Letters
We welcome all readers’ letters, but reserve the right to edit them or withhold names and addresses. Please email: [email protected]
Please keep letters to a maximum of 150 words, and include your full name, address and a daytime telephone number
Help inpatients by offering them nicotine replacement therapy Further to the recent media coverage on the call for smoking be banned from NHS hospital grounds, as a smoking cessation course trainer I would like to point out that smokers are addicted to nicotine. Instead of being judged, they need support to cope with policies that restrict them from smoking. Nicotine is metabolised quickly in the body and most smokers experience withdrawal symptoms a few hours after having a cigarette. If these unpleasant feelings are not relieved by another dose of nicotine – the next cigarette – they continue to get stronger. It should not be a surprise that sick people, desperate to get relief from these strong cravings, will leave their hospital beds to smoke outside. An alternative strategy would be to provide tobacco users with nicotine replacement therapy on admission. Offering patients a safe, alternative source of nicotine will make it easier for them to manage their cravings while in hospital, so they will not feel the need to go out so often to smoke. Jennifer Percival, by email
A FRESH APPROACH IS NEEDED TO HELP SMOKERS WHO WANT TO QUIT ‘Fresh’ was the UK’s first dedicated regional programme to tackle smoking-related illness and death. Established in the north east of England in 2005, the region has since seen adult smoking rates fall at twice the national average. Yet 11 people still die each day in the north east from preventable smoking-related illness. So we at Fresh warmly welcome the National Institute for Health and Care Excellence guidance on smoking cessation in acute, mental health and maternity services. 34 december 4 :: vol 28 no 14 :: 2013
The NHS needs a great deal more help to encourage the two thirds of smokers who would like to quit to receive timely, cost-effective and evidence-based support. The guidelines highlight the broader role that the NHS can also play around protecting patients from secondhand smoke and continuing to shift social norms around tobacco use. Many NHS trusts have recognised the importance of supporting smokers to minimise harm to themselves while in their care and routinely provide nicotine replacement therapy. It is everyone’s business to address smoking and adopt an on-site smoke-free policy. We at Fresh hope that the RCN will provide full support to the rapid implementation of this guidance, which has the potential to save thousands of lives and save the NHS millions of pounds by preventing smoking-related illness. Ailsa Rutter, director, Fresh www.freshne.com
WHERE ARE THE UNIONS WHEN IT COMES TO WHISTLEBLOWING? Rachel Potter (Letters November 13) asks what should nurses do when they have reported instances of unsafe staffing to managers and their concerns have been ignored? In the past, the advice has been to raise such concerns with your union or professional organisation, but I wonder now how they would deal with this? With increasing competition from the private sector for health contracts, it will become even more difficult for whistleblowers to raise concerns without, for example, fear of victimisation and loss of promotion opportunities. We have heard little from the unions and professional organisations on just how they intend to support staff who blow the whistle. Yet we hear on a regular basis about substandard care, caused mainly by poor management. To our shame, many of these situations were brought to the
NURSING STANDARD
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attention of unions at an early stage, but were often ignored. Employees have always acted voluntarily as stewards, but are frequently subjected to the ruthlessness of poor managers. Unlike the nurse at the coalface, many managers are not accountable for what they do and are much better at covering up their mistakes. There should be a register of managers, with a stronger system of accountability and supervision. Michael Owen, Bolton
DO NOT EMPLOY MORE ADMIN STAFF AT THE EXPENSE OF THE FRONT LINE The government’s response to the Francis report (Editorial, News and Analysis November 27) sounds promising, but does this mean that yet more administration staff will need to be employed to ascertain and publish the figures and data on staffing levels? The NHS is infamous for planning changes and then having to employ more office staff to implement them, often at the expense of front line staff. Nursing is the last area where we need cutbacks. None of this poor care should have happened in the first place. Does it really take report after report to understand the care and support that ill people need? Marian DeLancey, by email
NHS CHAPLAINS ARE PROFESSIONAL MEMBERS OF THE HEALTHCARE TEAM Michael Owen believes there is a role for Christian hospital chaplains (Letters October 30), but says they ‘should be funded and supported by their local churches or parishioners. They are then accountable to God and their church, not to a formal employer such as the NHS’. As a working chaplain in a multi-faith team, such sentiments seem to me to be a million miles away from today’s NHS chaplaincy. Chaplains are not appointed to serve the agenda of their faith group. They are professional members of the multidisciplinary healthcare team working with other NHS staff
NURSING STANDARD
to deliver patient-centred care in our diverse communities. I am not trying to defend chaplains’ jobs, but to ensure that patients receive a quality service. Meeting the spiritual and religious needs of patients should not be left to chance. This aspect of care should be provided by professionally accredited and appointed chaplains – of all faiths. Indeed, one very good reason why the NHS employs chaplains is so that they are accountable to the healthcare provider. Reverend Mark Burleigh, president, College of Health Care Chaplains
