Mark Butler is RCN West Midlands Regional Board Chair and has been a steward for more than 20 years.
"The RCN’s Nursing Workforce Standards are proving to be a fantastic resource and I’ve been able to use many of them in my work representing members. I recommend them to all RCN reps as part of their toolkit, as I think it’s one of the best documents we’ve ever produced.
I had one case involving a member who was a very experienced and dynamic ward sister. In the middle of the pandemic, she moved from a hospital setting to a very busy community-based team, where she was given a case load, but no support or help to settle in. In her new role, she followed a policy that applied in hospitals, but there was no equivalent in the community setting. This resulted in a complaint and my needing to represent her.
As her health was being adversely affected, I was able to cite Standard 13 which talks about how the nursing workforce is entitled to work in healthy and safe environments. Standard 10 was also useful, as it talks about how more senior staff, who are taking on additional or different roles, need a period of preceptorship until their competence and confidence are achieved. As a result of my intervention, managers decided there was no case to answer and she returned to work, receiving her back pay and a formal apology.
Another case involved a healthcare support worker, who worked night shifts on an acute mental health admissions unit. There was an incident where a fire alarm was activated as a prank, during a very busy time. She was disciplined over a complaint that she shouted at a patient, but it was to make herself heard above the noise of the alarm. The consequences of facing a disciplinary included losing such a large amount of her wages she was forced to start using food banks.
In my role representing her, I was able to talk about the qualities of good leadership, referring to the introduction in the standards document, which says: “Nursing leadership must embody compassion both in style and behaviour towards the staff they lead.” I also cited Standard 12, which talks about how leadership should support and nurture psychological safety and Standard 10, with its focus on staff working within their scope of practice. Eventually the case was dismissed and she returned to work, with the opportunity to have more training, helping her career pathway.
When I’m delivering preceptorship training, I also use Standard 8. We talk about how you manage a ward using staffing; how you judge that staffing; and how ward managers should build in enough practice time for mentors, preceptors, learners and students.
These standards are helping to create lasting change, with my trust working towards a new and improved system that is altering how we deal with a range of issues, including absence management, disciplinaries and performance. This has come about through my repeatedly asking managers to show how they are complying with these standards. We know they are studying them closely, especially those elements around responsibility, accountability, staffing and leadership.
I think it’s demonstrated to managers that the RCN’s approach is more robust than ever. This says: these are the standards we expect as a minimum. And as an employer, if you’re not meeting them, you need to be prepared to be challenged."
Which Nursing Workforce Standards did Mark used to help members?
• Standard 8: When calculating the nursing workforce whole-time equivalent (WTE), an uplift will be applied that allows for the management of planned and unplanned leave and absence. “Underestimation of either or both planned and unplanned leave will result in an establishment that cannot meet day to day staffing requirements,” says the standard. “…over reliance on supplementary staffing, such as bank and agency staff, will impact on overall costs and quality of care.”
• Standard 10: Registered nurses and nursing support workers must be appropriately prepared and work within their scope of practice for the people who use services, their families and the population they are working with.
• Standard 12: The nursing workforce should be treated with dignity, respect, and enabled to raise concerns without fear of detriment, and to have these concerns responded to.
• Standard 13: The nursing workforce is entitled to work in healthy and safe environments. “Health, safety and wellbeing is more than just the absence of work-related disease or injury rather, an emphasis on achieving good physical and mental health amongst the nursing workforce,” says the standard.