03/01/2012 - Newly qualified nurses - how can we support them ?

#NurChat to discuss "Newly qualified nurses - how can we support them?" 03/01/2012 8pm

We can all remember those first shifts as a newly qualified staff nurse as they are very scary times – the feeling that you are now “out there” practising as a registered nurse is very awe inspiring as a newly qualified nurse. It is vital that newly qualified nurses are supported and mentored through these times as “Building confidence is an essential part of the transition from nursing student to qualified practitioner.” (Nursing Standard) A Scottish scheme called Flying Start sets out to ease the transition between being a student nurse and qualified practitioner, with online learning, structured study days and mentor support. The program requires nurses to show evidence of learning in 10 areas to complete preceptorship and ensures that newly qualified nurses have mentors and protected learning time. This scheme has now been extended to England.

So how important is it that we support our newly qualified colleagues through this very important time? Preceptorship programmes exist to support newly qualified nurses but are these sufficient ? And are there enough of these programmes for newly qualified nurses to access ? What sort of things do preceptiorship programmes cover and is this enough ? Do newly qualified nurses have mentors as a matter of course, especially within the current climate? And is there a difference between what the NHS and what the private sector offer to newly qualified nurses?

Flying start Scotland

Flying start England

My top ten suggestions for improving nursing - Nursing Times

Are newly qualified nurses prepared for practice? - Nursing Times

A flying start for the newly qualified - Nursing Times

NMC welcomes recommendations of the report of the Prime Minister’s independent Commission on the Future of Nursing and Midwifery - NMC

General Practice Nursing Preceptorship & Assessment Booklet - NHS East of England

Preceptorship - RCN Direct Advice

Expectations of newly qualified nurses -Nursing Standard

Preceptorship gets nurses off to a flying start - Nursing Standard

Summary by Teresa Chinn RN

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Post chat summary

View our Nursing Times blog for this chat

This chat kicked off by asking if we need to support newly qualified nurses. The general feeling was that newly qualified nurses do need support and some questioned the amount of practical experience students get and felt that because of this they did need support.

The idea of a probationary year was put forward and this was generally liked but it was agreed that mentors are key. It was mentioned that universities and the NHS need to work more closely in order for this to happen effectively – the skills passport was mentioned as a solution to this.

Preceptorship was also discussed and in particular the Flying Start programme. Some NurChatters had heard of this and had accessed it through both the NHS and private sector. It was stated though that the flying start scheme did not seem to be very well promoted but did provide lots of structured reflection.

Newly qualified nurses in the private sector was discussed a little and it seems that (especially in Scotland) newly qualified nurses are increasingly being employed in nursing homes. Concerns over well trained mentors and supervision were raised and it was suggested that maybe CQC has a responsibility to ensure this happens- this ledto a debate over CQC responsibilities in this area.

Rotations were discussed and some had very positive experiences of rotations post qualifying.

A lack of mentors was identified by the participants as being a hurdle – some stated they would happily act as voluntary mentors to newly qualified nurses and ideas of how this could happen included using social networking, skype, and face to face time. Who should be responsible for this though was very much a debate and suggestions ranged from universities for 1 year post registration, to CQC and the NMC and a sigle qualifying body to support newly qualified nurses.

The chat closed by asking what participants would take away from the chat and how would they support newly qualified nurses? Suggestions included:

“Don’t be afraid to offer your knowledge you may not be a mentor but we all have something to offer and share” @kathjlo

“We need to lobby more regionally and nationally” @riffraff1985

“Important thing is that all nurses share responsibility for developing others – whatever grade” @amnerisuk

“Firmly believe we do ALL have a responsibility but frankly some need to be supported on how to support” @ SpinalNurse

Summary by Teresa Chinn RN

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Chat transctript (Via Storify)

20/12/2011 - Should Nurses Be Healthy Role Models?

#Nurchat to discuss “Should nurses be healthy role models?” – 20/12/2011 8pm

So as we are nearing Christmas and this is the last #NurChat of the year we are going to be discussing if nurses should act as healthy role models. This is very apt as we enter the new year as it is traditionally a time for lifestyle changes – so what resolutions will you make? Do you feel that as a nurse you should not smoke, exercise regularly and eat sensibly? Or do you feel that this is not applicable at all?

An article on the Nursing Times website earlier this year by Steve Ford quoted Paul Miller Managing Director of Leicester City Community Health Service Business Unit as saying“We are out there promoting healthy lifestyles, but actually a lot of our staff are not doing what they are trained to do and actually ignoring their professional knowledge, completely and utterly”

In 2008 the QNI launched a campaign called Nursing No 1 - to encourage nurses to adopt healthier lifestyles some links to articles about this campaign are below, And in regard to this years Flu campaign which focussed on getting staff to have the flu jab Dame Christine Beasley Chief nursing Officer for England stated “ as trusted nurses and midwives, you all play a key role in helping people make decisions about their healthcare. By getting vaccinated yourself, you are then able to discuss the vaccination with your patients and clients from a first hand perspective “ This clearly shows that nursing bodies are concerned about nurses health and about nurses being good role models

So should we as nurses be expected to live healthy lifestyles? Is this a realistic expectation ? Or should we be free to make our own lifestyle choices regardless of the impact on public health?

Thank you to @Hollybest1 for this great end of year discussion.

Click on the picture to download a prinatble PDF for notice boards

Below are a few links to articles that you may like to read prior to the discussion. Please feel free toadd to this is you find anything else that is relevant and useful.

District nurses setting a rubbish example on public health - Nursing Times

A messgae for nurses and midwives - Dame Christine Beasley Chief Nursing Officer for England

Barriers to healthy eating in the nursing profession: Part 1 - Nursing Standard

Barriers to healthy eating in the nursing profession: Part 2 -Nursing Standard

Childrens nurse selected for national ice hockey team - Nursing Times

Nurses urged to look after themselves better - Nursing Times

Impact Report 2008 - The Queens Nursing Institute

Summary by Teresa Chinn RN

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Post Chat Summary

View the Nursing Times blog for this chat

This #NurChat focussed on whether nurses should be healthy role models. The chat started by asking if we should expect nurses to be healthy role models? Answers were diverse – from “yes” to “we should be realistic” and it was suggested that being treated by a smoking nurse for smoking cessation advice was not a good incentive to quit.

