Nurses and midwives would strengthen the public trust if they were to take a pledge to provide high-quality care, according to a new report.
The paper by the Prime Minister's Commission on the Future of Nursing and Midwifery in England said they should renew the pledge they made when they first qualified.
The call comes after a number of recent examples of poor practice came to light.
In the report, it is claimed that many staff feel they need a new beginning.
It adds: "We therefore propose that all nurses and midwives renew their promise to society and service users in a public pledge to deliver high-quality care."
The report said that in order for nurses and midwives to provide high-quality care, employers, regulators and education providers have a duty to provide them with adequate support and protection.
The pledge would complement the Nursing and Midwifery Council Code, the NHS Constitution and other professional codes and regulatory standards.
Strong national campaigns must be launched to tell new stories of nursing and midwifery which will boost the recruitment of high-calibre men and women of all ages and backgrounds, it has been suggested.
Health minister, Ann Keen, who chaired the commission, said: "We need to demonstrate that they are not poorly educated handmaidens to doctors."
Copyright © Press Association 2010
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"What rubbish - there will always be great nurses as well as bad ones as in any trade - taking a pledge is an insult to my integrity" - Karen, London
"What utter nonsense! How many more hoops do the government want us to jump through? Soon there will be no time at all to give the care our patients deserve. Every day we battle against red tape and unnecessary paperwork to do our job. We study, keep up to date and are forever trying to do the
same/better job with depleted resources. How many other professions take such a pledge? Perhaps if all government ministers and top bank officials were to lead the way and be held as accountable as we already are, more heads would have rolled over the recent disgraces with finances public money" - Lesley Hutton, Northern Ireland
"What nonsense! I remember writing an essay about why nurses are not 'doctor's handmaidens' during my training in the 1980s!! This is hopelessly out of date, and as for asking us to take a pledge ... It's insulting in the extreme to imply that we are all perhaps doing a half-hearted job, but will suddenly improve by taking the 'Brownie-Guide' style 'promise' suggested here! why not start by getting politicians to take a pledge not to do any more damage to the NHS than they already have?!" - Laura, Leeds
"It's a sham that the money spent on researching this wasn't spent on providing more staff! Another example of how bad the NHS has become under New Labour. They still do not get that targeting individuals does not work, and that is part of the problem. Perhaps they should pledge to undertake to do what the public ask of them instead of turning this country into George Orwell's Animal Farm and them being the pigs" - Sandra Robinson, Manchester
"96% of nurses have taken the pledge. When I started it was a vocation and you dedicated your life to care for others without thanks from patients and colleagues alike. We do it not for the pay but for job satisfaction. But like everything else there are those who are in it for others reasons, just like you get bent police officers. Nurses and doctors generally do their best and the NMC council statement that states now we have the right
to refuse to do what we do not think we are capable of or have the training for. Before now we would have to do it" - Dorrel Fyffe, Peterborough
"Stupid idea. I often wish that I had an aptitude for accountancy as I would have been earning a lot more money than I do now, despite having postgraduate qualifications. Do people really think that the vast majority of nurses go into the profession with any other thoughts than of paid altruism? Many get the initial good intentions of 'looking after people' knocked out of them. I pay through the nose for regulation (as every other nurse does), which I hope will get rid of the very few who are not good nurses. What do the government want? Us stood in an assembly hall with our hands on our hearts quoting the Nightingale Code?? Well, we will do it after all those high ranking civil servants, bankers, company directors, etc etc. After you gentlemen" - BL, Wiltshire
"The idea of a Pledge is utter nonsense. All nurses are bound by the NMC Code of Conduct and regulated. We are not handmaidens to doctors. I have worked as a nurse for 26 years, give excellent care and consideration to my patients. The idea of any political party endorsing a Pledge will not get any votes" - Name and address supplied
"Poorly educated handmaidens. What a disgraceful way to talk about nurses. I have been a nurse for 30 yrs and have never been or considered myself a doctor's handmaiden. I plan to retire next year and with statements like that I am glad. Now that nurses will be expected to enter the student training with a degree I think they will choose another profession. A profession that will not only respect them but will offer decent remuneration" - Anne St.Pier, Essex
"Stupid idea regarding the pledge. It is like promising someone you can do something when you haven't the resources. I am not condoning poor patient care but with insufficient staffing levels and more being piled on all the time, it is about being realistic and it is time we stopped promising the public something we cannot physically deliver. There is only so much you can pile into a car before the police warn it is a dangerous load! In my role I am constantly being given extra tasks yet my appointments were full before, so where have those patients gone? They don't get seen! Do the GPs care? NO!! Poor management skills, poor insight, poorly treated staff. It is about time that it is realised that higher level academia does not provide more quality application of care. Nursing has deteriorated since the profession went degree crazy. We need care and common sense" - Name and address supplied
"As a nurse, I have seen good, very good and poor care standards. Some nurses are not fit to do the job, regardless of the resources available to them. As a mother of a sick child, I have seen the best and the worse of nursing care given to my child. I for one, can surely say ... weed out the bad nurses and keep the ones who really want to care ... It may mean a real low stock of nurses, but you would get the best bunch, the ones who REALLY want to nurse. People tend to forget the whole idea of nursing ... it's CARING! This pledge idea seems nonsense, specially for the few of us who are doing our job properly. There needs to be a different method available to weed out 'bad' nurses (pardon the pun!)" - Maria Oliver, London
