Friday, 3 October 2014

Poor managers v dynamic managers

Sometimes a leader in nursing in the NHS writes something that seems so patently obvious that it is quite breathtaking that it had to be written, but is also so true.  Deputy chief nurse Pete Murphy did just that in an article for the Nursing Times about improving nursing (Nursing Times Staff Management article 24 9 14).

He wrote ‘You (as a deputy chief nurse) cannot sit in your office and be effective, you have to get out and about, see and talk to patients and staff to understand the opportunities and pressures that exist. Personal integrity is key.’ 

One of the saddest aspects of unjust and unnecessary suspensions, is the lack of knowledge by the managers concerned higher up the chain of command, who don’t know their staff, and don’t know that this is a silencing or bullying issue.  Such disloyalty, such ignorance as to the very severe damage this action does to people, sometimes destroying them, is utterly depressing. 

It also needs an environment where leaders are allowed to do this, to know staff in order to support them.  In the early days of CAUSE, we heard from a first level manager who tried to do just that and was nearly destroyed.  False allegations, suspension, disciplinary action, removal to another part of the organisation.  It was more than a year before she was well enough to work again, outside the NHS of course.  Who would trust anyone there again?

‘Personal integrity is key’ is the other staggering comment written by Mr Murphy.  Something that you would expect to be a given, has to be written.  That is another problem with unjust and unnecessary suspensions.  The suspending manager now has to justify their action, prove themselves competent to their colleagues.  A ‘transparent and fair investigation’ – they don’t know the meaning of these words.  What they do know, is that they now have to prove their action was justified, so the witch hunt begins.  Look at record keeping, talk to other staff to see if someone there will complain about this staff member who has annoyed the manager by speaking out or by being very good at their job and well respected by the patients.  Integrity?  They don’t know the meaning of that word either. 

One of the aspects of the whole sordid business for family members and friends, observing events, is their astonishment and disbelief that this can happen without any other managers being aware and that the poor powerless staff member, the ‘accused’ has no redress.  The words ‘kangaroo court’ are often used to describe these situations.

Thinking about the inquiry into whistleblowing by Sir Robert Francis, the team seem to be starting at the wrong end of the problem.  Yes they need to hear people’s stories, the like of which they have already listened to in the Mid Staffs inquiry, but they also need to be interviewing the very managers involved in the injustices to see what can be done to prevent them from behaving in these horrendous ways.  They won’t hear any truth from them of course.  They will be trying to save their careers.  That is what makes it so difficult.

So back to Mr Murphy.  I hope his words have an impact but fear that the people who should be reading them, don’t take professional journals, don’t keep up to date and avoid self reflection like the plague.

Gloomily yet again!

Thursday, 18 September 2014

Whistleblowing Inquiry by Sir Robert Francis and unaccountable managers – an impossible situation to resolve

I despair of senior managers and leaders in the NHS ever understanding why whistleblowing is a very dangerous activity.  All their urgings and all the policies and revised constitutions in the world will not change toxic organisations and therefore will not protect whistleblowers or patients.  And now, to make matters worse, staff face possible disciplinary action if they ignore poor practice.

The Campaign Against Unnecessary Suspensions and Exclusions UK (CAUSE)  was set up twelve years ago to provide information to NHS staff who have been wrongfully suspended, many of whom have tried to blow the whistle and been silenced. 

How might staff get into this whistleblowing position?  A common process is a nurse who works in an area with excellent leadership where staff are respected and consulted, then changes jobs.  They start on a new ward  to find poor working practices.  They cannot understand why staff seem to tolerate these harmful practices.

They try having a quiet word with colleagues who seem approachable.  Some may agree but others are defensive and hostile. They try speaking to the Ward Manager and get a negative response. By this time they are labelled as a trouble maker. Worse still, one day they are called into the office and asked to bring a union rep or colleague with them and in a state of shock they are told of vague, unsubstantiated allegations against them. To their disbelief they are suspended and marched off the premises. This scenario, and the ensuing processes, are unbelievable unless you have experienced them, as the team at CAUSE have done.