The NMC Code of conduct was raised in particular that as nurses we should not bring the profession into disrepute – this theme reoccurred throughout the chat. It was put forward that as professionals we have a shared code but not a shared set of values.

Barriers to being healthy role models were mentioned – stressful jobs, shift patterns, tiredness. It was agreed that the constraints of the job can make it difficult to chose a better or healthy option.

During the chat definitions of role models were touched upon – some suggested leading by example for people who share your interests; other suggestions were a person who serves as an example.

The way in which nurses act as role models in other areas was seen as very important – being caring and compassionate. It was suggested that nurses should be seen as role models for advocacy and dignity rather than physical roles.

It was also suggested that maybe being overweight or a smoker may give us greater empathy with our patients – this was agreed to be a good thing.

The chat concluded by asking nurchatters what they would takeaway from the chat – answers ranged from “we are all human” to “we are not just role models at work but in life”

Summary by Teresa Chinn RN

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Chat transcript (via Storify)

06/12/2012 - The Mid Staffordshire inquiry

#NurChat to discuss "The Mid -Staffs inquiry" - 06/12/2011

The Mid Staffordshire Inquiry took place as a result of the standards of care at Mid- Staffordshire Hospitals between 2005 and 2009. The initial inquiry concluded that patients were routinely neglected by the trust who were preoccupied with cutting costs, targets and processes. It’s estimated that between 400 and 1200 more people died than was expected during the three year period in question. A further public inquiry then commenced in November 2010.

Since this Inquiry other reports involving poor patient care have been published the Patient Association report has also condemned poor care in hospitals along with a recent CQC report “The State Of Care”

There are many issues that surround all of these reports from fundamental nursing care to leadership and from whistle blowing to staff ratios. But what can we as nurses learn from these reports and how can we take these lessons forward to improve patient care in the future?

Thank you to @nursemaiden for suggesting this highly emotive discussion.

Click on the picture to downlaod a prinatble PDF for notice boards

There is a wealth of information out there about this subject of which there is a small slection below, however if you find something else that's relevant then please feel free to share.

Final report of the independant inquiry into care provided by Mid Staffordshire NHS Foundation Trust

Nurse-patient relationships 'have changed' - BBC News

Stafford Hospital inquiry told NHS whistle-blowers need support - BBC News

Timeline: Stafford Hospital in crisis 2007-2010 - BBC News

Stafford Hospital Public Inquiry: diary of evidence - BBC News

How skill mix affect quality of care -Nursing Times

Stafford Hospital public inquiry to begin -Nursing Times

Ward ratio of 60:40 is low as you can go, CNO tells Mid Staffs inquiry- Nursing Times

A profession in the spotlight: what makes good quality care? - Nursing Standard

Care Campaign - The Patients Association

Patients Association launches damning report into poor care in England’s Hospitals.

Care Campaign - Nursing Standard

Dignity and nutrition for older people - CQC

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Post Chat Summary

View the Nursing Times blog for this chat

The Mid-Staffordshire inquiry was discussed in this NurChat. To begin with we asked what were the key points of the inquiry for nurses? Thoughts ranged from the inquiry changed the focus of nursing care, that concerns that the themes of the inquiry related directly to nursing care to the mid staffs failure being rooted in focussing on targets not patients. It was generally agreed that the accounts of the poor care experiences were shocking.

This word cloud shows the key themes discussed

It was brought up that some nurses had not even heard of the mid staffs inquiry which was seen by participants as a negative thing with some thinking that every nurse should read the inquiry reports.

The chat then moved on to whistle blowing - it was clearly stated by a few participants that according to the report whistle blowing did happen and it was ignored. Concerns were raised that whistle blowing in the NHS is ignored or that nurses are put off whistle blowing because they are scared and frightened to speak up. It was discussed that at mid staffs a management culture existed that ignored staff concerns.

The role of student nurses was also raised in regards to raising concerns about care – it was stated that students are often best placed as a fresh pair of eyes to raise concerns however this can lead to difficulties in their placement. It was agreed that it is the mentor’s role to support students with this but sometimes it is not the case.

The idea of a safe haven for staff that raise concerns about care was discussed and participants put forward suggestions such as an anonymous and centralised whistle blowing department in the NHS. There was a suggestion that a nationwide whistle blowing hotline should be set up. It was also put forward that collective action through better networking and support would also help to empower nurses who had concerns – it was agreed that tools like twitter give nurse support and promote good practice.

NurChatters then discussed what nurses could learn from the mid staffs inquiry: ensuring senior staff act as good role models and support each other was seen as important. In addition the idea that change should come from the top down and bottom up and everywhere in between was accepted as being a good thing.

Social and economic issues ran through out this discussion with themes such as mid staffs were driven by cost cutting and the de valuing of care in society underpinning a lot of discussion.

One of the really important issues that was discussed as something NurChatters could do was to pass on the inquiry report to colleagues to read.

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Transcript (via Storify) - share, via twitter

#NurChat to discuss "The effect of the environment on pts & health"- 22/11/2011

As nursing students we are taught that in order to care for a patient we must consider them holistically taking into account physical, psychological, socio-cultural, political-economic and environmental. But how often do we actually look at our patients holistically and in particular the effect of the environment into account when considering a patients health?

The effect of the environment on the patient and even more widely on public health is not a new concept even Florence Nightingale was concerned of the effects of the unsanitary conditions of the Crimean War. Projects that help and encourage patient access to green spaces especially within the mental health branch have been advocated by nurses for a long time. The negative effect that a ward environment can have on a patients well being is also well documented- a 2009 article by Hannah Foley explains how a noisy, stark environment with little natural light led to poor patient experiences one patient commented that they felt “psychologically drained” because of the ward environment.

But there are also wider implications in regard to the environment and health – a blog entitled “Nursing Sustainability and Climate Change” written by Christelle Page states that “each day nurses see the environmental impacts on health” and goes on to state that increased road traffic leading to more road traffic accidents, the effect of more pollutants in the air for those with respiratory complaints, the effect of extreme weather on crops and livestock thus effecting local economy and then health, and the global effects of climate change on public health are all factors that can and are impacting on health.

