Principle H

Published: 22 February 2013

RCN HCA and AP Adviser Tanis Hand takes a look at Principle H

In each of our e-newsletters we have been focusing on the RCN Principles of Nursing Practice, as they are such a fundamental part of good nursing care. Whether you are a health care assistant (HCA) or an assistant practitioner (AP), and whether you work in acute care, mental health, the independent sector or indeed anywhere, the principles will apply to you and your colleagues.

The Principles make clear exactly what quality nursing care looks like. They were developed with patients and for patients. They can be used by nursing staff to reflect on their own practice and evaluate nursing care. They can also be shared with patients and their families or carers so they can give feedback on the care provided.

Principle H: Nurses and nursing staff lead by example, develop themselves and other staff, and influence the way care is given in a manner that is open and responds to individual needs

Many people think of leaders as the most influential of public figures, or the more senior members of staff where they work. How often do you hear –  or even say – "I am just an HCA"? I don’t think we should ever hear that phrase, as every person who is a member of the nursing team is as important as the next – and we can all be leaders in our own ways.

As a student nurse many years ago, I was hugely influenced by the nursing auxiliaries that I worked with. One in particular was on the children’s ward, and I shall call her Mandy.

Mandy was in her forties and had been working on the children’s ward for about 10 years. She had two teenage children and lived with her family about a mile from the hospital. Her husband was a plaster technician in A&E. I was a young and very naive student nurse, and Mandy took me under her wing. She made sure that I was around when anything new was happening and that I was able to help when she was preparing feeds for babies – a totally new experience for me. As she worked, she would chat away, and it was only later that I realised how much information she imparted and how many wise words she said.

Rapport with patients

Mandy was always able to form a great rapport with each set of parents, even in the most difficult of circumstances. She was a total professional, in the best sense of the word. Children, parents and staff all trusted her completely. She taught me to be patient and quiet when a person was scared, and she taught me how to cheer up lonely children who were missing their parents. But most of all she taught me that in every single case, the most important person there was the patient and with the patient came the family as their needs were interdependent.

At the end of the three months of my working on the children’s ward, I asked Mandy how she knew so much, and she told me she and her husband had lost their first child to meningitis at the age of two. This experience, where their child had been nursed on the very same ward, had given her the incentive to work there once her other children grew up. She had such a wealth of knowledge and compassion to impart but she did it so quietly and calmly.

To me, Mandy was a true leader. She stood up for her patients and her colleagues. She always led by example and in her presence everyone seemed to always do their best – poor practice was not an option. She was respected by all members of staff and I would often hear the senior staff asking Mandy how a baby or child was doing. But in her mind, she was “just an auxiliary”.

To me, Mandy was one of the most influential people I met as a student. I hope I never forget what she taught me on that ward. Mandy was a true leader, and demonstrated every aspect of Principle H.