Repeatedly we hear of unaccountable managers protecting themselves and undertaking biased investigations, character assassination, lengthy suspensions, disciplinary hearings which resemble kangaroo courts and ultimately dismissal of staff who previously had exemplary work records. The human resources staff seem to feel they need to protect themselves so work with the managers. Undisclosed sums of taxpayers’ money are paid, in out of court settlements if the staff member has the energy and legal support to take their case to employment tribunal.

Being wrongfully suspended is the most harmful, destructive and devastating action that management can take against a staff member.  It is devastating to their families too.  Other staff think it is such a serious action to be taken, there must be something wrong and this person’s career and reputation is seriously damaged.  The effect of this wrongly labelled ‘neutral act’ makes people ill.  When colleagues who know what is happening, see all this, it is understandable that they feel powerless to change anything.  Who in their right minds would raise a whisper let alone blow a whistle?

The unions have some proactive volunteer reps and fulltime officers who are well versed in employment law and not afraid to speak out for their members.  However more often the fulltime officers are hard to contact, probably doubt the member’s innocence and will work for the least serious disciplinary outcome.  A final written warning is viewed as a victory because dismissal has been avoided even though their member is not guilty of any misconduct.
Nationally CAUSE asked the unions to establish a joint working group to provide expertise to officers faced with these situations, but the numbers of people affected remain comparatively small and the resources of the unions are limited. 

The Nursing and Midwifery Council (NMC) hopes to develop a system to monitor systemic failure in trusts.  So far they have ignored the processes I have been describing.  This was clearly seen in their ruling for the M Haywood case by the Fitness to Practice team.  They described the covertly filmed neglect as ‘failures of an exceptionally serious nature’ but then took no action against the perpetrators and the manager, who had conducted a woefully inadequate investigation .  Instead they found the whistleblower guilty and struck her name from the register.  The message to whistleblowers was clear – don’t expect us to protect public and staff by taking action where there is malfunctioning management.

The tragedies that have been uncovered will continue until the Department of Health and the Care Quality Commission face up to the complexity of the situation and the need to look at the indicators that suggest all is not well – the number of suspensions and how they are dealt with, levels of staff sickness and staff retention, and most importantly, patient outcomes, in order to identify and change these toxic organisations.

So will Sir Robert Francis be able to achieve anything, as he listens to peoples’ tragic stories?  Will he be able to make recommendations that will change this dire situation?  I so hope so, but while no action continues to be taken against managers who ignore employment processes and often seem to act out of malice or ignorance as to what constitutes danger to patients etc, then I doubt it.

Yours sadly

Saturday, 6 September 2014

The devastation of suspension and loss of employability

The devastation of suspension

Lack of understanding about the deadly impact of suspension is a failing I despair about.  How will managers ever understand that to be cut off from one’s essential, life enhancing, rewarding work in the most humiliating, unexpected and shocking manner, is a blow that will cause psychological harm, even injury and in many cases, damage the person for life.

I wish I was exaggerating.  The insights that follow are used with permission and anonymised to protect the sufferer.  Read on and if you have any power to change this system, PLEASE use it.
Impact of Suspension

I was suspended by my line manager, motivated I believe by personal dislike.  I was cleared of the false allegations over a protracted four month investigation and disciplinary process, involving two independent investigators.  The process ended in me leaving the company, just like I had been told - almost no-one goes back to work after a suspension because the process destroys the necessary 'mutual trust and confidence' between employer and employee.

Now that I have been dismissed, I am free to work.  However I am very unwell as a result of the suspension and the events that took place during my suspension.  Suspension is not a routine decision, it is a ‘nuclear option.’