Do we as nurses see the environmental effects on patients in our day to day work? Is it important for nurses to consider the health implications of the environment ? And should it be considered at both a local and a global level?

Thank you @Christellesongs and @BennyGoodmanUoP for suggesting this very interesting discussion.

Click the picture to downlad a printable PDF for notice boards

There are some links below to relevant background reading, please feel free to add more by using the comment facility.

Gardening as a therapeutic intervention in mental health - Nursing Times

Nursing sustainability and climate change - blog by Christelle Page

Health through a better environment - WHO

Nursing the planet - Nursing Standard

There has been some additional reading suggested via twitter on this subject that you might also find useful and informative.

Designing wards to release time to care - Nursing Times & Health benefits of outdoor therapies - Nursing Times. Thank you @EileenShepherd for both of these links
Climate change set to exacerbate child vulnerability in SA: study - SABC Thanks goes to @SSHRplymUni for suggesting
Summary by Teresa Chinn RN
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Post Chat Summary

View the Nursing Times blog for this chat

The effect of the environment on patients and health was discussed in this NurChat. Initially we looked at what we mean by the environment and generally two things were proposed – the immediate environment and the global environment.

We firstly looked at the immediate environment: noise, light and differentiation between night and day were cited as being important. In addition access to green areas was discussed and participants’ agreed that mobilising in and being able to see green areas had positive effects on patients. The difficulty of having bedbound patients and giving them access to these areas was raised and solutions included windows that looked out on to green spaces, indoor plants artwork and water features. It was suggested that patients recover more quickly if windows look out onto more that just bricks. Worries were raised over having enough time to take patients outside and this was resolved with suggestions such as outside physiotherapy, volunteer groups and even just pushing beds into the sunshine!

The chat then moved on to the global environmental effect on patients and health and the question was asked if as nurses it was our job to be more eco friendly? It was suggested that as nurses we can make a difference because we are the link between both factors- the outside world and an individual’s health. It was also proposed that it is our job as nurses to promote a healthy environment and that nurses are responsible for all aspects of the patient journey including health. Participants generally agreed that small changes make big differences – suggestions included local produce at mealtimes and putting flowers and plants back into the hospital environment.

To close the discussion NurChat asked what each participant would do differently following the discussion- the nurses involved came up with suggestions such as asking their ward manager for more plants on the ward, caring for more people at home in their own environment, using a bike, working smarter to allow time to get patients outside, promoting the sourcing of local food, reducing waste, giving patients more say in their environment and telling another nursing colleague about the effect of the environment on patients.

Summary by Teresa Chinn RN
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Chat transcript (Via Storify)

08/11/2011 - Assessing & maintaining nutrition in patients

#Nurchat to discuss "Assessing & maintaining nutrition in patients" 08/11/2011

With one third of all patients coming into hospital at risk of malnutrition (Nursing Times 2011) it is more important than ever that we ensure nutrition of our patients remains high on the agenda. As Nurses we are all aware that “Good nutrition, hydration and enjoyable mealtimes can dramatically improve older peoples health and well being” (McWilliams 2008) and how important it is to consider nutrition when thinking of other aspects of care such as wound healing, medication, and susceptibility to infection. So with this in mind how can we identify these “at risk” patients at the point of admission?

But the care does not stop with assessing and identifying the patients who are at risk; what can we do practically to promote good nutrition especially to those who are most vulnerable? From ensuring that those who need assistance get assistance to promoting a good eating environment, ensuring that patients have the right equipment with which to eat and promoting the right calorie intake – how can nurses ensure that their patients are getting the right nutritional care?

Thanks goes to @KevinHamPlymUni for this discussion suggestion.

Click the picture to download a printable PDF for notice boards

Some suggested reading material is linked below – please feel free to add to this if you find something that others will find useful.

Third of hospital inpatients at risk of malnutrition (2011) Nursing Times

Assessing the benefits of a malnutrition screening tool McWilliams (2008) Nursing Times

Malnutrition Universal Screening Tool – BAPEN

Innovations: a nurse led, multi professional approach to nutrition (2008) Nursing Times

Nutrition Now (2007) Nursing Standard

Nutrition older people (2011) Nursing Standard

Summary by Teresa Chinn RN

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Post Chat Summary

This #NurChat was about "Assessing and maintaining nutrition in patients" The chat started by asking what can we do to identify those at risk of malnutrition? It was agreed that MUST is a great tool and it was reported to be widely used amoungst the nurses participating, however there were concerns raised about whether is was just paid "lip service" Must was described as just an assessment tool and it was recommended that this is always followed up with a care plan and implementation of care.

NurChatters then discussed what canbe done to tackle malnutrition in patients: suggestions ranged from allowing relatives to bring in food, more staff, identifying those malnourished patients before they get to hospital and provision of good quality food.

It was stressed that malnourishment alsoincludes overweight and obese patients - action to improve their malnourishment seemed to a lot less one trust merely gave out a leaflet. It was agreed though that the health and recovery implications for overweight and obese patients were just as great as for those who are underweight.

Concerns were raised over some pateints, particularly the elderly, being able to feed themsleves and their food being left. Ways identified of combatting this were red tray systems and protected mealtimes. Other suggestions were to encourage visitors to visit at mealtimes and the use of volunteers - this in trun seemed to have restrictions in some trusts due to choking risks.

A comment was made about a US hospital employing the use of a coloured nightwear sysytem to identify vulnerable patients - but this scheme did not sit well with the nurses participating in the chat.

The importance of oral hygeine was raised - and all agreed that this was often forgotten about but should not be.

"The good old days" were brought up and whether malnourishment was prevalent in the past - itwas shared that in the 1970s malnourishment was on a similar scale to what it is today. However onsite kitchens,fresh food and ward kitchens cooking food on demand was noted as being something that used to be the case but no longer is.

Training was debated at length - particularly experiencing what it is like to be a patient and be fed and student nurses and lecturers confirmed that these types of learning took place.

