve been saying
FROM HERE
What about regulating APs? It is so expensive to do a nursing degree
these days that it is no longer an option for
So I understand that nursing associates are most. Good luck to them, they deserve this
now being regulated and registered by the progression opportunity and we need them!
NMC (RCN Bulletin, February issue, page 3).
As an assistant practitioner (AP), I think Alison Lee on Facebook
we too should be regulated and registered.
I feel we don’t get any recognition or Experience hands-on
acknowledgement of our training and often nursing first
get referred to as HCAs. I have studied for
three years to be awarded my job title, but The Government’s NHS Long Term Plan
now feel worthless and degraded. I would outlines new ideas for nurse education
like the RCN to work with the NMC and (RCN Bulletin, February issue, page 8).
government on this matter which affects What I feel they should do is to introduce
Anma Ageli thousands of APs. Hopefully, one day soon, a four-year nursing course. The first year
Registered nurse we will be awarded the recognition and should be learning the basics, the reality
registration we deserve. of nursing and ward life as an HCA, which
I was on a night shift when I was asked to will boost numbers on wards with people
take an A&E patient to a ward. The woman Neil Priestley by email doing hands-on nursing. Then it should
was quite short of breath, had a chronic lead to the three-year degree. In the first
lung condition and diabetes. My instinct NA role should be celebrated year, the student should get paid as an
told me this wasn’t a good idea. But after HCA, so they will have money coming in.
being checked over and stabilised, I was told The nursing associate (NA) role provides a Wards will have numbers and those truly
she was OK to be escorted. brilliant opportunity for experienced and dedicated will stay.
motivated unregistered staff to develop their
After just a few moments in the lift, the skills and progress into a more senior role. Susan Kendall on Facebook
woman collapsed, went into cardiac arrest
and stopped breathing. I started CPR, which
the lady’s granddaughter found brutal to QUOTE OF THE MONTH
watch. She tried to pull me off her relative but
I was on autopilot and got on with the job. We’re determined to secure safe staffing
legislation across the UK, to ensure patients get
When the lift reached the ward floor, I
carried on compressions, while shouting for the safe, quality care they need and deserve
help. A sister from ITU took over, while I
RCN President Anne Marie Rafferty on our campaign on staffing for safe and
went to get the defibrillator. The patient was
effective care
shocked three times and eventually came
round, much to everyone’s relief.
FOUR THINGS TO DO IN MARCH
At the end of the shift, I was told I’d done
an amazing job and the woman wouldn’t
1. Order your party pack to celebrate 3. Book your free place at RCN Congress
be alive if it wasn’t for my quick actions.
Nurses’ Day from 6 March: to join the debates, learn something
I stayed in touch with the granddaughter
rcn.org.uk/nursesday new and meet colleagues from all over
for a short while after the incident and
2. Tell your patients about the the UK: rcn.org.uk/congress
she told me that what happened in the lift
inspired her to become a nurse herself. importance of eating and drinking 4. Get an early bird rate on a conference
well during Nutrition and Hydration on safe and secure handling of
Sometimes you don’t get much gratitude Week, 11-17 March: medicines. Book at rpharms.com/
in this job, but the whole experience made nutritionandhydrationweek.co.uk events?details=3727 by 4 March.
me realise why I’m a nurse – to save lives.
And to always trust my instinct if I feel
something isn’t right. GOT SOMETHING TO SAY?
The RCN Magazines team is always looking for members to contribute to the opinion
rcn.org.uk/myrcn pages. If you’re keen to share your views, email bulletin@rcn.org.uk
RCN.ORG.UK/BULLETIN RCN BULLETIN MARCH 2019
7
Share your thoughts on nursing issues.
Email bulletin@rcn.org.uk
MESSAGE
TO MEMBERS
Sue Warner
Chair of RCN Council
I truly believe the RCN’s biggest strength is
you, our members. Not many organisations
can say they have such a large membership.
The RCN represents the biggest group of
nursing staff in the UK but I know that we
can only be the real voice of nursing if we
know what you’re experiencing, what you’re
passionate about and what you need.
