Post by Nigel on Feb 26, 2010 15:08:31 GMT
This week has seen some truly shocking tales emerge of appalling failures at Stafford hospital – failures for which there is no justification and can be no excuse.
Many of those involved in the running of the hospital failed to demonstrate the care we would expect – whether for the welfare of patients or the concerns of staff.
The public and the people affected by these dreadful events want to hold someone responsible. But who? Where were the managers in the hospital? Where were the managers at the Primary Care Trusts and Strategic Health Authorities who should have stopped this? Why didn't more staff speak out?
I can only assume that for such a catastrophic failure to have occurred, the roots must have run very deep, and must have exerted a pervasive influence on the daily culture in which people were working. The staff were quite simply beaten down by it – and defeated by the fact that when they did speak out, as one of them told me when I visited, the concerns were filed in the wastepaper basket.
Imagine you were working on the wards, put yourself in the position of the qualified nurse and health-care assistant left to look after 30 patients overnight. Which buzzer would you answer next?
It was managers, meanwhile, who decided that it was more important for the institution to get Foundation Trust status than it was to sort out staff shortages.
Nurses are in charge of wards and they are responsible for patients. But if you are that nurse, trying to tend to the needs of dozens of sick people whom you can't possibly treat or get to know, then it's hard to remember the humanity that brought you into the profession in the first place. If you've asked for more staff, and told your manager that the situation is unsafe, only to be ignored, you won't feel too human yourself either.
Andy Burnham, the Health Secretary, recently wrote an article in this newspaper where he talked about the pilot Chesley Sullenberger, who executed that perfect landing on the Hudson river last year, saving hundreds of lives. He argued that we should check and value the skills of doctors as much as we would if we expected them to do the exceptional under similar pressure.
What if we valued caring and nursing in the same way? If NHS managers held high-quality care to be so important that no compromise was possible, could we possibly have reached a situation where managers simply got away with slashing 150 posts at Mid Staffordshire?
Chesley Sullenberger was rightly proclaimed to be a hero. "For 42 years," said the pilot, "I've been making regular deposits in this bank of experience, education and training. On January 15 the balance was sufficient to make a very large withdrawal."
His heroic behaviour was not just based on his being a good and responsible person, but on his being invested in by his employers, and having had the authority to raise concerns and have them addressed.
I understand that it might seem a strange week to suggest that we should start to regard the people who care, whether they are doctors, nurses or health-care assistants, as heroes. However, if we plan to fly somewhere, we expect the pilot to be well trained, well rested and well supported, otherwise we won't get on the plane.
Care matters, and it is going to matter more in the future rather than less. Medical and scientific advances will help people to live longer and to survive conditions that would previously have been a death sentence. But nursing care is increasingly necessary to make lives worth living.
I visited the hospital in Mid Staffordshire soon after the Healthcare Commission report last year. I spoke to a patient who had been in the hospital for three weeks. He told me that he had initially been frightened to be admitted because of what he had seen on television and read in the newspaper. However, he could not fault the care he had been given, not just by the nurses but by all the staff he had seen.
It was always the case that some parts of Stafford hospital were warm and caring and human places which put patients first. So what went wrong elsewhere? It must be to do with the value that is put on care.
Many of those involved in the running of the hospital failed to demonstrate the care we would expect – whether for the welfare of patients or the concerns of staff.
The public and the people affected by these dreadful events want to hold someone responsible. But who? Where were the managers in the hospital? Where were the managers at the Primary Care Trusts and Strategic Health Authorities who should have stopped this? Why didn't more staff speak out?
I can only assume that for such a catastrophic failure to have occurred, the roots must have run very deep, and must have exerted a pervasive influence on the daily culture in which people were working. The staff were quite simply beaten down by it – and defeated by the fact that when they did speak out, as one of them told me when I visited, the concerns were filed in the wastepaper basket.
Imagine you were working on the wards, put yourself in the position of the qualified nurse and health-care assistant left to look after 30 patients overnight. Which buzzer would you answer next?
It was managers, meanwhile, who decided that it was more important for the institution to get Foundation Trust status than it was to sort out staff shortages.
Nurses are in charge of wards and they are responsible for patients. But if you are that nurse, trying to tend to the needs of dozens of sick people whom you can't possibly treat or get to know, then it's hard to remember the humanity that brought you into the profession in the first place. If you've asked for more staff, and told your manager that the situation is unsafe, only to be ignored, you won't feel too human yourself either.
Andy Burnham, the Health Secretary, recently wrote an article in this newspaper where he talked about the pilot Chesley Sullenberger, who executed that perfect landing on the Hudson river last year, saving hundreds of lives. He argued that we should check and value the skills of doctors as much as we would if we expected them to do the exceptional under similar pressure.
What if we valued caring and nursing in the same way? If NHS managers held high-quality care to be so important that no compromise was possible, could we possibly have reached a situation where managers simply got away with slashing 150 posts at Mid Staffordshire?
Chesley Sullenberger was rightly proclaimed to be a hero. "For 42 years," said the pilot, "I've been making regular deposits in this bank of experience, education and training. On January 15 the balance was sufficient to make a very large withdrawal."
His heroic behaviour was not just based on his being a good and responsible person, but on his being invested in by his employers, and having had the authority to raise concerns and have them addressed.
I understand that it might seem a strange week to suggest that we should start to regard the people who care, whether they are doctors, nurses or health-care assistants, as heroes. However, if we plan to fly somewhere, we expect the pilot to be well trained, well rested and well supported, otherwise we won't get on the plane.
Care matters, and it is going to matter more in the future rather than less. Medical and scientific advances will help people to live longer and to survive conditions that would previously have been a death sentence. But nursing care is increasingly necessary to make lives worth living.
I visited the hospital in Mid Staffordshire soon after the Healthcare Commission report last year. I spoke to a patient who had been in the hospital for three weeks. He told me that he had initially been frightened to be admitted because of what he had seen on television and read in the newspaper. However, he could not fault the care he had been given, not just by the nurses but by all the staff he had seen.
It was always the case that some parts of Stafford hospital were warm and caring and human places which put patients first. So what went wrong elsewhere? It must be to do with the value that is put on care.