At the end of the conversation nurchatters agreed that is came back to fundemental care skills, culture and investment in quality and training.

Summary by Teresa Chinn RN
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Chat transcript (Via Storify)

If Storify isn't working for you download the PDF transcipt here

25/10/2011 - Basic care in nursing

#NurChat to discuss "Basic care in nursing" 25/10/2011

“Nursing skills such as maintaining personal hygiene and assisting patients with food and fluid intake are often dubbed 'basic', but are vital for improving health and wellbeing.” (McNaughtan 2011) With this in mind what is basic care, should we even call it basic care – maybe fundamental care or essential care would be more appropriate ? What are the basic essentials that should be provided for every patient in our care?

Basic care is a very hot topic at the moment – opinions on whether modern nurses are forgetting the basics rage daily in the press. CQC have recently produced a report on their inspection findings of 100 hospitals and stated “Around half of the hospitals needed to do more to ensure that they were meeting people’s needs – with twenty of the hospitals visited failing to meet essential standards required by law” So is basic care being provided in all care environments and by all nurses? Are student nurses being shown the basics as part of their training? Are we as nurses getting involved in basic care? And is it important that we get involved in basic care?

Thanks you to Stu Robson for suggesting this discussion.

Click the picture to download a printable PDF for notice boards

There is a lot of material surrounding this highly emotive subject – but here are just a few articles that you may want to read. Please feel free to add to this list if you find anything else of interest.

CQC calls for action to improve care for older people

‘Basic’ skills are essential to good care nursing standard 2011 Emma McNaughtan Nursing Standard

Don’t wait for others to act – we can all make a difference Nursing Times

Hot Topic - Laura-Lee Leatherbarrow Nursing Times

Frontline nurses are key to ensuring quality care Rosemary Kennedy Nursing Times

NMC guidance for the care of older people

Summary by Teresa Chinn RN

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Post Chat Summary

This chat was a highly emotive subject and kicked off by asking if we should even call basic care "basic" ? the words 2fundemental" and "essential" were proposed to be more appropriate. it was suggested that there is nothing basic about basic care. In the end the general opinion was that it really did not matter what it was called so long as the patient felt that they had recieved good care that was all that mattered.

The downgrading of basic care was discussed and if these tasks were beneath nurses. it was agreed thatwe should all do the basics consistently and it is the essence of good nursing. basic care was discussed as being an opportunity to do so much more.

The debate then explored the theory that nurses are too academic and opinions ranged from "this is a red herring" to "maybe in trying to keep up with the world we have shifted our focus"

Socio - political issues were raised and provided some debate- some though that staffing levels, devaluation of care, devauluation of old age, and skill mix were causative factors in poor basic care. All agreed that good positive role models were essential for the provision of good basic care.

Everyone agreed that basic care tasks such as bathing, feeding, washing were an important part of nursingand they enable nurses to do so much more- get to know patients, assess patiemts and build trust.

Some solutions to improve failing hospitals were discussed and ideas included empowering nurses, employing more nurses, developing staff and standing proud as a profession. The idea that a ward made up of NurChat nurses being a truly amazing ward was retweeted all round!

Thanks to all those who took part in this discussion - the entire transcript is below, please feel free to share this with anyone who missed the chat.

Summary by Teresa Chinn RN

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Chat Transcript (in reverse chronological order)

PamNelmesFoH Nurse power - we can make a difference. PS....Sorry I'm behind the curve tonight #nurchat ters! Keep caring :-)) goodnight tweeps x 9:03 PM

MacMoomin @McCandlish couldn't see you properly on the #nurchat timeline and not able to retweet you either! Have you changed settings? 9:02 PM

NurChat And goodnight :) #nurchat 9:02 PM

AgencyNurse @PamNelmesFoH stand together, stand strong and stand proud #nursepower #nurchat 9:01 PM

gemslunix RT @mikkywatt: Has been a fab chat guys, so encouraging to see so much passion about the topic :D agreed ! #nurchat 9:01 PM

NurChat RT @mikkywatt: Has been a fab chat guys, so encouraging to see so much passion about the topic :D #nurchat 9:01 PM

Christellesongs RT @PamNelmesFoH: Perhaps we should stand proud as a profession and start hitting back - not literally of course (I need a job!!). #nurchat 9:00 PM

NurChat Of course, carry on chatting :) and follow and enjoy your colleagues and fellow NurChatters beyond these sessions! #nurchat 9:00 PM

mikkywatt Has been a fab chat guys, so encouraging to see so much passion about the topic :D #nurchat 9:00 PM

stuartrobson :-) RT @AgencyNurse: some amazing nurses here - imagine if we all were on one ward .. what a ward that would be!!! #nurchat 9:00 PM

PamNelmesFoH My heart gets heavy (and my breath wasted) as nurses continue to blame each other as too old, too educated/academic, too young, #nurchat 9:00 PM

AgencyNurse some amazing nurses here - imagine if we all were on one ward .. what a ward that would be!!! #nurchat 8:59 PM

gemslunix thankyou@nurchat its been a great eye opener and brilliant to express and see other views :-) #nurchat 8:59 PM

NurChat As usual the tanscript will be online with a summary, if you would like an attendance certificate please DM us #nurchat 8:59 PM

BennyGoodmanUoP that went quickly, thanks! #nurchat 8:59 PM

stuartrobson Thanks all - brilliant stuff & community :-) #nurchat 8:59 PM

MacMoomin RT @NurChat: Thanks all for joining us this evening, special thanks and a warm welcome to a few first time NurChatters :) #nurchat 8:58 PM

NurChat Thanks all for joining us this evening, special thanks and a warm welcome to a few first time NurChatters :) #nurchat 8:58 PM

gemslunix RT @MacMoomin: RT @NurChat: if you would like to suggest a topic add one via the NurChat blog > http://t.co/4QFVkw9x #nurchat 8:58 PM

BennyGoodmanUoP groupthink, bystander apathy, socialisation and other psycho-social factors turns 'thinking' sour without the nurse knowing it #nurchat 8:58 PM

AgencyNurse would love to know what will each of you do to drive up essential care standards in your workplace? #nurchat 8:58 PM

