Advice for lead nurses in an operational crisis
As the Royal College of Nursing, we recognise how professionally challenging it can be for a lead nurse when an organisation is in a clinical or operational crisis.
We are working urgently to raise our members’ concerns to UK governments to influence change and we are calling for transparent mandatory reporting of corridor care. We also want to support nursing staff at all levels to raise concerns.
We are highlighting some key points for you to consider.
The Code
The Code: Professional standards of practice and behaviour for nurses, midwives and nursing associates (2018) is explicit in the requirement for registered nurses to act without delay to raise concerns where they believe there is a risk to patient safety or public protection. This sits under the key theme of 'preserve safety'.
The Code places an obligation on registered nurses to: 'raise and, if necessary, escalate any concerns you may have about patient or public safety, or the level of care people are receiving in your workplace or any other health and care setting and use the channels available to you in line with our guidance and your local working practices.'
As a lead nurse you are the registrant on the board and are therefore responsible for the nursing advice you give. We have put a few questions here for you to review as a support to you.
Questions to consider
- What methods have you used to demonstrate to Nursing staff that you share and have raised their concerns to Trust Board and beyond?
- Have you looked at risk in real time and are your mitigations current and timely and are outputs evaluated and changed as required?
- Do you review real-time Datix information, and do you have a reporting system for your most serious events to come directly to you?
- Have you raised your concerns to your Chief Executive and Board Chair in writing and are you sure they are aware of the seriousness of your concerns?
- How are you supporting staff in this crisis? As an employer, health and safety legislation places duty of care on you for your staff and the people they care for, and as such requires you to take all reasonable and practicable steps to address their concerns.
- Have you reviewed the RCN Workforce Standards to identify if there is anything more that could be done within your organisation?
