UNPLEASANT NURSES IN THE NHS

A NATIONAL Health Service trust is offering nurses free cappuccinos and chocolate chip biscuits to encourage them to smile at patients. King's College hospital NHS Trust in London introduced the reward scheme after surveys raised concerns that nurses were not being nice enough to the sick. One common complaint was that nurses almost ignored the patient and chatted about the person's condition as if he or she were not present.

In recent years there have been growing concerns about nurses who are "too posh to wash" and prefer to spend their time on administrative and technical tasks rather than basic care. Two years ago a resolution at the annual congress of the Royal College of Nursing proposed that nurses were now "too clever to care" and suggested that the compassionate part of their job should be delegated to healthcare assistants. The provocative motion was a reference to nurses increasingly concentrating on technical duties.

The new motivational scheme originated in a Seattle fish market, where it was used to boost sales. Trusts are introducing new initiatives to improve their "customer services" because, under government reforms, hospitals now need to compete for patients. Matrons at King's College hospital hand special thank-you cards to nurses who are seen smiling at patients or relatives, chatting with patients, having a positive attitude or doing something to make someone's day better. The thank-you cards are then entered in a draw and nurses whose cards are picked out are entitled to free coffee and biscuits at the hospital cafe.

Selina Truman, head of nursing in general medicine at the trust, said: "When our patient survey and complaints came through, we could see that the attitude of some of the nurses was not as positive as it might be. Patients said nurses did not spend enough time with them. We felt that the way in which nurses engaged with patients could be better. "This scheme is very motivating because matrons and ward sisters praise the nurses directly. It has put patients back at the centre of our work." Truman added that although staff were initially cautious about how the scheme would work, they had enjoyed receiving the praise and the treat.

However, an editorial in Nursing Times magazine said nurses did not need bribes to be helpful and pleasant to patients. It said: "Excessive workloads and paperwork prevent nurses from spending time with their patients and caring for them properly. This is a fundamental problem that can never be rectified with a hot drink and a biscuit, or other such imports from industry." Katherine Murphy, of The Patients Association, said: "Good patient care should be part and parcel of the job of nursing, not an add-on."

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

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