MacMoomin RT @NurChat: if you would like to suggest a topic add one via the NurChat blog > http://t.co/dCxtm0no #nurchat 8:57 PM

nursiedeb RT @Nursey_Shez: #nurchat, being able to assist patients with tasks they may struggle with is a privilege, i really value nurse/patient relationships i build 8:57 PM

AgencyNurse RT @stuartrobson: @AgencyNurse Id make sure that Nurses were aware of their power they have. We are empowered to enforce care #nurchat 8:56 PM

Hhaylo RT @PamNelmesFoH: Perhaps we should stand proud as a profession and start hitting back - not literally of course (I need a job!!). #nurchat 8:56 PM

NurChat if you would like to suggest a topic add one via the NurChat blog > http://t.co/dCxtm0no #nurchat 8:56 PM

stuartrobson yup! RT @BennyGoodmanUoP: @AgencyNurse #nurchat employ more nurses! develop your staff #nurchat 8:56 PM

gemslunix i think and its sad to say that now its all looked at financially by businessman rather than the on the ground care/patient needs. #nurchat 8:56 PM

stuartrobson @AgencyNurse I'd make sure that Nurses were aware of their power they have. We are empowered to enforce care #nurchat 8:56 PM

StuartBerry1 RT @PamNelmesFoH: Perhaps we should stand proud as a profession and start hitting back - not literally of course (I need a job!!). #nurchat 8:55 PM

NurChat not long to go all, just enough time to thank @stuartrobson for this topic we have all enjoyed, thanks Stuart :) #nurchat 8:55 PM

BennyGoodmanUoP @AgencyNurse #nurchat employ more nurses! develop your staff 8:55 PM

PamNelmesFoH Perhaps we should stand proud as a profession and start hitting back - not literally of course (I need a job!!). #nurchat 8:55 PM

AgencyNurse RT @mikkywatt: What a day that would be if it happened though, think there will be a lot of pigs in the sky that day ;) -lol agreed #nurchat 8:54 PM

stuartrobson Try teaching the 'individual factors' of changing a persons wet bed at 3am. It becomes obviously hard to teach without a role model #nurchat 8:54 PM

AgencyNurse so what would be the one thing that you would do to drive up standards of basic care in a failing hospital ? #nurchat 8:54 PM

Hhaylo #nurchat Not Political? My wards staff cut for efficiency savings, 6 patients need feeding, only 3 staff, what suffers first? basic care. 8:53 PM

mikkywatt @AgencyNurse What a day that would be if it happened though, think there will be a lot of pigs in the sky that day ;) #nurchat 8:53 PM

AgencyNurse @BennyGoodmanUoP if poor nurses work in organisations its the organisations fault - whatever happened 2 professional accountability #nurchat 8:53 PM

MacMoomin RT @PamNelmesFoH: Role modelling is critical- mentors need time to mentor. Nurses need to be valued by society and 'cared' for by their employer. #nurchat 8:52 PM

khalldearn RT @PamNelmesFoH: Role modelling is critical- mentors need time to mentor. Nurses need to be valued by society and 'cared' for by their employer. #nurchat 8:52 PM

NurChat RT @PamNelmesFoH: Role modelling is critical- mentors need time to mentor. Nurses need to be valued by society and 'cared' for by their employer. #nurchat 8:52 PM

Nursey_Shez RT @AgencyNurse: @mikkywatt sad but true - when did the nurse of the year make the fron page of the daily mail!!! #nurchat 8:52 PM

BennyGoodmanUoP @AgencyNurse which one? have i gone off on one? #nurchat 8:51 PM

stuartrobson @mikkywatt yeah :-( unfortunately.. #nurchat 8:51 PM

@mikkywatt sad but true - when did the nurse of the year make the fron page of the daily mail!!! #nurchat 8:51 PM

PamNelmesFoH Role modelling is critical- mentors need time to mentor. Nurses need to be valued by society and 'cared' for by their employer. #nurchat 8:50 PM

gemslunix @agencyNurse i know i keep going over while writing an answer ! #nurchat 8:50 PM

AgencyNurse @McCandlish - welcome daughter :)) #nurchat 8:50 PM

mikkywatt @stuartrobson Good stories don't make the news though do they? Sell more papers with a story about bad nursing than good #nurchat 8:50 PM

Christellesongs @stuartrobson sadly a lot of the media write the story that helps them make sales and ratings before they help causes :-( #nurchat 8:49 PM

NurChat RT @MacMoomin: @BennyGoodmanUoP #nurchat agree! nursing and NHS still so political. I remember being shocked by this when I was a student! 8:49 PM

AgencyNurse @BennyGoodmanUoP WOW !!! 140 characters is not enough to respond to that one !! #nurchat 8:49 PM

NurChat RT @Nursey_Shez: #nurchat, being able to assist patients with tasks they may struggle with is a privilege, i really value nurse/patient relationships i build 8:48 PM

stuartrobson lets get the media & filmmakers on board to help highlight things - media can be so influential! They could help change attitudes?! #nurchat 8:48 PM

MacMoomin @McCandlish #nurchat welcome to the chat daughter! X everyone-daughter. Daughter-everyone! 8:48 PM

BennyGoodmanUoP @AgencyNurse #nurchat but no one sets out to neglect, if poor nurses work in organisations it is the organsiations fault for recruiting 8:47 PM

AgencyNurse RT @Hhaylo: Bloody hell #nurchat is good but I really think we should get more political before its too late #savethenhs - agreed #nurchat 8:47 PM

MacMoomin @BennyGoodmanUoP #nurchat agree! nursing and NHS still so political. I remember being shocked by this when I was a student! 8:47 PM

Hhaylo Bloody hell #nurchat is good but I really think we should get more political before it's too late #savethenhs (sorry @AgencyNurse ) 8:46 PM

mikkywatt @Nursey_Shez Couldn't agree more, love the one to one time with patients that feeding, bathing etc give me, best time of the day :) #nurchat 8:46 PM

AgencyNurse @BennyGoodmanUoP ....and we are each accountable for our own actions & omissions! #nurchat 8:46 PM