Let’s reclaim the unravelling of our hackneyed image, but
would subvert the toxic masculinity that
As your new Chair of Council, one of my
priorities is to make sure we’re connecting
image of nursing stifles all genders. The toxic masculinity
demanding that a man must be stoic,
with members in a meaningful way. A lot
of work is going on around that and we’re
ruthless and proud, without space for undertaking research to understand how
Members Emma Matthews and humanity, sensitivity and nuance. We can you want to be communicated with so we
Diana Greenfield consider how celebrate the women who founded nursing, can get better at it.
nursing can become a more those who uphold and certainly those who
gender-balanced profession advance it, while empowering men to join Although Council leads the College, we ask
without stigma or raised brows. every single member to get involved in some
It’s not immediately obvious how the way. That could be reading RCN Bulletin,
statement “our future depends on men” As we recognise the necessity of a more going to a meeting, joining a forum, voting
aligns with feminism. Yet for nursing, it’s gender-balanced workforce, let’s be active in in our elections or tweeting your MP about
true and supports a feminist ideal. reclaiming our image and making it appeal an RCN campaign.
to the young boys and bright girls who were
Nursing is steeped in stereotype. Simply advised to aim higher at school. Let’s banish It’s my job to make sure we offer something for
look at any snapshot of pop-culture terms such as “sister” and “matron”. everyone because this is your organisation and
featuring nurses and you’ll see. The extent I want to make sure it’s the organisation you
to which we’re defined by cliché undermines We cannot be what we cannot see, so let’s need it to be. If you think we could improve
our achievements – our life-saving, life- ask our brilliant nurses to broaden the on something, tell me. My ability to deliver
affirming and life-enhancing achievements language and image that define us. on what you want depends on you telling me
– and impacts our own self-portrayal. what that is. I’m really keen for members to
Gender in particular, and various tropes International Women’s Day is celebrated contact me directly at sue.warner@rcn.org.uk
of femininity – sexy, surly, matronly – each year on 8 March. The theme this with any suggestions, concerns or feedback
reinforce nursing as the professional year is #BalanceforBetter, with the aim of so we can have a conversation about that and
extension of a “woman’s place”. celebrating the achievements of women while deliver the changes you want to see.
creating a more gender-balanced world.
To improve the gender imbalance we rcn.org.uk/council
see in nursing would not only hasten the Visit internationalwomensday.com
RCN BULLETIN MARCH 2019 RCN.ORG.UK/BULLETIN
8 FEATURES
Members crucial to READ MORE
ONLINE
securing safe staffing law
rcn.org.uk/
bulletin
Nursing staff will shape every aspect of our campaign for legislation in England
“I’m petrified of losing my PIN, not campaigns in Wales and Scotland, and Patricia adds: “We can’t stand back and
because I’m not a good nurse, but because we’ll be working alongside members to allow our health services to deteriorate
we’re under so much pressure due to lack shape every aspect of the campaign. But any longer because of something that
of staff that mistakes could be made that how do you begin to tackle a problem this is within our government’s control. We
have an impact on patient care.” big when there are almost 41,000 nurse need funding for nursing education and
vacancies in England right now? clear accountability for tackling the huge
These are Natalie’s words. She qualified a shortfall of nursing staff. We must come
year ago and is already questioning her future For Patricia Marquis, the Director of RCN together to make this happen.”
in the unit where she works. “I leave every England, it’s about getting members to
shift feeling that I could have given better feel that they can do something, no matter Making it happen involves lots and lots of
care if we had more staff,” she says. Natalie’s how small, to drive change. “I know how members. Over the next few months
not alone. When we surveyed members passionate members are about this and campaign plans in each of the RCN’s nine
about their last shift at work, shockingly, harnessing this passion will be pivotal,” English regions will take shape, with members
more than half said they felt care had been she says. at the forefront of leading local action.
compromised because there were fewer
nurses on shift than there should have been. In February, the first meeting to kick-off the Danielle is one of them. “We need this
campaign in England brought members, campaign to be exciting, to empower
It’s why the RCN’s campaign on staffing for RCN reps and staff together to decide what people and to get them believing that this
safe and effective care is so desperately needed can be done locally to make this an issue on is a battle they can help win,” she says.
and why we need your help to make sure it’s everyone’s radar. Chair of RCN Council Sue “There are so many ways we could drive
a success. Over the past few years we’ve been Warner told those attending that ensuring this campaign, the most important thing is
collecting evidence and have come up with the campaign for safe staffing succeeds that members join in.”
five key things we want a law to deliver in all across the UK is her top priority. “Members
four countries of the UK (see box right). have told us time and time again that this Make no mistake. The road to success
is what needs to happen in order for them won’t be swift, and is likely to be bumpy.
