Extraordinary bureaucratic madness: Nurses’ uniforms that ban patients from trying to speak to them
A row has broken out over a hospital trust’s decision to give nurses ‘Do Not Disturb’ uniforms to wear during routine ward duties to prevent patients from speaking to them. When nurses are wearing the bright red tabards, patients have to address any concerns to care assistants, who do not have clinical qualifications.
The hospital says interruptions, such as patients asking questions about toilets and meal times, stop nurses from doing their jobs properly and could lead to patients being given the wrong medication.
But Joyce Robins, from campaign group Patient Concern, described the initiative as ‘grotesque and ridiculous’. She said: ‘If you’re a nurse and you can’t do more than one thing at a time, you’re a pretty hopeless nurse. It sends patients completely the wrong message.
‘They already see nurses as too important to disturb or too lazy to help and you’re very vulnerable lying there in a hospital bed when your buzzer doesn’t work and no one comes. ‘Often the drug round is the only time you see a nurse to talk to them. Now these red tabards will send out a further “get off me” signal. ‘It’s grotesque and ridiculous.’
After a successful trial at East Kent Hospitals University NHS Foundation Trust, the uniforms are being introduced for staff nurses and matrons in hospitals across the country, to be worn during drug rounds on wards.
During these times, patients will be encouraged not to speak to the nurses. Instead, they will have to address concerns unrelated to their medication to care assistants, who will accompany their more senior colleagues on their rounds. The red tabards are worn on top of a nurse’s uniform and have large white print on the front, which reads: ‘Do Not Disturb. Drug Round in Progress.’
In March, a pilot scheme trialled the tabards on two wards at the Queen Elizabeth The Queen Mother Hospital in Margate, Kent. One nurse said: ‘What we do when interrupted is simply turn round to face the patient and point to the words. ‘I don’t have to say anything and it’s amazing how successful a few simple words have been in rectifying a very serious situation.’
The uniforms were considered so successful by staff that the hospital is buying 500 tabards at a cost of £15,000 so they can be rolled out across the trust’s 58 wards. The money will also be used to buy different coloured tabards for nurses carrying out auditing and nutritional work, and buying safety boxes for patients to keep valuables in.
The uniforms have also been rolled out at hospitals in Middlesex, Colchester, Cardiff, Aberdeen and Derby. A study that examined whether they worked was carried out at Aberdeen Royal Infirmary.
The research team found the average number of interruptions was reduced from six to five after the tabards were introduced – a difference it described as ‘significant’. It also found a slight reduction in the number of errors made over the five-week period of the study compared with the previous year.
According to the National Patient Safety Agency, getting the wrong medication is one of the most common errors made in hospitals.The hospital watchdog, the Care Quality Commission, is aware of the initiative and supports it.
Penny Searle, ward manager at Queen Elizabeth The Queen Mother Hospital, said the tabards allowed nurses to be more ‘productive’ and helped them ‘work efficiently’. She said: ‘We cannot change the workload, but we can change the way we address it. ‘Nurses need to be able to concentrate and interact with the patients they are working with at any given time. ‘If we get distracted, whether that’s from other care professionals, staff or visitors, we can’t concentrate and interact with the person we’re giving medicine to.
‘I can see that people might think we’re stopping communication, but what we’re trying to do is not limit interactions but minimise them.
‘If a patient suddenly collapses, we wouldn’t carry on with the drug round.’ Mrs Searle added: ‘It’s not that someone can’t interrupt, but we’re trying to minimise the times that happens.’
Immigration to Britain is no longer taboo – but tackling it still is
The Coalition has merely tinkered with the rules on who gets into Britain, rather than taking real action.
Immigration used to be the great unmentionable. If anyone pointed out the rate at which it was increasing, and the problems for infrastructure, education and the NHS of adding two million people to our population every decade, they were accused of being racist. I know: it happened to me.
It was an effective way of preventing the topic from being discussed, and was frequently used by Labour ministers for precisely that purpose. But at the last election, it was impossible to prevent the issue – which everyone knew was one of the most important for voters – from being raised. The Tories came up with measures that they promised would diminish the number of immigrants, to which the Lib Dems, when they became partners in government, reluctantly agreed.
So it must have been depressing for the Conservative members of the Coalition to see last week’s Office for National Statistics figures, which showed that, far from going down, net immigration (the number of foreigners settling in Britain minus the number of Britons leaving) has risen by 20 per cent, to reach 239,000.
Those statistics are, admittedly, from 2010, when the Coalition’s policies had not yet been implemented. And the net increase is entirely the result of a reduction in the number of Britons leaving the country, rather than an increase in the number of immigrants arriving.
Nevertheless, the figures still raise the delicate question of whether the Coalition’s policies will actually succeed in reducing immigration. The first thing to note is that they certainly could do so. Nick Clegg was simply wrong when he insisted that controls are pointless, because most of the people who settle in the UK are from countries in the EU. In fact, 80 per cent of migrants to Britain are from outside the EU, so there is no legal barrier to restricting significantly the number who are allowed to settle. Nothing, in principle, stops the Government from putting effective controls in place. The difficulties are essentially practical.