ZERO-HOURS CONTRACTS LEAD TO GROSS EXPLOITATION OF WORKERS Peter Cheese (Letters September 18) says zero-hours contracts can work for employers and employees. As chief executive of the Chartered Institute of Personnel and Development, he claims that zero-hours contracts have been ‘unfairly demonised’. At Unite, we believe that this view is divorced from reality. Millions of workers, many of them in the health services, are being exploited by zero-hours contracts. Independent research conducted for Unite by the social survey company Mass1 has pointed to a growing subclass of insecure and low-paid employment, with as many as 5.5 million people on zero-hours contracts in the UK. There should be no place for such gross exploitation in the UK. Companies can well afford to employ people with proper contracts, decent pay and guaranteed hours. Employers use zero-hours contracts to cut wages and avoid holiday pay, pensions and other benefits. Workers are unable to take on other work, as they are obliged to be available for shifts at the whim of their employer. With this high level of insecurity comes the risk of bullying, harassment and stress. All zero-hours contracts should be scrapped. Steve Turner, assistant general secretary, Unite
TWEETS OF THE WEEK #NScomment There’s a difference between us smoking and us enabling our patients to make their own decisions, as they are entitled to @nursehels
Yes, I think it is hypocritical for nurses to smoke while they are in uniform. It sends the wrong message @SusieJ13
I’m sure that the stress of being in hospital doesn’t make it the best time to give up @critical_nurse
Smoking ban is unenforceable. How can staff enforce it without risk of abuse in return? @pierogi4me
#WeNurses Let’s stop referring to ‘acute’ and ‘community’ and refer to hospital based care and community based care. Subtle difference @CrystalOldman
I think we focus too much on learning from our failures and not enough on learning from our successes. #Leadership #PersonalGrowth @bruceVH
#CNONI13 Take home message. Tonight, the standard you walk past is the standard you accept @charlottemcardl
Honestly, if you start an email to me with ‘Dear Sir’, you aren’t going to get very far @melaniebien
Follow Nursing Standard @NScomment and join the #NScomment chat on Thursdays at 12.30pm december 4 :: vol 28 no 14 :: 2013 35
Downloaded from RCNi.com by ${individualUser.displayName} on Nov 14, 2015. For personal use only. No other uses without permission. Copyright © 2015 RCNi Ltd. All rights reserved.
We welcome all readers’ letters, but reserve the right to edit them or withhold names and addresses. Please email: [email protected]
Please keep letters to a maximum of 150 words, and include your full name, address and a daytime telephone number
Help inpatients by offering them nicotine replacement therapy Further to the recent media coverage on the call for smoking be banned from NHS hospital grounds, as a smoking cessation course trainer I would like to point out that smokers are addicted to nicotine. Instead of being judged, they need support to cope with policies that restrict them from smoking. Nicotine is metabolised quickly in the body and most smokers experience withdrawal symptoms a few hours after having a cigarette. If these unpleasant feelings are not relieved by another dose of nicotine – the next cigarette – they continue to get stronger. It should not be a surprise that sick people, desperate to get relief from these strong cravings, will leave their hospital beds to smoke outside. An alternative strategy would be to provide tobacco users with nicotine replacement therapy on admission. Offering patients a safe, alternative source of nicotine will make it easier for them to manage their cravings while in hospital, so they will not feel the need to go out so often to smoke. Jennifer Percival, by email
A FRESH APPROACH IS NEEDED TO HELP SMOKERS WHO WANT TO QUIT ‘Fresh’ was the UK’s first dedicated regional programme to tackle smoking-related illness and death. Established in the north east of England in 2005, the region has since seen adult smoking rates fall at twice the national average. Yet 11 people still die each day in the north east from preventable smoking-related illness. So we at Fresh warmly welcome the National Institute for Health and Care Excellence guidance on smoking cessation in acute, mental health and maternity services. 34 december 4 :: vol 28 no 14 :: 2013
The NHS needs a great deal more help to encourage the two thirds of smokers who would like to quit to receive timely, cost-effective and evidence-based support. The guidelines highlight the broader role that the NHS can also play around protecting patients from secondhand smoke and continuing to shift social norms around tobacco use. Many NHS trusts have recognised the importance of supporting smokers to minimise harm to themselves while in their care and routinely provide nicotine replacement therapy. It is everyone’s business to address smoking and adopt an on-site smoke-free policy. We at Fresh hope that the RCN will provide full support to the rapid implementation of this guidance, which has the potential to save thousands of lives and save the NHS millions of pounds by preventing smoking-related illness. Ailsa Rutter, director, Fresh www.freshne.com
WHERE ARE THE UNIONS WHEN IT COMES TO WHISTLEBLOWING? Rachel Potter (Letters November 13) asks what should nurses do when they have reported instances of unsafe staffing to managers and their concerns have been ignored? In the past, the advice has been to raise such concerns with your union or professional organisation, but I wonder now how they would deal with this? With increasing competition from the private sector for health contracts, it will become even more difficult for whistleblowers to raise concerns without, for example, fear of victimisation and loss of promotion opportunities. We have heard little from the unions and professional organisations on just how they intend to support staff who blow the whistle. Yet we hear on a regular basis about substandard care, caused mainly by poor management. To our shame, many of these situations were brought to the
NURSING STANDARD
Downloaded from RCNi.com by ${individualUser.displayName} on Nov 14, 2015. For personal use only. No other uses without permission. Copyright © 2015 RCNi Ltd. All rights reserved.
