Opinion

Vantage point Leading Valiantly in Healthcare Catherine Robinson-Walker Sigma Theta Tau US$39.95/£24 | 336pp ISBN: 9781937554835

CATHERINE ROBINSON-WALKER has brought to life two decades of work with nurse leaders to create a book written in a unique coaching style. Concentration on the human dimension of leadership will be the most appealing aspect

of this book, while the real-life stories are as engaging as they are educational and the practical examples act as an excellent starting point for insight into leadership. The contents make up a master-class delivered as a whole package in one book, giving the unique opportunity for personal development without leaving the comfort of your favourite reading place. Whether for personal curiosity, knowledge or development, the book is set to become an essential item on the desks of nursing leaders and of those aspiring to be one: a most enjoyable and insightful read. Zulfkar Hussain is a nurse at Carisbrooke Healthcare, Nottingham

Letter Another ‘C’ is needed: continuity AT THE recent chief nursing officer summit there was discussion among attendees about the 6Cs: care, compassion, competence, communication, courage and commitment. There are now many good examples of these values and behaviours being put into practice and a desire among nursing and midwifery leaders to embed them throughout the system. However, during these discussions little was said about prevailing models of care delivery in our health services. Do they create the conditions in which these values and behaviours are most likely to flourish? I am convinced that while midwives can give the 6Cs regardless of the model of service delivery in which they work, they are more likely to be able to do this if another ‘C’ is brought into play: continuity. In maternity services, continuity of care can be provided via a small team of midwives, team midwifery, or through caseload midwifery that aims to ensure that the woman receives all her care from one midwife or her practice partner. Midwives provide antenatal, intrapartum and postnatal care in a range of settings to women who are low and high risk. Evidence tells us that such models are evaluated highly and that outcomes are better than in models where continuity is limited. The level of implementation of these systems is unknown but is certainly NURSING MANAGEMENT

low. In a recent Care Quality Commission (CQC) survey of 23,000 women’s experience of maternity care in England, 65% did not see the same midwife every time antenatally. For 28% of these women, this was seen as a problem and they reported less positive experiences with their care (CQC 2013). Of course, nurses and midwives should have the ability to build relationships quickly but it is noteworthy that of the women who did not know their caregiver in labour, 27 per cent reported they did not have definite confidence and trust in the staff (Bourke 2013). It is hard in busy environments where care is based on the condition or the stage of treatment rather than on the person, and where staff work three 12-hour shifts a week to create positive relationships. I believe care suffers as a result. If more care is to exemplify the values and behaviours of the 6Cs, our courage and commitment should be focused on increasing continuity and, as a result, relationship-based care – not just in midwifery but in nursing too. Professor Cathy Warwick is chief executive of the Royal College of Midwives References Bourke G (2013) Support Overdue: Women’s Experiences of Maternity Services. National Federation of Women’s Institutes, London. Care Quality Commission (2013) Women’s Experiences of Maternity Care in England: Key Findings from the 2013 NHS Trust Survey. CQC, London.

Old institutions offered sanctuary A PIGEON landed on the window ledge of Ward 1B at Denbigh Mental Hospital. Bill warned the nurses to watch out: the winged observer was a German spy. The staff knew all about Bill’s aversion to pigeons since he read an article on Nazi espionage. In his paranoid delusion, Bill was targeted, and he would become agitated if he felt no one was taking him seriously. So the nurses would enter his world, and offer a counter-explanation: the pigeon was once a German agent, but now it was on our side. Of course, such an approach would not be found in a textbook. But with caring intent, staff pacified Bill and helped him through his distress; no need to call the doctor, or for more medication. This anecdote from my father, who began mental nurse training in 1959, conveys some of the unacknowledged value of nursing in the bygone asylums. Mental health nursing has been neglected by historians of psychiatry, who have tended to focus on legislation, treatments and the character and deeds of medical superintendents. As Nolan (2012) argues, ‘this neglect speaks volumes about the power relations, professional hierarchies and class divisions that prevailed when psychiatric services were delivered in institutions, but which still prevail’. Therapeutic advances are attributed to doctors, to the neglect of nurses who looked after patients night and day. I am writing a book on this era with professor Peter Nolan for publication in 2015. After radical change to services, the loss of such places of sanctuary is sometimes regretted. With signs of re-institutionalisation, lessons should be learned from the past. Share your experiences by emailing n.mccrae@ kcl.ac.uk, or visit tinyurl.com/ntok7kp Niall McCrea is lecturer at the Florence Nightingale School of Nursing & Midwifery, King’s College London, and a member of the Nursing Management editorial advisory board Reference Nolan P (2012) Reviewing the history of mental health nursing. British Journal of Mental Health Nursing. 1, 2, 78-80.

February 2014 | Volume 20 | Number 9 13

Downloaded from RCNi.com by ${individualUser.displayName} on Feb 04, 2016. For personal use only. No other uses without permission. Copyright © 2016 RCNi Ltd. All rights reserved.

Another 'C' is needed: continuity.

Another 'C' is needed: continuity. - PDF Download Free
72KB Sizes 2 Downloads 0 Views