AgencyNurse @BennyGoodmanUoP i would agree with you to an extent - but we all know that poor nursing happens... #nurchat 8:46 PM

gemslunix as said before so many people are far to politically correct now that all aspects of care are so covered ! #nurchat 8:45 PM

Nursey_Shez #nurchat, being able to assist patients with tasks they may struggle with is a privilege, i really value nurse/patient relationships i build 8:44 PM

AgencyNurse RT @stuartrobson: @BennyGoodmanUoP Devaluation of old age - massive issue! - agreed #nurchat 8:44 PM

BennyGoodmanUoP @AgencyNurse #nurchat the personal troubles experinced by patients as a result of poor nursing result from wider sociopolitcal issues yes 8:44 PM

stuartrobson @MacMoomin Yeah, social media could encompass SO many elements and we need the support & green light to get on with it! #nurchat 8:43 PM

AgencyNurse @BennyGoodmanUoP so what you are saying is that basic care is suffering due to social & political issues not poor nursing? #nurchat 8:42 PM

mikkywatt Definitely RT @BennyGoodmanUoP: issue 2 devaluation of old age in a society that does not want to pay for their care #nurchat 8:42 PM

MacMoomin @stuartrobson @bennygoodmanuop massive cultural issue. Where do we start with that one? #nurchat 8:42 PM

NurChat RT @PamNelmesFoH: Good to see so many nursing students #nurchat ting tonight. 8:42 PM

NurChat RT @mikkywatt: @Hhaylo couldn't agree more, if students and other nurses see what we do hopefully we will lead by example #nurchat 8:41 PM

gemslunix it would be nice to think if to learn by example you get your hands dirty first...?? #nurchat 8:41 PM

stuartrobson @BennyGoodmanUoP Devaluation of old age - massive issue! #nurchat 8:41 PM

PamNelmesFoH Good to see so many nursing students #nurchat ting tonight. 8:41 PM

AgencyNurse @MacMoomin thats reassuring to hear #nurchat 8:40 PM

mikkywatt @Hhaylo couldn't agree more, if students and other nurses see what we do hopefully we will lead by example #nurchat 8:40 PM

AgencyNurse RT @BennyGoodmanUoP: issue 2 devaluation of old age in a society that does not want to pay for their care #nurchat 8:40 PM

BennyGoodmanUoP issue 3: get the skill mix right..more not less RNs #nurchat 8:40 PM

AgencyNurse RT @BennyGoodmanUoP: issue 1 devaulation of care , it is seen as female labour and so not worth paying for #nurchat 8:40 PM

SophieLer #nurchat I was taught basic care ie washes, oral care etc via HCA's on my placement as my first year of training was mainly study 8:39 PM

gemslunix what better way to give this trust back to patients- should be by utilising our basic care in a high standard. #nurchat 8:39 PM

BennyGoodmanUoP issue 2 devaluation of old age in a society that does not want to pay for their care #nurchat 8:39 PM

MacMoomin #NurChat my daughter @McCandlish is studying nursing now and getting very good detailed care. Seems a great mix of practical&academic. 8:39 PM

AgencyNurse RT @Hhaylo: @AgencyNurse #nurchat Be posiitive role models, its so simple its stupid. - I LIKE ! #nurchat 8:38 PM

stuartrobson Agree 100% RT @Hhaylo: @AgencyNurse #nurchat Be posiitive role models, its so simple its stupid. #nurchat 8:38 PM

PamNelmesFoH I wish we could care more for one another - that might be a good start #nurchat 8:38 PM

BennyGoodmanUoP issue 1 devaulation of care , it is seen as female labour and so not worth paying for #nurchat 8:38 PM

AgencyNurse @BennyGoodmanUoP what wider issues do you think should be addressed ? #nurchat 8:38 PM

Hhaylo @AgencyNurse #nurchat Be posiitive role models, it's so simple it's stupid. 8:38 PM

i_de_serve RT @Hhaylo: #nurchat student nurses often feel that they are let down if they are asked to perform 'basic' nursing care. Herein lies the problem. 8:38 PM

mikkywatt @AgencyNurse @Nursey_Shez we got lectures on it but no practical, were told it was up to our mentors to teach us this stuff #nurchat 8:37 PM

BennyGoodmanUoP @AgencyNurse #nurchat get active 'politically' there are wider issues here, key skill is networking which this is! 8:37 PM

gemslunix @macmoomin , its a great privilege to be trusted by others that rely on us in one way or another in any sector great to see a mix #nurchat 8:37 PM

stuartrobson @AgencyNurse Yeah :-) #nurchat 8:37 PM

stuartrobson Yes money is an issue in the private sector, but that doesn't influence my work & care whatsoever... #nurchat 8:36 PM

AgencyNurse @stuartrobson i love working in care homes - gives me chance to get back to basics and really nurse #nurchat 8:36 PM

mikkywatt @gemslunix I'm not - agency nursing home while I look for a job. See great 'basic' care in some it's not done by the nurses though #nurchat 8:35 PM

AgencyNurse so what can we - in our role as nurses- do to ensure ALL patients recieve the care they need #nurchat 8:35 PM

FayeMoran_ RT @Nursey_Shez: @Hhaylo #nurchat, the ability of students to provide good basic care is essential to their learning, and enhances nurse/patient relationship 8:35 PM

stuartrobson I feel like i have to stand up for old peoples rights, in my work (sorry - i know it sounds cheesy!!) & that drives me... #nurchat 8:35 PM

Hhaylo @MacMoomin @mrs_tufty It will be Private companies & their focus on money rather than quality, and will be too late to #savethenhs #nurchat 8:34 PM

MacMoomin @gemslunix I am community gem. #nurchat feel the same as my acute colleagues though. A privilege to be allowed into people's lives. 8:34 PM

SophieLer @PamNelmesFoH Hello Pam! Saw your tweet and remembered you telling me about this at our last meeting, really like #nurchat 8:34 PM

AgencyNurse @Nursey_Shez i remeber being taught the basics, bed baths, feeding etc does this still happen? #nurchat 8:33 PM

stuartrobson Elderly nursing home (private) for me - but makes a world of diff when you care about what you are involved in. #nurchat 8:33 PM

