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ProNurse Interviews: Bestselling Author and Nurse Bethann Siviter on Improving Nursing Standards and the 48 Hour Week.

This is the second in our series of interviews with Bethann Siviter. We suggest you read the <a href = “http://www.pronurse.co.uk/education/articles/1781-pronurse-interviews-bethann-siviter-bestselling-author-of-the-student-nurse-handbook-and-the-newly-qualified-nurses-handbook-”>first article on the background to her books Student Nurse Handbook and The Newly Qualified Nurse’s Handbook before starting on this article.

PN: I must have read the preface to The Newly Qualified Nurse’s Handbook at least three times before I actually started reading the book. Hearing an experienced nurse describe how she feared her encounters with the nurses who were looking after her is a real eye opener. Did your negative experiences make you resolve to finish this book even faster and to make it even better?

BS: It did to some extent; unfortunately it made me go a year and a half over my deadline. I took the book completely apart as I wanted to approach it through the eyes of a patient and this is why it was very important to me to include the preface. It points out that this is very personal to me and I have been hurt by some of you.

Being newly qualified means you have different problems and I think this book is a bit darker. It points out that if you make a mistake you’re going to hurt somebody. However, it was the students who cared for me were wonderful and that is why I persevered. To be honest I wasn’t going to write it, but then I realised that the students needed to be the nurses that they wanted to be, not necessarily the ones that they were becoming.

PN: Do you think that substandard nursing is caused by bad training, or not enough support when the new nurse starts working?

BS: I think it is a combination of those things, nurses are very busy. There are more nurses in the NHS and hospitals in general than anyone else. Nurses have got so good at being masters of everything that they are left without ward clerks, porters, and dietary aids. They just have to make do. So when it comes to a choice between taking care of a student or taking care of a patient, who do you choose? You choose the patient!

I think we need dedicated staff within a clinical environment to make students their one priority. Because as a student, and I know this first hand, from being both a nurse and a student, when things are busy, doing it the right way isn’t nearly as important as doing it. Well, that’s wrong!

Students are put in impossible ethical situations and it is not fair to them. They are supposed to have a preceptor when they qualify and this is why the NMC is looking at completely re-vamping nurse education. I’m involved with this as I have been appointed to the committee that is working on this issue.

PN: Many of our members complain about not having enough time and having too much to do in a working day. There are stories of midwives working 12 hour shifts without having time for a drink or going to the toilet. Do you have any tips for nurses who feel that they do not have enough time to do everything that is required of them in one shift?

BS: I think that sometimes if you can’t juggle all the balls that you have in the air you need to choose which balls to juggle. You have to prioritise. It’s not always easy, but you have to think about which things have to be done and which things are not going to collapse if they don’t get done.

You have to delegate and some people find delegating the most difficult thing. It can be difficult when you ask the nursing assistant to do something and they roll their eyes and say nobody else asked them to do it.

Sometimes you have to go to the patient and say “Could you take your blood sugars for me please and I’ll come back and find out what they are”. Too often we try to do everything, but we can also sometimes reach out to families. You could say “It is very difficult to get your mum to eat, would you mind coming in at lunchtime and try feeding her for us?” We have to think outside of the box, so it doesn’t end up that we have to do everything.

If you’re that short-staffed that you can’t get your break in then you need to complain and write an incident report. You can’t work on empty. I know it is not British to do this, but it is professional. If you don’t complain and something goes wrong then you have no proof that you tried. The only licence that is going out the window is yours.

I think that 12 hours shifts and back-to-back shifts should be made illegal. If you’re so exhausted that you can’t worry about yourself, how are you going to worry about anyone else?

PN: Won’t these things be stopped now with the 48 hour working week coming in?

BS: All that is doing is costing nurses money, because they are working 48 hours in one job and instead of getting paid overtime they are working on the bank. This means the bank is paying them less money and on a lower grade then they would be working on their regular shift. The 48 hour limit does not mean an individual, it means a contract. So this just means they are getting out of paying overtime as the hours don’t turn up on the paperwork.

PN: There has been some negative press about nursing and healthcare in general over the past few months. However, there are a huge number of nurses and many people tend to remember a bad nurse and forget a good nurse. Considering the extra roles that nurses are now expected to perform, do you think the overall standard of nursing is continually improving?

BS: There is usually a gradient. I think some nurses are achieving amazing things. My GP is a nurse practitioner and she is the best I have ever had. Some people are cynical of this practice, but it works because these nurses are supported and monitored, they receive clinical supervision.

On the other hand, there are nurses working in very, very demanding areas like care of the older person who are really struggling to meet minimum standards. Some people have the attitude that older people are supposed have pain, confusion or to be incontinent. The nurses are so busy run off their feet that they don’t have time to think. Nurses across the spectrum need support and clinical supervision and guidance so they can give the right care. I think it kills nurse’s souls when they are put in the position when they are forced to give minimal care. They burn out and then they are not nurses anymore.

In the third part of the interview, Bethann covers the attributes of being a good nurse and whether some people are destined to be a nurse.

Bethann would like to stress that the opinions raised during this interview are her own and not that of her publishers, or employer.

Both The Student Nurse Handbook: a Survival Guide and The Newly Qualified Nurse’s Handbook: A Survival Guide are available on Amazon.

Bethann is a member of ProNurse so you can network with her via her profile or ask her some questions via her Bethann’s Student and New Nurse Sanctuary group here on ProNurse.

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