In England, we’ll be building on what to be able to give safe and effective care to But as RCN President Anne Marie Rafferty
we’ve learned from our successful ongoing patients,” says Sue. says: “We are nurses and we will do this.”
What’s happening across the UK?
So near but yet so far in Safe staffing law within Wales leads on legislation,
Northern Ireland reach in Scotland now we want more
There is no law for safe and effective nurse The Health and Care (Staffing) (Scotland) After 10 years of campaigning, members
staffing in Northern Ireland but some Bill was introduced in May last year. in Wales helped secure the Nurse
progress was made before the collapse Through our Ask for More campaign Staffing Levels (Wales) Act which
of the Northern Ireland Assembly and members have influenced the bill as it has became law on 21 March 2016. It means
Executive in 2017. In 2014, following passed through parliament. The campaign health boards have a legal duty to regard
input from members, the Department of has secured changes to strengthen the the importance of ensuring appropriate
Health in Northern Ireland published a importance of reporting and accountability levels of nurse staffing in all settings.
framework that set out plans to measure for staffing levels and has made sure the On adult wards in NHS hospitals, an
nurse staffing levels against patient Scottish Government has responsibility appropriate nurse staffing level must be
outcomes, initially in certain adult hospital for ensuring an adequate supply of maintained and action taken if staffing
practice settings, for the first time. Progress nurses for the NHS. The bill now says levels aren’t met. Members continue
has stalled because of the current political senior charge nurses should not hold a to campaign for enough nurses to be
impasse and poor funding. Meanwhile, the caseload and nursing staff should have educated and for the act to be extended
number of vacant nursing posts continues time for CPD. The bill is now due to to other areas. Visit tinyurl.com/rcn-
to grow. Visit tinyurl.com/ni-staffing- enter the final stage of the parliamentary wales-staffing to watch a film on how
framework to read about the framework. process. Visit rcn.org.uk/askformore members helped to secure the law.
RCN.ORG.UK/BULLETIN RCN BULLETIN MARCH 2019
We need legislation that
defines what safe and
effective care is
There’s a fine line between I want to be able to
being busy and working protect our nurses and
in an environment that’s do something to make
unsafe change happen
What we want
The RCN is building its campaign for legislation in all parts of the UK.
Though each country is on a different journey, our work is underpinned by
five principles for ensuring nurse staffing for safe and effective care.
NUMBERS ACCOUNTABILITY STRATEGY
We want the right number of We want it to be clear whose job it We want a vision for tackling
nurses, with the right skills, to is to make sure there are enough nurse shortages and making sure
be in the right place, at the right nurses to meet patients’ needs. nursing helps meet the whole
time – so patients’ needs are met. country’s health needs.
PLANS EDUCATION
We want clear plans for getting We want governments to
the right numbers and skill mix of educate enough nursing
nursing staff and we want checks to students, and develop existing
make sure they really happen. staff, to meet patients’ needs.
Members need to feel We need to campaign for
empowered. We must somebody to be responsible
tackle the attitude that for what’s happening in
nothing will improve terms of staffing
Pictures by Gareth Harmer
Words by Kim Scott
10 FEATURES
Seven steps to speaking up about
poor practice in your workplace
It’s never easy to raise concerns about a colleague. But if you witness care that poses a risk
to patients, you have a duty to tackle it head on. As an RCN member you’re not alone.
Learning and development facilitator Rachel Wood explains what to do
1 3 6
Read your local policy Consider whether Remember your
Your employer will have a you can talk to the contractual duty
policy which explains the person directly Whatever your It’s normal to
process for raising concerns If your concern is something role, you probably have a find it hard but
internally or directs you to an minor that can be easily resolved, contractual duty to speak
outside specialist body such as then you could approach your
to do nothing is
up if you believe there is a
Public Concern at Work. colleague informally. risk to patient safety or not an option
public protection.