I say this because suspension is a form of exclusion, and human beings react badly to exclusion (probably ever since cavemen died, if they were thrown out of a cave).   Employees suddenly must spend huge amounts of time, energy and money fighting the ‘machine’ that kicks in after suspension, replacing a productive day at work with an unfairly balanced dispute that acts negatively upon the employees and their families.  It becomes very difficult to fight the case when there is limited access to the necessary information, due to the sanctions placed on a suspended employee.

If an employee is being investigated whilst still at work, they will continue to have good days and bad days like we all do.  If the employee is suspended before being investigated, they are effectively stuck in a bad day and they can’t move on from that.  It becomes difficult to eat or sleep because the employee is stuck at a particularly troublesome point in time, repeating over and over in their brain whatever happened on those last few days at work.

Employees can quickly become deskilled and lose confidence after suspension.  In my case, I had a job that was 70% outward facing, and I simply disappeared one day.   I was locked in the battleground that is a suspension, fighting to clear my name, and not able to give any explanation to key stakeholders as to why I had disappeared.

I was moved by the section of the NHS Suspension website which examines the effect on those close to the suspended employee - -  and impressed by the ‘Suggestions for Ways to Change the System’ which resulted from this report.  

A Doctor’s Opinion

During my suspension, I spoke to a senior doctor who looked after the well-being of medical staff across two counties.  In his experience, suspensions are hugely stressful situations that result in greater coronary strokes and increased risk of suicide amongst other things.  However he did not know of any hard data and therefore he stated that he believed that further research was essential.

This person has given a very factual and unemotive account of some of the fallout of suspension that now impacts her daily life and job opportunities.  Suspension is a crime against humanity when it is unjust or unnecessary and there need to be ways of preventing it in any organisation, not just the NHS. 

Can you help?

Yours hopefully

Tuesday, 11 February 2014

Failing managers

I enjoy reading Jenni Middleton’s editorial comments in the Nursing Times.  She doesn’t mince her words though I imagine she has to be careful not to be sued and to keep Department of Health still talking to the Nursing Times.

And there is that slow but relentless Nursing Times campaign to allow nurses to Speak Out Safely. 
In the meantime, the surveys of staff continue to show that there has been absolutely no change in conditions for many and in some cases, a worsening of the situation.

The NHS is awash with the tears of its staff who end their shifts an emotional wet rag, exhausted and utterly frustrated that they haven’t been able to give the care needed.

But time and time again I am wondering why their managers are not being held to account for these dire situations.  Some nurses report that they are just told to ‘get on with it’ when they ask for agency or bank staff to try and fill the gaps.
What sort of response is that?

An elderly relative lives in a well run small care home.  When there are not enough staff on a shift, the manager rolls up her sleeves and gets stuck in.  I imagine that historically, ward sisters did the same in these situations. 

Of course these days, they’d be rolling up their sleeves every day of the week and at night too, on some of these wards.

In developing countries, where health care is scarce, the families are expected to come with their patient and look after them.  I can see that being an answer here in the UK!  Any family member with complex care needs , often already depends on family members to get the care they need.

When the situation is so dire and the Government are not going to do anything about it, perhaps that is what hospital managers should set in place! 

Hospital managers – ahh.  I remember when I was suspended and the whole process was taking forever, I had a meeting to attend with the investigating officer at their pleasant headquarters.  I had already learnt that when secretaries and administrators were off sick, agency staff were employed to fill the gap.  Oh the riches of being in management.

As I was sitting in a comfortable area, waiting to be called to my meeting, the Director of Nursing and other such worthies, walked by, chatting and laughing without a care in the world it seemed, while I sat there as a visible sign of sheer waste, powerlessness and their incompetence!  Oh the waste of tax payers money and my life. 

While the managers continue to avoid contact with their staff, or listen to them or even know who they are and while their bosses conveniently ignore this fact with complaints piling up and adverse events hidden or not reported then there continues to be no hope for vulnerable patients and caring staff.

Yours very sadly