"Taking the pledge is what comes from the NMC code of conduct problem being - nurses are not respected by non clinical and management theory - it is all about saving budgets and targets - nursing is not about targets but individuals care
which is often difficult to put into boxes for government" - Jackie Hutchinson, North East
"Stupid idea from another expensive think tank. Maybe if they saved some money by having less 'commissions' we could have more hands on deck at the grass roots and have the time to do our jobs properly?" - Pamela Fry, Berkshire
"Every year I pay to maintain my nursing registration and hope that some of the money helps to 'weed out' those who shouldn't continue to practice. It's about time that all the dodgy politicians were also weeded out!" - Jo Greaves, Ely, Cambridge
"Does any other profession take a pledge to say they do their job properly? We are a caring professional group of people and I take pride in the fact I do a good job. I think this is utterly ridiculous. We are regulated, we pay union and NMC fees and we remain very poorly paid for what we do and the responsibility we take on. There are nurses who do not wear their uniform or badge with pride, but would taking a pledge make them smarter or better at their jobs? I think not. There are good and bad in all professions. I am not a handmaiden! I am a professional in my own right and indeed spend a lot of my working hours making clinical suggestions to my GP colleagues which they respect and taken on board. This is enough to make me want to leave the profession!!! Where has the respect gone? Here here to the PM making his own pledge, and the doctors and the lawyers, and the police..." - Name and address supplied
"I think the strength of feeling in these comments say a lot. They should be forwarded to the Prime Minister to show just what the general feeling is amongst nurses about this latest nonsense. If the government continues to berate nurses and come up with these ill thought out ideas instead of tackling the real underlying problems in the NHS then there won't be any
nurse left to care any more!" - J Foulston, Durham
"During a career that has spanned over thirty years both qualified and unqualified I have, on the whole, been proud to be a nurse and indeed have strived to work to the best of my ability with often scant resources. I feel a double blow now with the profession becoming all degree and with the suggestion of a 'pledge'. We are bound by a Code of Conduct already. It is basically our own doing that we tolerate bad practice and this should be addressed 'in house' and upheld by the NMC. Nursing ceased to be a vocation some time ago and until recently was the only career for me. What next? I am of the opinion that it does not pay to work oneself into the ground for a compensation led disgruntled public who, on the whole do not appreciate the cost either in monetary or personal terms of the care they receive" - Christine Jones, S Wales
"This shows how bankrupt our politicians are when it comes to enlightened policies regarding healthcare and provision in this country! It also shows how undervalued those self-same politicians regard us as a profession. This 'pledge' that the Prime Minister's Commission on the Future of Nursing and Midwifery in England envisages that all nurses should undertake is complete codswallop, maybe those who portend to rule on our behalf should by example 'pledge' on a yearly basis to the public to support and protect front-line services, not just by words, but by actions which can be seen and the benefits measured. To further add to the NMC's codes, the NHS Constitution and other regulatory standards appears crude, crass and above all an over-simplistic approach to improving healthcare in this country, when words are cheap and filled with spin, but resources scarce!" - DavyP, Scotland
"This idea further undermines the autonomy and integrity of nursing, and reduces the professional status of nurses. It is a sad reflection on and indictment of society that there is such little trust amongst human beings" - Carmel Blackie, London
"I am heart broken to have read this article. I work hard and care greatly for my patients as do most of my colleagues. You are now asking me to make a Public Pledge for something I do daily as if I have to justify my care. There are problems within the NHS and primary care and these shouldn't be dismissed, but making nurses the scapegoats is not the answer. I am sure the public do not need us to stand there and promise to look after them and care; if the public saw sometimes how the nurses were treated maybe the outcry would be for a Public Pledge from the employers and the government" - J Rees, Haverfordwest
"Given the pressure that nurses and support staff experience, being for the most part short-staffed, working beyond the hours they are paid for, and with no time allocated for study or personal development, it is hardly surprising that some become demoralised and begin to lose the ability to care. I do not condone neglect or mistreatment of patients or their families, but employers must take responsibility for looking after their staff, ensuring proper staffing levels and protected time off the ward for learning. If staff feel that no-one cares about them, they will eventually lose the ability to care about others. I feel that this urge to take a public pledge is an absolute nonsense, and that the responsibility for the culture within an organisation rests firmly with the employer. Perhaps it would be more useful for upper management within the NHS to take the pledge to deliver high-quality care to patients and staff" - Sally Moore, Aberdeenshire
"I think that this is complete joke, the majority of us who work within the NHS work very hard indeed and our 'Pledge' is that we come to work every day, work within difficult situations often without much thanks. We do this not because we are getting £100,000 salaries but because we care and we believe that this is more than a profession it is a vocation. I think that the NMC and the RCN should be shouting from the rooftops regarding the great work that the majority do instead of capitulating to stupid ideas when something goes wrong. Sure, there will be failings and I do not wish to undervalue the failings that have been highlighted recently in the press, this has been a harrowing experience for the patients and their families but in the majority of cases people are cared for very well. Perhaps this is an issue of value, when people feel that they are not valued quality drops, the NMC, RCN and government are to blame for years of neglect towards nurses in this country. I'm sick of listening to the talk without the action. We deserve the highest praise and support but as a society we are more interested in supporting financial institutions that caring for each other" - Ally Little, London