In the first instance, read the If you do this, you will need to
policy so you can be sure you’re make sure it’s followed through Members registered with
following the right process. It and results in change. It’s the Nursing and Midwifery
will tell you who to speak to still a good idea to read your Council (NMC) will also have
and what to do if you need to employer’s policy and seek a professional duty.
escalate your concerns. support before doing this.
When investigating errors or
incidences of poor practice, the
NMC may look at whether other
2 4
Seek support as Escalate to more staff could have known about
soon as possible senior colleagues these and not reported them.
From the beginning, If the concern is more
It might be tempting to say
ask yourself: “Do I need some serious or an informal chat
that you didn’t notice but if you
help here?” isn’t an option, then your
choose to overlook something
employer’s policy will outline
that results in patient harm,
You can speak to an RCN rep who to speak to and in what
you could find yourself in
in confidence to discuss your order. You can also raise a
difficulty with your employer
concerns and seek their expert concern in writing and the
and the NMC.
support and advice. policy will tell you how.
This can be invaluable as your
5 7
rep will ensure you have the
Keep a log Know that you’re
correct understanding of your
workplace policy and guide Make sure that you keep doing the right thing
you through the right process. a timeline and record Challenging something
your concerns and notes from is tough and takes courage.
It’s a good idea to speak to any related conversations. Read the RCN’s
your RCN rep before you However minor, it is important But remember you’re full guide on raising
approach anyone else. to keep a record as it could absolutely doing the right concerns at rcn.org.
escalate at a later date. You thing and you’re doing what’s uk/publications
If you don’t have a rep, don’t could also complete a reflection expected of you as a member (code 005 841)
know who they are, or don’t so that you can learn from of the nursing profession. You can call RCN
feel able to approach them, the situation. But remember, There’s no need to feel Direct on 0345 772
you can call RCN Direct on you must maintain patient alone. Seek support from 6100. Lines are open
0345 772 6100 for support. confidentiality at all times. the RCN. 8.30am to 8.30pm,
365 days a year.
RCN.ORG.UK/BULLETIN RCN BULLETIN MARCH 2019I N S U R A N C E from the heart
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Sally champions hand hygiene
in Cambodian hospital
Battambang Hospital has about
200 beds – metal frames with
thin mats on top. “Relatives sleep
on the floor underneath because
Relatives are
they’re responsible for much of
the nursing care and for feeding responsible for
the patient.” much of the
nursing care
People seeking treatment queue
up at the hospital’s door each
morning. Patients are triaged and
those who don’t reach the front
of the queue before the doors
close at 5pm must return the
following day.
Shifting goalposts
Sally and her colleagues went to
Cambodia with detailed plans for
support they thought they might
offer. But she says the goalposts
shifted daily and instead they
simply responded to the need they
RCN member Sally Young has trip, offers education, training observed in the hospital. Infection
been a registered nurse since and clinical expertise, principally control was among the priorities.
1990. She served for 18 years in in Battambang Province in
the Territorial Army, worked in Cambodia’s north west. One of the “We spent the second half of
emergency care for 17 years, and charity’s directors, Sue Smith, is the week teaching basic hand
is a nurse practitioner. She has Executive Chief Nurse at University hygiene,” Sally says. “Although
seen and done much as a nurse Hospitals of Morecambe Bay NHS there were lots of big signs saying
Foundation Trust, where Sally is how important hand hygiene is, it
Even so, when she went to now a quality assurance matron. was absolutely not embedded.”
Cambodia last year as part of a Words by Daniel Allen
group of volunteers helping to A challenging environment Sally is hoping that the action
drive improvements in clinical plan she devised with local staff, Volunteering
practice she was shocked by some Sally visited Battambang Hospital along with regular audit, will
last November, part of a team of produce results. She says all
internationally
of what she saw, particularly the
poverty among patients in the volunteer health professionals the staff she encountered were Read our guide on
hospital where she spent a week. that included specialists in exceptionally keen to learn from doing humanitarian
paediatrics, alcohol-liaison and the UK visitors and to improve work at tinyurl.
