REFLECTIONS
Is pay deal too little, too late? Readers panel Were union members right to accept the government’s 1 per cent pay rise offer?
Union members, including those from the RCN, Royal College of Midwives and Unison, recently voted to accept the government’s offer of a 1 per cent pay rise for NHS staff in 2015/16. After the wilderness years of no pay increase, a 1 per cent rise feels like a victory, but it is a hollow one. Remember that this is the pay rise recommended by the NHS Pay Review Body (RB) for all NHS staff for 2014/15, which health secretary Jeremy Hunt refused to implement. Never has the health service so desperately needed to retain its staff; the pressures are unrelenting and crisis follows crisis. Yet the very people the services depend on are
ISTOCK
This is a hollow victory for staff – and a year overdue
consistently being denied a decent wage for a decent day’s work. It is high time this stopped. Jane Scullion is a respiratory nurse consultant at Glenfield Hospital in Leicester @JaneScullion
The health unions should have put up a better fight Even though it is not a fair offer, I voted to accept the 1 per cent pay rise because it is the only offer we will get.
Ethical dilemmas Anne Gallagher advises on the tricky issue of gifts from patients I am a nursing student on placement with a mental health community team. A regular service user has been bringing me a gift each time he comes for his appointment. It started with a packet of biscuits, then chocolates, and last week he brought me flowers. What should I do? The revised Code from the Nursing and Midwifery Council states that you must ‘refuse all but the most trivial gifts, favours or hospitality, as accepting them could be interpreted as an attempt to gain preferential treatment’. As no definition is offered, it is a matter of professional judgement about what counts as ‘trivial’. A packet of biscuits seems to qualify, but the gift giving appears to be escalating from small to larger gifts, raising a number of ethical issues. 28 march 18 :: vol 29 no 29 :: 2015
The greatest resource the NHS has for providing high quality patient care is its staff, yet the government seems intent on continuously attacking public sector pay. If we had rejected this offer, I doubt there would have been another one. Demoralised staff do not make good workers, and health unions should have fought harder for a better pay deal, including a promise from the government not to abolish our yearly increments and unsocial hours payments and to protect our pensions.
The service user might intend the gifts as recognition of your positive contribution to his care. He might also believe that gift giving will result in some preferential treatment. A further possibility is that the gifts suggest a more personal or romantic interest in you. In this situation, an ethical response is one that preserves the dignity of the service user, supports your wellbeing as a student, and maintains professional boundaries. I recommend discussing this issue with your mentor and, if appropriate, meet with the service user together so that you can thank him for the gifts in a respectful and kind manner, while making him aware that policy and ethical guidance does not permit further acceptance of gifts. It is important to remember that you are not alone. Your mentor, other members of the community mental health team, university staff and professional guidelines are all there to support you as a nursing student and provide you with the guidance you need. Ann Gallagher is professor of ethics and care at the University of Surrey
NURSING STANDARD
STUDENT EXPERIENCES IN THE REAL WORLD OF NURSING
But do any of us have the stomach left for this sort of fight? Drew Payne is a community staff nurse in north London @drew_london
Members could have held out for at least 2 per cent Unions may have had to accept this deal on behalf of members, but this does not mean it is an adequate offer. The deal came after a long and difficult struggle for NHS staff, with many taking industrial action. This obviously sent a strong warning to the government that NHS staff could no longer put up with the lack of a pay rise. But considering the input of NHS staff, 1 per cent is paltry. With the well-supported actions that were planned, I believe we should have held out for at least another 1 per cent. Elsie Gayle is an independent midwife
If this offer is a pre-election sweetener, what is next? Further strike action would have played nicely into the hands of those who love to bash the NHS, and I imagine that union members felt they had little choice but to accept this offer. What concerns me most though is how quickly the government reversed its position. Only last year they were telling the RB not to make recommendations for 2015/16, yet here we are with a pay offer – less than two months before a general election. Coincidence? I think not. Considering this is what NHS staff are already entitled to, it is creating an issue out of nothing. I cannot help thinking this is a sweetener before an attack on unsociable hours. Daniel Athey is a charge nurse on an acute medical unit at University Hospitals Coventry and Warwickshire NHS Trust @danjathey
Join the debate What do you think? Share your views on the Nursing Standard Facebook page
NURSING STANDARD
Starting out