NurChat RT @Nursey_Shez: @Hhaylo #nurchat, the ability of students to provide good basic care is essential to their learning, and enhances nurse/patient relationship 8:33 PM

AgencyNurse @gemslunix i am an agency nurse and go everywhere - hospitals, care homes, clinics - all sorts! #nurchat 8:33 PM

Nursey_Shez @Hhaylo #nurchat, the ability of students to provide good basic care is essential to their learning, and enhances nurse/patient relationship 8:32 PM

gemslunix are we all hospital based here..? #nurchat 8:32 PM

AgencyNurse @BennyGoodmanUoP yes i love this concept - have always done it but never had a label for it #nurchat 8:32 PM

stuartrobson Ha ha! RT @MacMoomin: @Hhaylo @mrs_tufty the media will find someone else to pick on soon! #nurchat 8:31 PM

MacMoomin @Hhaylo @mrs_tufty the media will find someone else to pick on soon! #nurchat 8:31 PM

BennyGoodmanUoP @cathieb #nurchat the 'new' thing is intentional rounding or something similar, means looking at out patients and picking up issues! 8:30 PM

PamNelmesFoH @SophieLer @NurChat Hello Sophie.. Lovely to see you on #nurchat 8:30 PM

gemslunix @nursiedeb well said ,you have to love the job and care about what your doing. well said #nurchat 8:30 PM

AgencyNurse so why when i see so many nurses (such as yourselves) are hospitals failing on these issues?? #nurchat 8:30 PM

stuartrobson Yeah, workloads, staffing levels etc.. = frustrations, and these can draw peoples focus away from basic care & onto other things?? #nurchat 8:30 PM

MacMoomin @nursiedeb it's core to the role and to the profession. Yes. We do get distracted and pulled away from it though. #NurChat 8:30 PM

BennyGoodmanUoP @STNNurse_Mikey #nurchat the competency based curriculum (NMC) squeezes out teaching care as the focus is on skill acquisition, 8:29 PM

Hhaylo @Mrs_Tufty Totally agree, we are social workers of the 2010's, vilified for every mistake and never acknowledged for the positive #nurchat 8:29 PM

AgencyNurse @nursiedeb i think you have hit the nail on the head there !!!! #nurchat 8:29 PM

stuartrobson @SophieLer Hi there! #nurchat 8:28 PM

i_de_serve RT @Hhaylo: #nurchat I make sure everyone stops what they are doing at meal times. every member of stops and concentrates on feeding patients, so simple 8:28 PM

nursiedeb #NurChat the 'basics' of all nursing care is actually giving a hoot about what you are doing. Being a nurse isn't what I do, its what I am. 8:28 PM

MacMoomin Kate in Hampshire. Had a good chat with some commissioners today. It included basic/fundamental care. Encouraging. #nurchat 8:28 PM

cathieb Should 'hourly nursing rounds' be introduced to ensure patients receive quality nursing care?? #nurchat. 8:28 PM

PamNelmesFoH If I forget the #nurchat tag again........ Apologies and at last @Hhaylo Yes indeed! (re:busy mentors that is!!) 8:28 PM

AgencyNurse @SophieLer welcome ! #nurchat 8:27 PM

stuartrobson @Christellesongs For sure - it can look very different person to person!.. #nurchat 8:27 PM

NurChat RT @SophieLer: Hello @NurChat my first time here great to use as a student (: #nurchat 8:27 PM

AgencyNurse @STNNurse_Mikey you have a good point there mikey - do we have time to care with all the other stuff we have to do? #nurchat 8:27 PM

SophieLer Hello @NurChat my first time here great to use as a student (: #nurchat 8:26 PM

Christellesongs #nurchat I've always found that 'essential' nursing care is individual, in collaboration with what the patient feels is essential to them. 8:26 PM

AgencyNurse @BennyGoodmanUoP i see good nursing every day, but this is not reflected in the media #nurchat 8:26 PM

STNNurse_Mikey #nurchat Perhaps focusing less on infection control,IT solutions,PCTwelfare provision, we should be focussing on teaching lost art of caring 8:25 PM

SophieLer @Nursey_Shez I 100% agree with you! #nurchat 8:25 PM

AgencyNurse @nursiedeb i like this - this is good nursing #nurchat 8:25 PM

Hhaylo #nurchat has compassion really gone or have the Telegraph and Daily mail taken hold of all of us, I see real compassion here. 8:25 PM

BennyGoodmanUoP @AgencyNurse selective memory! the USA is actually currently arguing that degree education is a must and should be pushed further #nurchat 8:24 PM

Nursey_Shez #nurchat as a student the first thing i wanted to learn was basic nursing care, pts have expressed to me that is what nursing lacks 8:24 PM

nursiedeb #nurchat been offered mouth care. Given basin to wash in post loo. Really follow up on pain score. Good info at all times and lots of smiles 8:23 PM

AgencyNurse @BennyGoodmanUoP but "old" nurses would have you believe that things were different in their day ! #nurchat 8:23 PM

stuartrobson being Academic has its place for sure, but maybe in trying to keep up with the world, we have shifted a bit of our focus?? #nurchat 8:22 PM

PamNelmesFoH @stuartrobson hello Stuart :-) #nurchat 8:22 PM

BennyGoodmanUoP @AgencyNurse #nurchat the university argument is a red herring, the issues have longet histories predating university education 8:22 PM

AgencyNurse RT @STNNurse_Mikey: but we often lack the basics such as compassion, or even basic english sometimes. Isnt this basic care? #nurchat 8:22 PM

gemslunix one could say that this world is becoming to PC that the simplest of basic care can be difficult (not in all cases) #nurchat 8:22 PM

FayeMoran_ RT @AgencyNurse: nurses have recently been accused of being too academic - is this a problem when it comes to essential care? #nurchat 8:21 PM

AgencyNurse @Hhaylo thats a brilliant approach ! #nurchat 8:21 PM

AgencyNurse @nursiedeb Hi Deb - thats great to hear !! #nurchat 8:21 PM

STNNurse_Mikey #nurchat - but we often lack the basics such as compassion, or even basic english sometimes. Isn't this basic care? 8:21 PM