Cambodia is a proud nation with emergency care. She was asked their practice. com/rcn-
a terrible recent history. In the by the charity to undertake work humanitarian-
1970s, the murderous regime of around patient safety. Since returning from Cambodia, work or find
communist leader Pol Pot a further team of volunteers has out more about
instigated genocide that left an The experience was a “massive visited Battambang Hospital. volunteering in
estimated two million eye-opener”, says Sally, a member They’ve said that handwashing Cambodia at
Cambodians dead. of the RCN Professional Nursing facilities are now installed in transformhealth
Committee. “In Cambodia, they all clinical areas and the safety carecambodia.
Transform Healthcare Cambodia, are no less caring than us, but it’s a champion role Sally introduced org.uk
the UK charity that arranged Sally’s really challenging environment.” is working well.
RCN.ORG.UK/BULLETIN RCN BULLETIN MARCH 2019FEATURES 13
Reducing fear of health checks
through desensitisation
Ellan explains how she makes adjustments for people with learning disabilities so they get
the health care they need
Hospitals, GP surgeries, opticians
and dentists – many health care
settings are frightening places
when you don’t understand what’s
going on. Needles hurt. Tests are We mocked up a
confusing. Someone messing with needle made of
your eyes is extremely unpleasant. plastic that looked
like the real thing
So my job is to support adults
with learning disabilities to get
the treatment they need, such
as health checks. I help them
understand what’s available
and why it’s important to attend
appointments and tests.
My role is all about talking to
people and making sure they
Picture by Royston ‘Stone’ Naylor – Stonefree Photography
understand what’s going on. We
shouldn’t be surprised if people READ MORE
are uncooperative when they We always take the individual’s interesting or rewarding career. ONLINE
haven’t had what’s happening needs into account. For some We’ve seen a huge drop in the rcn.org.uk/
explained to them in a way they it’s helpful to visit a GP surgery number of student nurses coming healthcare
can understand. in advance and see the same to us and recently we struggled to mag
practice nurse each time. In fact recruit to one of our nursing posts.
A lot of my work is about desensitisation is important in Ellan Corner is an
communicating information in many scenarios like going to the But I’ve worked with people with assistant practitioner
a simple way and making sure dentist or getting nails cut. a learning disability for more than with Teignbridge
reasonable adjustments are made. 19 years now and I wouldn’t want Primary Care
Providing relevant easy-to-read Helping people prepare to do anything else. Liaison Team
information is important and
using pictures is a great way to We found that practising with
help people understand what’s the equipment really helps too. 100 years of learning disability nursing
going to happen. One of my colleagues mocked up 2019 marks a century since the first specific training
a needle – it was made of plastic certificate for learning disability nursing was introduced.
For example, if someone needs but looked like the real thing, This anniversary is cause for celebration but we also
a blood test for an underactive and using it has really helped the have huge concerns about the falling number of nurses
thyroid and they’ve had a bad people we work with prepare for a working in the specialty.
experience in the past, we need range of treatments. It’s all about
a specific care plan to make sure getting used to the environment The RCN Learning Disability Nursing Forum is leading a
they get the test they need. I’m on by looking at the machines before project this year to promote learning disability nursing to
hand to break down the process anything actually has to happen. young people. We’re also supporting Mencap’s Treat Me
into small steps. Well campaign, which calls on NHS staff to make
It worries me that many reasonable adjustments for people with a learning
It can take a long time but we’re prospective nursing staff don’t disability. Visit mencap.org.uk/treatmewell or
often successful and that’s what see working with people with rcn.org.uk/forums
really matters. a learning disability as an
RCN BULLETIN MARCH 2019 RCN.ORG.UK/BULLETIN14 FORUM FOCUS
Recipe for success
Making sure patients eat and drink well is essential for their recovery. Ahead of
Nutrition and Hydration Week, Claire Campbell explains the important role of nursing staff
There’ll be national conversations Claire started her career in the one hand, we have the obesity
about the importance of food gastroenterology and noticed crisis and consequences of that
and drink from 11 to 17 March as its connection with nutrition. on health. On the other hand, a
part of the fifth annual Nutrition Many gastroenterology patients significant number of people are
and Hydration Week. Nutritional also have nutritional issues and malnourished, and that needs a
On the one
knowledge is relevant in all nursing patients undergoing gastro-related whole different set of advice.” hand, we have
roles, but because food and drink surgery often need enteral feeding the obesity
are everyday considerations, they tubes, followed by support to Nursing staff in hospitals and the crisis. On the
can be overlooked. use the tube at home or switch community can often see what other hand,
back to oral food. Now Chair of patients are eating and drinking.
