Leadership.
I once worked a community job where there were reams of managers, virtually all female, all promoted into newly invented posts where they did nothing of value, (*) attended heaps of meetings, pretended they were busy doing ‘clinical governance’ and other b/s non-words, drank coffee and wrote buckets of reports packed with gobbledegook. When you did see them, it would be some specially convened meeting, shoehorned into time you’d sooner have been spending on patients, to tell you about a new policy or initiative you now had to obey on top of all the others, or forms you had to fill in before you could go home.
That will all have to go. By this afternoon. And, since you can’t make an omelette without breaking eggs, it must be done rapidly, mercilessly and permanently. Remember, these women (ok, some men too) have been stealing a living from the taxpayer for years.
*) I just caught myself being overly judgmental. They did do something of value at work. Well, if you consider gaining a Masters (modules in how to ruin a hospital, demoralise staff, invent unnecessary jobs for your family and friends) to be valuable, they did plenty of that. On work time.
Day One. Shut down all those unnecessary departments, directorates, committees etc. Thanks, dear. No you needn’t finish that report, file it in the recycle bin. Go home, you’re on gardening leave. You’ll soon be assigned a clinical job (so long as you kept your registration live) from the long list of vacancies we can’t fill. Yes, you’ll probably be put on a ward. Well, that will be your choice, dear. Payroll will post out your P45. Next. Oh, it’s you. I’m afraid you’ll be more difficult to place on the wards because no-one wants to work alongside you. That’s right dear, please try to calm down, screeching won’t work for you anymore. Exactly, nobody trusts you. It’s because you worked for Internal Affairs, sorry, my bad, Professional Standards.
Day Two. I’ll come on to that. But in essence, it will be replacing those frauds we just rid ourselves of with leaders. Real world definition = staff who can successfully lead a team, not because a twat over-promoted them to a job title containing the word leader and granted them the power to enforce our obedience to their air-headed decisions. Instead we will promote real leaders, someone who professionals follow willingly and with respect, knowing they are honest, trustworthy, know what they are doing and aren’t shagging their own manager to climb the greasy pole of preferment.
I once read the best definition of leader I ever heard and decades later, I haven’t found a better one. ‘Someone who sees what needs to be done and gets doing it.’
Training. I’m excluding University student nurse training in this post.
The training for one of my jobs consisted (mostly) of e-learning. Cheap, rubbish ‘courses’ of a sweet voiced woman reciting ‘we musts’ and ‘everybody should’ cobblers. It was utterly valueless as regards preparing me for the job. But the Trust’s managers are able to show it to the CQC as ‘evidence’ staff are trained in x, y and z varieties of government mandated bullshit and that’s what it’s really for. Fortunately, the real live people in my team were brilliant and taught me themselves.
That also has to change. The point of training someone for a new role is to take someone who knows the fundamentals (of nursing, social work etc) but not the specifics of this particular job and turn them into someone who is competent to do it on their own.
It can’t be done on the cheap. It can’t be achieved by sitting in front of a computer. That only teaches meaningless bullshit and how to memorise and pass silly tests regurgitating policies written by a wet blanket. Trusts have been pretending for ages that ‘passing’ these meaningless e-courses means staff are now ‘trained’ and ready to start the new role. Don’t believe it. It just fits the obsession with micro-measuring everything and box ticking. There will come a point when a new starter is ready to take on their own caseload, take charge of a clinic or shift. NB It isn’t after they score 10/10 on a meaningless e-questionnaire. It takes longer than that.
But take heart. In OSMN’s Brave New WorldTM the Trust’s primary purpose has been recalibrated. No longer is it our function to pass audits and please the CQC sellouts. No, it’s to treat the patient. (See Refocusing priorities. Treat. Prevent. Risk. Pts 1 – 3. To treat.)
That’s the new standard that the nurse, their manager and the suit at the top of the Board are now being judged against. ‘But I couldn’t nurse him properly because the CQC forbade me’ is no longer an excuse.
So, how do you turn a generalist into a specialist?
Shadowing. Supervision. Support. Time. Resources. Goodwill. Freedom to learn from failing and making mistakes.
You put the new staff on duty with a willing and capable buddy/mentor/old head. You trust them to work it out because they want to be good at this job, that’s why they joined. What you DON’T do is micromanage them (*) or give them an Encyclopaedia Brittanica sized handbook of ‘competencies’ to tick off. Soon enough, that newbie is a mentor themselves. I know it works because I was trained that way, once upon a time in a galaxy far, far away.
*) In OSMN’s Brave New World managers will find micromanagement difficult if not impossible, because their numbers will be reduced to a fraction of what they are now and none of them will be paid to sit around bullshitting. They will all have a lot of real duties to perform and won’t be allowed to hire their girlfriends and mothers as ‘assistants’. That reminds me of a story a colleague told me. A manager, multi rungs above him in the stratosphere, whose catch phrase was ‘smoke and mirrors, lad, smoke and mirrors,’ managed to employ his own mother as a manager. One day she was serving on a supermarket counter, the next she was making decisions about the qualified health professionals below her.
Polly, no senior manager was disciplined or sacked in the telling of this story.
Continues in ‘How to get there…Pt 3’
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