BennyGoodmanUoP @nursiedeb #nurchat, brilliant to hear that! we need good news 8:21 PM

Hhaylo #nurchat I make sure everyone stops what they are doing at meal times. every member of stops and concentrates on feeding patients, so simple 8:20 PM

AgencyNurse @stuartrobson i wouild agree, its about taking the chance to get to know yr pt, assessing them, build a trusting relationship #nurchat 8:20 PM

AgencyNurse nurses have recently been accused of being too academic - is this a problem when it comes to essential care? #nurchat 8:19 PM

BennyGoodmanUoP @stuartrobson @Hhaylo rember the essence of care document? #nurchat spelled it out clearly 8:19 PM

stuartrobson unfortunately i have come across some Nurses who don't like to get their hands dirty, but Basic care isn't just about that.. #nurchat 8:18 PM

nursiedeb #NurChat Hello its Debbie from her hospital bed. Op went ok. Superb care here. How all care should be. Individualised to the patients needs 8:18 PM

mikkywatt @Hhaylo Agree, was once told as a student that it wasn't my job to help people to the toilet (still did though) #nurchat 8:18 PM

STNNurse_Mikey Helo #nurchat ers - Some would argue that basic care is exactly what is missing in the #nhs today. We have cutting edge tech, @NurChat 8:18 PM

BennyGoodmanUoP @Hhaylo #nurchat and that is why we must remember the affective element of care not just 'technical doing to' stuff which is still important 8:18 PM

gemslunix none everyone has a duty of care no matter what there role .. a nurse a domestic a cook ! you all have a duty of care. #nurchat 8:17 PM

AgencyNurse @stuartrobson i agree - i see basic care as an opportunity to do so much more #nurchat 8:17 PM

AgencyNurse @Hhaylo really ? so are these tasks beneath nurses? #nurchat 8:15 PM

stuartrobson @Hhaylo Yeah, how has this 'downgrading' of basic care happened?! It should be right at the top as the essence of good nursing! #nurchat 8:15 PM

NurChat RT @Safer_ICU: #nurchat We should all strive to raise the floor of healthcare, that begins with doing the basics consistently to every person, every time. 8:15 PM

Hhaylo #nurchat The Nursing role is being sold as a 'junor doctor' type role and disregards the basic human needs of the vulnerable patient. 8:15 PM

AgencyNurse @Safer_ICU well said !! #nurchat 8:15 PM

stuartrobson @PamNelmesFoH Hi Pam, nice to 'tweet' with you! #nurchat 8:13 PM

Safer_ICU #nurchat We should all strive to raise the floor of healthcare, that begins with doing the basics consistently to every person, every time. 8:13 PM

Hhaylo #nurchat student nurses often feel that they are let down if they are asked to perform 'basic' nursing care. Herein lies the problem. 8:13 PM

mikkywatt @AgencyNurse Things that involve direct patient contact are the things I would class it as #nurchat 8:13 PM

BennyGoodmanUoP the whole package is needed so mikkywatt is bang on, it is not easy! #nurchat 8:13 PM

AgencyNurse RT @stuartrobson: http://t.co/3naG7dhE for a blog post on basic care (and a picture of a bum) ;-) #nurchat 8:12 PM

AgencyNurse @BennyGoodmanUoP yes you have a point there its all about patient experience #nurchat 8:12 PM

BennyGoodmanUoP @AgencyNurse #nurchat it may be useful to catagorise care as: psychomotor skills (hands on) affective (feelings) and cognitive, all needed 8:11 PM

stuartrobson http://t.co/yhWyJxfP for a blog post on basic care (and a picture of a bum) ;-) #nurchat 8:11 PM

PamNelmesFoH Hello @NurChat ters! Pam signing in from #Cornwall to #nurchat 8:10 PM

BennyGoodmanUoP #nurchat we can have a discussion around the word but from a patients prspctive the issue is how they experience care not what its called 8:10 PM

mikkywatt Hi, Michelle in Edinburgh here :) Basic is the wrong word, takes a huge amount of skill to do those tasks well #nurchat 8:10 PM

stuartrobson @AgencyNurse Thats a hard one, as it can be just the tip of the iceberg - its sometimes just a starting place for what follows #nurchat 8:09 PM

AgencyNurse @stuartrobson btw loved your blog about it - can you post a link for others to read? #nurchat 8:09 PM

AgencyNurse so what care do we place in the essential care bracket ?? #nurchat 8:08 PM

stuartrobson @gemslunix too right! #nurchat 8:08 PM

stuartrobson I've heard lots of different names for it - but its still the same - all the names highlight diff aspects of it #nurchat 8:07 PM

AgencyNurse RT @cathieb: Nothing basic about nursing care. Always highlight to students that quality care is a fundamental & essential skill. #nurchat 8:07 PM

BennyGoodmanUoP #nurchat basic has been around for a long time and always has negative overtones to it, the move seems to be in favour of essential 8:07 PM

gemslunix nothing should be basic about it , top quality care is essential to the care/nursing industry. #nurchat 8:07 PM

AgencyNurse @stuartrobson i totally agree with you and was pleased when you suggested it #nurchat 8:07 PM

NurChat tonight we are discussing basic care ..... is basic care the right label? #nurchat 8:05 PM

cathieb Hi #nurchat. Nothing 'basic' about nursing care. Always highlight to students that quality care is a fundamental & essential skill. 8:05 PM

stuartrobson cool...its a big important subject #nurchat 8:04 PM

NurChat @stuartrobson thanks stu fort suggesting tonight subject #nurchat 8:04 PM

gemslunix hi gems here from tiverton hello all. #nurchat 8:04 PM

AgencyNurse hi teresa here - tweeting from lovely exeter this evening #nurchat 8:03 PM

stuartrobson hi all :-) Stu in bristol... #nurchat 8:03 PM

NurChat so who is out there this evening??? #nurchat 8:01 PM

NurChat Hi All -As always please remember the NMC code of conduct when tweeting tonight & that your opinions are all your own #nurchat 8:00 PM