a significant
“It is everyone’s responsibility the National Nurses Nutrition
and yet nobody’s responsibility,” Group, Claire hopes to forge closer They’re in a position to discuss how number of
says Claire Campbell, Nutrition connections between this and the this affects general health, but also people are
Support Nurse Specialist RCN Gastrointestinal Nursing address changing nutrition needs malnourished
and a member of the RCN Forum to explore these links. in times of ill-health and ethical
Gastrointestinal Nursing Forum. questions around tube feeding.
Claire currently works in a
“Nursing staff can look at the bigger dedicated nutrition team at Frimley Claire says: “If nursing staff
picture – what’s going on with each Health NHS Foundation Trust. She felt more confident to speak to
individual patient. Their underlying supports nursing staff to address patients about food and drink Find out more
condition, mental health and nutrition as part of patient care. and drill down into issues a bit about Nutrition and
access to food all have an impact on further, that would potentially Hydration Week at
their ability to maintain a healthy “We have such mixed messages have a huge impact on patients’ nutritionandhydration
nutritional status.” about nutrition,” she says. “On overall health and wellbeing.” week.co.uk
New pocket guide for student children’s nurses
Clinical placements are an the card gives vital information
essential part of nurse training, quickly. It contains important
but can be daunting, especially for blood values for infants, children
new student nurses. and young people. This includes
laboratory and monitoring ranges,
The Nursing Essentials pocket- a handy referenced checklist and
sized guide is a set of cards given links to online resources.
to all first-year nursing students
who join the RCN, to provide The guide follows recommendations
support during placements. Now, from the inquiry into the
a new card has been added to hyponatraemia-related deaths of
assist children’s nursing students children in Northern Ireland.
and improve outcomes.
This new card helps improve
Designed by experienced quality of care and safety by
members of the Children and ensuring children’s nursing
Young People (CYP) forums and students have accurate
shaped by feedback from third- information about blood sodium
year Queen’s University Belfast levels and other important
children’s nursing students, measurements at their fingertips.
RCN.ORG.UK/BULLETIN RCN BULLETIN MARCH 201915
Highlighting the work of the RCN’s
specialist forums and networks
IN THE SPOTLIGHT WHAT I’M
THINKING
Procurement Network used in operating theatres. Michelle
and another forum member Harriet
Who’s the Chair? Dean-Orange will be leading
Unlike many other RCN forums, the initiatives in their workplaces.
Procurement Network does not have
a chair. Instead, active members The next Small Changes, Big Differences
work together to organise initiatives event is on 12 July in Plymouth, inviting
and share information. Clinical nursing staff to listen to and share stories
procurement specialist and senior of success in making nursing greener.
sister Michelle Winfield is one such
member. She joined the forum when Why join?
her head of procurement encouraged Michelle says: “The Procurement
her to get involved. Network is helpful and professional. You
can see what people are doing elsewhere,
Recent highlights? the information is amazing and it makes Dr Susanne Cruickshank
The Procurement Network has been me feel part of a wider professional Cancer and Breast Care
focusing on sustainability. The Small group so I don’t feel so alone. Forum Chair
Changes, Big Differences campaign
has helped to cut waste in a number “My role in procurement requires me Nursing staff communicate every day
of areas, including by standardising to balance cost with providing the best with people from all corners of society.
blood pressure cuffs and reducing care so there are sometimes financial What they say, when, and how is so
reliance on disposable gloves. Now, and ethical dilemmas I have to face. important. The specific words used to
Michelle and other members are This is where the professional side communicate information can set the tone
working to cut plastic waste. of being a nurse shines through. The for the relationship that emerges between
forum helps me to put projects in focus themselves and those they nurse.