So the real question is this: how badly do ministers want to cut immigration? The Lib Dems certainly don’t want to do anything: they are frank about regarding controls as either economically damaging or blatantly racist. The Tories say they’re committed to achieving dramatic cuts. But so far, the Coalition hasn’t done more than tinker around the edges of the system – as Damian Green, the immigration minister, must have known, even as he said on Thursday that ministers had initiated “radical changes”.
Around half of the immigrants who arrive each year are foreign students and their dependants. The Coalition’s new regulations require students to speak English, and to provide evidence that they can support themselves and the family members who come with them. It’s a start – but it’s not a “radical change”. Theresa May, the Home Secretary, claims that the rules will reduce the number of students and their relatives by 80,000. But no one knows how easy it will be to evade the new controls. They will be based largely on form-filling: if you tick the right boxes, you will get your visas. Our judges may anyway declare the new procedure by violation of human rights: the decision in a case that will test whether the Government can refuse to let an Indian man, who can’t speak English and refuses to learn, join his wife here is expected soon.
The Coalition also plans to end the link between being given a permit to work in the UK and having the right to settle here. That could diminish immigration significantly. The problem is that the proposal is just that: a proposal, not a policy. It is subject to consultation, a process which may enfeeble it. Whether it will be implemented at all remains to be seen.
The Conservatives have broken the taboo on discussing immigration. But what is still not being discussed are the practical measures that will be effective in diminishing it. That topic is still off limits – which means that it is surrounded by confusion, half-truths and spin. And that is not good for immigration policy. Or for democracy.
British counter terrorism officer sues London cops over De Menezes ‘cover-up’
It is a disgrace that nobody was found guilty of anything in this matter. This gives hope that the truth may finally come out.
I have a pretty good idea what is involved. The openly Lesbian and rather aptly-named Cressida Dick was in charge of the operation. Her incompetence at controlling it caused the disaster. But because she is a “minority”, she must be protected.
She was clearly promoted beyond her level of competence on “affirmative action” grounds so those who promoted her also need protection.
In my observation, Lesbians tend to be overconfident and often give the impression that they are more competent than they in fact are — leading to others having to bail them out when they get it wrong. Exactly that would seem to be going on now
A Christian counter-terrorism officer involved in the killing of Jean Charles de Menezes is suing the Metropolitan Police over allegations that senior officers tried to cover-up vital evidence.
He says his faith compelled him to blow the whistle and he is now claiming thousands of pounds for loss of overtime pay and promotions after Special Branch bosses allegedly sidelined him.
One allegation involves anti-terror officers perverting justice by replacing a chief inspector with another to give more favourable evidence at the 2008 inquest into de Menezes’s death.
An inquest jury returned an open verdict into the shooting of the 27-year-old Brazilian who was mistaken for a suicide bomber in 2005 – rejecting the police view that he was killed lawfully.
The detective sergeant, who cannot be named for legal reasons, first made his concerns known after he gave evidence under a codename at the inquest.
Two more serious concerns were reported about issues within the Met Police’s counter-terrorism department, known as SO15, last December that form the main part of his tribunal case.
He is also suing for religious discrimination and loss of earnings.
A senior source said: ‘The allegations are about such a sensitive subject that top brass are very worried about what could come out in a tribunal.’ ‘As this has been going on for such a long-time he was moved to another department and believes that his career was stalled because he spoke out.’
Mr de Menezes was shot seven times in the head at Stockwell Underground Station in South London after police mistook him for bomber Hussain Osman.
He was killed on July 22, 2005, the day after Osman and three fellow terrorists had gone on the run after trying to bomb the Tube in a follow-up attack to the July 7 London bombings which killed 52 and injured 977.
The jury at the inquest on the Brazilian electrician rejected the account of police marksmen, branding them ‘liars’, and sided with Tube passengers who said the officers failed to issue a warning before opening fire.
They returned an open verdict, which was the most strongly critical option available to them after the judge instructed them there was insufficient evidence to rule that de Menezes was unlawfully killed by police.
The Crown Prosecution Service ruled out criminal charges against anti-terror officers in 2006 and after the inquest in 2009. The Met was instead fined £175,000 under health and safety laws.
The Independent Police Complaints Commision has investigated one of the detective sergeant’s claims finding no evidence to support the allegation.
An IPCC spokesman said: ‘We received a referral from the Metropolitan Police Service on 4 January 2011, as a result of an allegation made by a detective sergeant to the Directorate of Professional Standards in December 2010. The allegation had also been the subject of employment tribunal proceedings.
‘The IPCC independently investigated the allegation, examining statements given to the Employment Tribunal and interviewing key people involved. The decision to call the DCI was made by counsel on the basis that he was better able to answer the questions. ‘The investigation found that there was no evidence to support the Detective Sergeant’s allegation.’