MY EFFORTS TO PROMOTE NURSING’S 6CS IN PRACTICE INSPIRED ME AND OTHERS Last year I designed a poster reflecting the chief nursing officer for England’s vision and strategy for nursing, midwifery and care staff. The aim of the poster (pictured) was to help deliver the message that the 6Cs – compassion, courage, care, communication, competence and commitment – must be embedded in the delivery of all nursing care. The tree represents the ward, with the roots acting as the foundation of change, and the branches representing how change will be achieved. The poster was displayed at Northampton General Hospital NHS Trust’s nursing and midwifery conference, where it won an award, and at the trust’s annual general meeting in September 2014. It was also used by NHS England last year as part of a presentation. The trust set up focus groups for each of the 6Cs. Along with a matron, sister, junior sister and healthcare assistant from different wards, I was part of the group aiming to ensure compassionate care for all patients. The group designed a board to be displayed in wards, clinics and departments at the trust, focusing not only on compassion, but on all of the 6Cs. The aim was to communicate to patients, relatives, carers and staff that we are serious about embedding the 6Cs in the culture of the organisation. The board included stories written by patients, relatives and staff that demonstrated the delivery of the 6Cs in practice. We hoped that celebrating
good practice would motivate staff, reassure patients and relatives, and create a sense of pride in the workplace. When I presented the board to staff at the trust, I felt emotional talking about how we must celebrate good practice. The board was well received, and people approached me afterwards to say they were inspired by listening to me. Nurses told me that they felt my passion, which was fantastic. I had never spoken in front of such a large crowd before, and was especially nervous because the deputy director of nursing and a film crew were present. After this positive experience, I too felt inspired. I update the 6Cs board on our ward regularly, with stories from a wide variety of people. Patients and relatives remain anonymous to ensure confidentiality, but staff members are mentioned by name, with a photograph if they consent to it, alongside the acknowledgements of compassionate care. Patients, relatives and carers often read the board, which I hope inspires confidence and provides comfort for those being cared for and those leaving relatives or friends on the ward. The 6Cs are essential to the delivery of high quality nursing care. I am proud of my poster and the 6Cs’ boards, and of the role I have played in improving the care and wellbeing of patients. Lucy Bazeley Chambers is a final year nursing student with the Open University, training at Northampton General Hospital
On the web rcni.com/students. Send your experience, between 500 and 600 words, to [email protected]
march 18 :: vol 29 no 29 :: 2015 29
Is pay deal too little, too late? Readers panel Were union members right to accept the government’s 1 per cent pay rise offer?
Union members, including those from the RCN, Royal College of Midwives and Unison, recently voted to accept the government’s offer of a 1 per cent pay rise for NHS staff in 2015/16. After the wilderness years of no pay increase, a 1 per cent rise feels like a victory, but it is a hollow one. Remember that this is the pay rise recommended by the NHS Pay Review Body (RB) for all NHS staff for 2014/15, which health secretary Jeremy Hunt refused to implement. Never has the health service so desperately needed to retain its staff; the pressures are unrelenting and crisis follows crisis. Yet the very people the services depend on are
ISTOCK
This is a hollow victory for staff – and a year overdue
consistently being denied a decent wage for a decent day’s work. It is high time this stopped. Jane Scullion is a respiratory nurse consultant at Glenfield Hospital in Leicester @JaneScullion
The health unions should have put up a better fight Even though it is not a fair offer, I voted to accept the 1 per cent pay rise because it is the only offer we will get.
Ethical dilemmas Anne Gallagher advises on the tricky issue of gifts from patients I am a nursing student on placement with a mental health community team. A regular service user has been bringing me a gift each time he comes for his appointment. It started with a packet of biscuits, then chocolates, and last week he brought me flowers. What should I do? The revised Code from the Nursing and Midwifery Council states that you must ‘refuse all but the most trivial gifts, favours or hospitality, as accepting them could be interpreted as an attempt to gain preferential treatment’. As no definition is offered, it is a matter of professional judgement about what counts as ‘trivial’. A packet of biscuits seems to qualify, but the gift giving appears to be escalating from small to larger gifts, raising a number of ethical issues. 28 march 18 :: vol 29 no 29 :: 2015
The greatest resource the NHS has for providing high quality patient care is its staff, yet the government seems intent on continuously attacking public sector pay. If we had rejected this offer, I doubt there would have been another one. Demoralised staff do not make good workers, and health unions should have fought harder for a better pay deal, including a promise from the government not to abolish our yearly increments and unsocial hours payments and to protect our pensions.