What’s coming up? and supports my moments of doubt.”
The focus on reducing single-use For people affected by cancer, the use
plastics and plastic waste will Find out more about the Procurement of language is extremely important, as
continue. There will be a particular Network at rcn.org.uk/forums or visit highlighted in a recent survey of more than
effort to cut the amount of plastics their Facebook page. 2,000 people by Macmillan Cancer Support.
It affects how people feel and how they
interact with others. Words associated with
“battles”, “fights” and “bravery” were viewed
Scrub up on infection as particularly unhelpful and it made me
prevention and control reflect on how these words have crept quietly
into the cancer vocabulary in recent times.
Preventing infection is a central part of
nursing, especially at a time when I have really noticed their use in the media.
antibiotic resistance is a growing threat. However, more worrying is their use in the
The new RCN Infection Prevention and titles of UK policy documents, such as “Beating
Control (IPC) Module develops your cancer”, and we should start questioning this.
clinical and leadership skills so you can
help tackle the issue in your workplace. I don’t believe nursing staff set out to use
It’s tailored for people in bands six or inappropriate language but 8% of patients
seven (or equivalent), in roles with a focus in the survey had heard health professionals
on IPC and offers a greater understanding say things that were unhelpful.
of the evidence behind IPC practice and
ways to implement positive change. The Being mindful of the language used in a
unique module involves three face-to- clinical conversation, and asking patients
face sessions by leading experts, six about the terms they are comfortable with,
coaching sessions and extensive online is a simple action all nursing staff can take.
learning support. The module starts on
23 September 2019. Book now at rcn.org.uk/forums
tinyurl.com/rcn-ipc-module
RCN BULLETIN MARCH 2019 RCN.ORG.UK/BULLETIN16 EVENTS For details of more events visit the
region and country pages of the RCN
website or go to rcn.org.uk/events
Sheffield
Abstracts sought for global
research conference
time to submit an abstract to present at the
3-5 September conference too. “We welcome submissions
from health professionals including
Sheffield Hallam University
student nurses, educators, practice
Howard Street developers, researchers, service users and
Sheffield S1 1WB carers,” says Daniel Kelly, RCN Nursing
Research Chair at Cardiff University.
This annual conference brings together
nursing researchers from all over the world “This includes those working in the NHS,
to share their latest findings and discuss the private and voluntary sectors, universities
impact of research on patient care. It and colleges. Presenting your own research
features a keynote speech from Linda Aiken, at an event like this is a great opportunity
whose pioneering research has created to showcase your work on an international to book.
evidence of the importance of nurse staffing platform and share innovation in research.”
levels for safe and effective care, which was
key to the development of a law in Wales. The deadline for submitting an abstract
is Friday 11 April. Visit
Anyone with an interest in nursing rcn.org.uk/research19 or call
research is invited to attend. There’s still 02920 546 460
Cardiff Antrim
Celebrating Mental health
creativity in nursing seminar
Friday 8 March 5-7pm 30 April 10am-1pm
RCN Wales Antrim Civic Centre
King George V Drive East 50 Stiles Way
Cardiff CF14 4XZ Antrim BT41 2UB
This event, hosted by RCN Wales, This free morning seminar for general
celebrates the value of arts for health by practice nurses aims to raise awareness
highlighting writers and artists who work of mental health issues.
in nursing.
It will help nurses in primary care
Olwen Morgan, singer and artist, will get to grips with the range of mental
perform her work, while children’s writer health conditions their patients may
Michele Pengelly will talk about the value present with.
of creativity in nursing for young people.
It aims to develop their skills to improve
RCN events and exhibitions manager communication with patients so they
Sarah Chaney says: “This will be a really can direct them to appropriate services
fun and informal event and promises to and treatment.
show the diverse ways in which nursing
staff make a contribution to society Free and open to all. Book online at To book email eventsreg@rcn.org.uk
through creative as well as caring means.” nursingcreativity.eventbrite.co.uk or call 02920 546 460.
RCN.ORG.UK/BULLETIN RCN BULLETIN MARCH 2019You can also read