attention of unions at an early stage, but were often ignored. Employees have always acted voluntarily as stewards, but are frequently subjected to the ruthlessness of poor managers. Unlike the nurse at the coalface, many managers are not accountable for what they do and are much better at covering up their mistakes. There should be a register of managers, with a stronger system of accountability and supervision. Michael Owen, Bolton
DO NOT EMPLOY MORE ADMIN STAFF AT THE EXPENSE OF THE FRONT LINE The government’s response to the Francis report (Editorial, News and Analysis November 27) sounds promising, but does this mean that yet more administration staff will need to be employed to ascertain and publish the figures and data on staffing levels? The NHS is infamous for planning changes and then having to employ more office staff to implement them, often at the expense of front line staff. Nursing is the last area where we need cutbacks. None of this poor care should have happened in the first place. Does it really take report after report to understand the care and support that ill people need? Marian DeLancey, by email
NHS CHAPLAINS ARE PROFESSIONAL MEMBERS OF THE HEALTHCARE TEAM Michael Owen believes there is a role for Christian hospital chaplains (Letters October 30), but says they ‘should be funded and supported by their local churches or parishioners. They are then accountable to God and their church, not to a formal employer such as the NHS’. As a working chaplain in a multi-faith team, such sentiments seem to me to be a million miles away from today’s NHS chaplaincy. Chaplains are not appointed to serve the agenda of their faith group. They are professional members of the multidisciplinary healthcare team working with other NHS staff
NURSING STANDARD
to deliver patient-centred care in our diverse communities. I am not trying to defend chaplains’ jobs, but to ensure that patients receive a quality service. Meeting the spiritual and religious needs of patients should not be left to chance. This aspect of care should be provided by professionally accredited and appointed chaplains – of all faiths. Indeed, one very good reason why the NHS employs chaplains is so that they are accountable to the healthcare provider. Reverend Mark Burleigh, president, College of Health Care Chaplains
ZERO-HOURS CONTRACTS LEAD TO GROSS EXPLOITATION OF WORKERS Peter Cheese (Letters September 18) says zero-hours contracts can work for employers and employees. As chief executive of the Chartered Institute of Personnel and Development, he claims that zero-hours contracts have been ‘unfairly demonised’. At Unite, we believe that this view is divorced from reality. Millions of workers, many of them in the health services, are being exploited by zero-hours contracts. Independent research conducted for Unite by the social survey company Mass1 has pointed to a growing subclass of insecure and low-paid employment, with as many as 5.5 million people on zero-hours contracts in the UK. There should be no place for such gross exploitation in the UK. Companies can well afford to employ people with proper contracts, decent pay and guaranteed hours. Employers use zero-hours contracts to cut wages and avoid holiday pay, pensions and other benefits. Workers are unable to take on other work, as they are obliged to be available for shifts at the whim of their employer. With this high level of insecurity comes the risk of bullying, harassment and stress. All zero-hours contracts should be scrapped. Steve Turner, assistant general secretary, Unite
TWEETS OF THE WEEK #NScomment There’s a difference between us smoking and us enabling our patients to make their own decisions, as they are entitled to @nursehels
Yes, I think it is hypocritical for nurses to smoke while they are in uniform. It sends the wrong message @SusieJ13
I’m sure that the stress of being in hospital doesn’t make it the best time to give up @critical_nurse
Smoking ban is unenforceable. How can staff enforce it without risk of abuse in return? @pierogi4me
#WeNurses Let’s stop referring to ‘acute’ and ‘community’ and refer to hospital based care and community based care. Subtle difference @CrystalOldman
I think we focus too much on learning from our failures and not enough on learning from our successes. #Leadership #PersonalGrowth @bruceVH
#CNONI13 Take home message. Tonight, the standard you walk past is the standard you accept @charlottemcardl
Honestly, if you start an email to me with ‘Dear Sir’, you aren’t going to get very far @melaniebien
Follow Nursing Standard @NScomment and join the #NScomment chat on Thursdays at 12.30pm december 4 :: vol 28 no 14 :: 2013 35
Downloaded from RCNi.com by ${individualUser.displayName} on Nov 14, 2015. For personal use only. No other uses without permission. Copyright © 2015 RCNi Ltd. All rights reserved.