The service user might intend the gifts as recognition of your positive contribution to his care. He might also believe that gift giving will result in some preferential treatment. A further possibility is that the gifts suggest a more personal or romantic interest in you. In this situation, an ethical response is one that preserves the dignity of the service user, supports your wellbeing as a student, and maintains professional boundaries. I recommend discussing this issue with your mentor and, if appropriate, meet with the service user together so that you can thank him for the gifts in a respectful and kind manner, while making him aware that policy and ethical guidance does not permit further acceptance of gifts. It is important to remember that you are not alone. Your mentor, other members of the community mental health team, university staff and professional guidelines are all there to support you as a nursing student and provide you with the guidance you need. Ann Gallagher is professor of ethics and care at the University of Surrey
NURSING STANDARD
STUDENT EXPERIENCES IN THE REAL WORLD OF NURSING
But do any of us have the stomach left for this sort of fight? Drew Payne is a community staff nurse in north London @drew_london
Members could have held out for at least 2 per cent Unions may have had to accept this deal on behalf of members, but this does not mean it is an adequate offer. The deal came after a long and difficult struggle for NHS staff, with many taking industrial action. This obviously sent a strong warning to the government that NHS staff could no longer put up with the lack of a pay rise. But considering the input of NHS staff, 1 per cent is paltry. With the well-supported actions that were planned, I believe we should have held out for at least another 1 per cent. Elsie Gayle is an independent midwife
If this offer is a pre-election sweetener, what is next? Further strike action would have played nicely into the hands of those who love to bash the NHS, and I imagine that union members felt they had little choice but to accept this offer. What concerns me most though is how quickly the government reversed its position. Only last year they were telling the RB not to make recommendations for 2015/16, yet here we are with a pay offer – less than two months before a general election. Coincidence? I think not. Considering this is what NHS staff are already entitled to, it is creating an issue out of nothing. I cannot help thinking this is a sweetener before an attack on unsociable hours. Daniel Athey is a charge nurse on an acute medical unit at University Hospitals Coventry and Warwickshire NHS Trust @danjathey
Join the debate What do you think? Share your views on the Nursing Standard Facebook page
NURSING STANDARD
Starting out
MY EFFORTS TO PROMOTE NURSING’S 6CS IN PRACTICE INSPIRED ME AND OTHERS Last year I designed a poster reflecting the chief nursing officer for England’s vision and strategy for nursing, midwifery and care staff. The aim of the poster (pictured) was to help deliver the message that the 6Cs – compassion, courage, care, communication, competence and commitment – must be embedded in the delivery of all nursing care. The tree represents the ward, with the roots acting as the foundation of change, and the branches representing how change will be achieved. The poster was displayed at Northampton General Hospital NHS Trust’s nursing and midwifery conference, where it won an award, and at the trust’s annual general meeting in September 2014. It was also used by NHS England last year as part of a presentation. The trust set up focus groups for each of the 6Cs. Along with a matron, sister, junior sister and healthcare assistant from different wards, I was part of the group aiming to ensure compassionate care for all patients. The group designed a board to be displayed in wards, clinics and departments at the trust, focusing not only on compassion, but on all of the 6Cs. The aim was to communicate to patients, relatives, carers and staff that we are serious about embedding the 6Cs in the culture of the organisation. The board included stories written by patients, relatives and staff that demonstrated the delivery of the 6Cs in practice. We hoped that celebrating
good practice would motivate staff, reassure patients and relatives, and create a sense of pride in the workplace. When I presented the board to staff at the trust, I felt emotional talking about how we must celebrate good practice. The board was well received, and people approached me afterwards to say they were inspired by listening to me. Nurses told me that they felt my passion, which was fantastic. I had never spoken in front of such a large crowd before, and was especially nervous because the deputy director of nursing and a film crew were present. After this positive experience, I too felt inspired. I update the 6Cs board on our ward regularly, with stories from a wide variety of people. Patients and relatives remain anonymous to ensure confidentiality, but staff members are mentioned by name, with a photograph if they consent to it, alongside the acknowledgements of compassionate care. Patients, relatives and carers often read the board, which I hope inspires confidence and provides comfort for those being cared for and those leaving relatives or friends on the ward. The 6Cs are essential to the delivery of high quality nursing care. I am proud of my poster and the 6Cs’ boards, and of the role I have played in improving the care and wellbeing of patients. Lucy Bazeley Chambers is a final year nursing student with the Open University, training at Northampton General Hospital
On the web rcni.com/students. Send your experience, between 500 and 600 words, to [email protected]
march 18 :: vol 29 no 29 :: 2015 29