A Met spokesman said: ‘The Metropolitan Police Service can confirm that it has received two employment tribunal claims from a Detective Sergeant lodged at London Central employment tribunal offices.’
The higher education bubble in Britain
Rachel’s post yesterday got me thinking about university education. Like many, I’m coming to think of it as being the next big bubble. Money is being ploughed into it higher education, and for many – probably most – people, it’s just not worth it. We’ve become afflicted by acute credentialism: to be taken seriously in many professions, you need a couple of letters after your name.
What’s wrong with this? Well, for a start, it makes it harder to break into new jobs. Credentialism raises barriers to entry, and protects certain professions from competition. (Incidentally, occupational licensure – which I consider to be one of the great evils of our time – is worse.) Moreover, it increases the penalties for making bad decisions. Did you spend your teenage years getting drunk and skipping class? Well, sorry, you’ve ruined your life because you can’t get the degree from that Russell Group university that you needed so you could do the job you wanted to do. And God help you if you chose art history instead of accounting on your UCAS form.
Worst of all, credentialism forces people in education to conform so that they get the grades they need. School and university are the two places in people’s lives where freethinking and contrarianism can thrive; where being brilliantly wrong is better than being boringly correct. When your on-paper performance matters so much to your future job prospects, this becomes more difficult. As a result, university becomes more like a training course and less like the thoughtful, argument-filled Academy that it should be.
In a speech at Oxford Brookes University last June, David Willetts said that more than 50% of degree courses were “license to practice” courses. In fact, the true figure is likely to be a lot higher. By now, almost all university courses are credentialist training courses, even humanities and social sciences, because having letters after your name is now so important to finding a decent job.
How did we get here? Mostly, I blame government. Long ago, it was decided that education was the key to social mobility. Targets were set to get people into university, irrespective of their ability. That someone thought it a good idea to get 50% of school-leavers into university says it all – university was just an extension of mass schooling, and shunting as many people through it as possible was the key to making people smarter.
Where a bachelor’s degree once set people apart from the crowd, now it’s a master’s degree. Some day, I’m sure a PhD will be the minimum. Standards have fallen and costs have risen as the bubble grows. Once, everybody wanted to own expensive tulips. Today, people are putting their money into letters after their name. Bubbles are pointless, madness of crowds hysteria driven by easy money, and we’re seeing one in education.
People use qualifications to signal their intelligence. It’s hard to show an employer that you’re smart, and a degree is like a good reference letter vouching for you to an employer. But forcing more and more people into university education has devalued that reference. Like trees competing for sunlight growing taller and taller, the credentials have become loftier and loftier to achieve the same ends. The bubble is growing. Someday, it will have to burst.
At Last: UK Government Goes Anti-Green
A long-awaited government report on green aviation policy has failed to endorse independent proposals for limiting the sector’s rapidly growing emissions, to the dismay of green groups.
The government yesterday published its response to an analysis presented by the Committee on Climate Change (CCC) in December 2009, which warned that air travel could not increase more than 60 per cent on 2005 levels by 2050 if the UK was to meet legally binding targets to reduce emissions 80 per cent by mid-century.
Yesterday’s formal response from the Department for Transport (DfT) acknowledged the CCC was right to warn that aviation emissions would result in the breaching of the UK’s legal emissions limits “without further action”.
It said aviation emissions were likely to reach 49 million tonnes of CO2 equivalent a year by 2050, just above the CCC’s projections, although it added they could reach as high as 59 million tonnes by the same date.
But yesterday’s report gave little indication as to how the government will stop emissions rising to this level when it publishes its Sustainable Framework for UK Aviation document early next year.
Instead, the response concentrates on encouraging further responses to its March scoping document on sustainable aviation, the consultation deadline for which has been extended to 20 October.
The document also underlined the government’s reluctance to limit airport capacity, suggesting that displacing air traffic to other countries would not only damage the UK economy, but lead to “less-efficient routing of passengers and cargo, with a consequential increase in global demand for aviation and hence CO2 emissions”.
Airlines are fiercely opposed to measures designed to reduce demand and instead have agreed voluntary technical and efficiency improvements they say will begin to help curb emissions, while also increasing investment in emerging biofuel technologies.
In a foreword to the response, transport secretary Philip Hammond made clear that cutting emissions from the sector should not compromise growth.
“I believe that to present the challenge we face as one of deciding between economic growth and reducing carbon emissions is a false choice,” he wrote. “This government is anti-carbon, not anti-aviation, and our goal is to find ways to meet our carbon reduction targets while supporting economic recovery.”
However, green groups said the government should prioritise demand reduction policies such as making the most of available capacity, introducing carbon caps, shifting more people to trains for domestic and short-haul flights and promoting greater use of videoconferencing.
They add that jet biofuels should only come into play once these measures have been taken.
Jean Leston, acting head of transport policy at WWF-UK, said the government was showing “a worrying lack of commitment” to including aviation emissions in the Climate Change Act or setting a national reduction target.