"Rubbish! Nurses are bound by the Code of Conduct and as part of their Registration must act within it. Why do we need to 'reassure the public' separately? Nurses on the ground do provide good care and exercise their duty of care to their patients but are often constrained by the 'business' model imposed from above of 'value for money', often not being provided with the means to exercise the best care for patients due to lack of resources at the coal face. We could improve the patient experience by removing much of the hierarchy and ensuring resources are targeted at the front line" - Name and address supplied
"Having nurses 'renew their promise to society and service users...to deliver high-quality care' will not change whether poor practice exists! Any nurse worth their salt will provide quality care as a matter of course! Rather than making a PR exercise out of it, the cost of this could be better spent eking out bad practice, in a more practical way" - Hazel Aldred, Barnsley
"I find it heartbreaking that we nurses, the vast majority of whom treat their patients with dignity and respect, are being made scapegoats for the failure of patient care within the NHS, which we all know is largely due to government box-ticking requirements together with the mismanagement of our NHS Trusts by failing managers! We work in a demanding, trying and at times heart-rending profession (which the vast majority of people could not or would not want to do), for which the financial reward doesn't even begin to compensate, but for most of us, the reward is in the fruits of our labour. I am sure there are a small minority of nurses who perhaps should be reminded of their duty of care, but most of us have never forgotten our 'promise to society and service users'! There are already systems in place by which nurses who are not of the required standard can be reminded of their duty of care, without this 'electioneering' idea of putting us all on the naughty step! I think this scapegoating of nurses is a not a positive move, and could deter future potentially good nurses from entering the profession, and possibly be the last straw for nurses already perhaps thinking of leaving the profession due to lack of support, poor working conditions, bad management, lack of resources and low pay. After reading this article I can honestly say I have never felt as disheartened regarding what is not just my job, but my vocation, ever before" - Ruth Harris, Manchester
"I think that the standard of nursing has declined. I have seen some nurses getting through who were not competent in the community, so how they were ever competent enough to pass their nursing beats me. The standard of nursing has dropped immensely. I am pleased to know that to qualify as a nurse has to be degree level. I actually know nurses who qualified with credits, they did not meet their competency level as a Community Staff Nurse and are now qualified Health Visitors. How can this be?" - Linda Corkish, London
"We can only provide high-quality care if given the resources to do so!!" - Caroline Grzegorzek, Surrey
"We are trying to provide high-quality services. Ask the commissioners why they are not filling posts, ask the comm why they are asking us to reduce the number of interventions we 'are allowed', more importantly, ask the nurses what the issues are they are facing and deal with them instead of shelving them in the name of cost cutting. Remember Baby P - it will happen again" - Name and address supplied
"What a load of political posturing! How dare politicians even begin to lay the problems of the NHS at the door of nurses. What we are seeing in the NHS has less to do with the global neglect of nurses to care for their patients, but systematic bullying to achieve more and more targets, with fewer and fewer resources. Targets which have little to do with improving the patient's experience of and journey through the NHS, and more to do with money, and squeezing the life blood out of a valiant human resource that is the employee. To even suggest that there is a need to demonstrate that nurses are not poorly educated handmaidens to doctors illustrates that the NMC has clearly failed to represent nurses at both the highest political level, and the people/public they profess to protect. What an insult" - Jillian Pooler, Devon
"Taking a public pledge is a good idea, somehow we have lost our sense of pride in being nurses and remembering that making our patients comfortable with a high standard of nursing care is what we trained to do. I have worked all over the country in both large teaching hospitals and small community facilities, and over the years the calibre and attitude of people coming into nursing has taken a downturn. A recent experience at a local A&E dept highlighted this with curt staff who could not provide even basic information. One nurse was even working in a pair of cargo trousers and an old polo shirt and trainers. He was however wearing a badge...If we don't display a smart recognisable public image, how can we ever expect nurses to take a pride in their profession and inspire a level of confidence in the public?" - Elizabeth Bell, West Sussex
"This is absolutely ridiculous. How on earth does making a 'public pledge' guarantee a higher standard of care?! There will always be good and bad nurses, just as there are in other professions. The NMC regulates nurses and their practice. When bad practice is reported to them THEY investigate it. This is the only way to ensure bad practice is reduced and competent nurses remain on the register. As for the comment made at the end of the report, 'We need to demonstrate that they are not poorly educated handmaidens to doctors' - I find this insulting. After three years' training and several years' experience I feel I am considerably more than 'a poorly educated handmaiden'" - Name and address supplied
"Perhaps the Prime Minister should renew his pledge to be guided by a moral compass, not make any mistakes on his expenses and promise to treat his staff with more respect!!" - A McIlwee, Birmingham
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