Analysis

Pay and recruitment take centre stage in packed RCN congress agenda

Delegates at congress in mid-May will debate the staffing crisis, the contentious water bottle issue and how to attract more men into nursing

Delegates at congress in mid-May will debate the staffing crisis, the contentious water bottle issue and how to attract more men into nursing

  • Congress will vote on whether to condemn the goverment over recruitment and retention failures
  • Breaks, body cameras and the ban on bottled water are also on the agenda
  • Fringe events include a look at the use of dogs in healthcare

A session of last year’s RCN congress in Liverpool. Picture: John Houlihan

About 3,000 nurses will gather in Belfast in mid-May to discuss the most pressing issues for the profession and the NHS.

RCN congress, from 12-16 May, will see passionate debate on important questions confronting the profession. The discussions, ranging from staff recruitment to body cameras and workplace hydration, will help shape the direction of the RCN’s work.

Stuart_McKenzie_250_JH
Congress chair Stuart McKenzie:
agenda reflects challenges nurses
are facing. Picture: John Houlihan

In addition, several emergency motions will be debated, while a packed calendar of fringe events will offer opportunities for learning, exercise, sharing expertise and networking.

Breadth and depth of nursing

Congress chair Stuart McKenzie expects the pay offer to be discussed as an emergency motion, but adds: ‘I’m really keen that we don’t just talk about pay. The RCN will be in the middle of its consultation with members over the pay deal when congress takes place.

‘We have a really full and reflective agenda on what nurses are facing,’ Mr McKenzie says.

‘Congress is an important place to show the breadth and depth of nursing – that despite what is happening politically we are still delivering high-quality care, and we care about moving the science and practice of nursing forward and the education of our students.’

Nursing shortages have been a high-profile issue in the profession, the media and politics for the past year, so it is no surprise that this will be the first debate at congress.

3,000

RCN members are expected to attend congress

Participants will be asked to vote on whether they ‘deplore and condemn’ the UK government’s failure to recognise the impact of its policies on the recruitment and retention of registered nurses. The motion also demands ‘credible action and engagement’ with the RCN by the government.

Several reports in the past year have drawn attention to NHS organisations being unable to fill vacancies, and to the high number of nurses leaving the profession.

In May 2017 the RCN said there were 40,000 unfilled nursing vacancies in England, resulting in unsafe staffing and a dilution of the skill mix.

In July, the Nursing and Midwifery Council announced that for the first time in recent history the number of nurses leaving the register was greater than the number joining it.

Then, in a survey of more than 30,000 nurses published by the RCN in September, more than half (55%) said their previous shift was not fully staffed.

23

key subjects to be debated

Announcing the proposed three-year pay deal, which would boost the starting salary of a nurse to almost £25,000, health and social care secretary Jeremy Hunt said it would have ‘a significant impact on retention and recruitment issues’.

Mr McKenzie says: ‘This is a good debate to kick off congress. We are clear we are losing nurses from the profession and there are massive repercussions. We need our experienced nurses to help the next generation of the profession.’

Sent into the unknown

Another debate will focus on the ‘casual redeployment of staff within the healthcare system to work in areas of unknown expertise’.

Trusts struggling with unfilled nursing vacancies have been looking at using other staff to fill rota gaps.


Colleen White: concern about
nurses being moved to unfamiliar
areas. Picture: John Houlihan

Northern Ireland RCN trade union representative Colleen White, who proposed the debate, is concerned that patient safety is threatened by moving nurses into areas they are unfamiliar with.

She says it is a UK-wide issue arising from the nursing shortage. ‘Every area of health has become so specialised that there is less transferability of skills. Nurses are being pressured into going to work in other areas with a completely different skill set, and it is putting patients at risk.’

While it may appear in such cases that the employer is meeting its obligation regarding the number of registered staff on duty, the staff may not be competent to deliver the care that is needed, Ms White says.

There has also been controversy about employers filling nursing posts with other professionals and unregistered staff.

Hydration and self-care

Congress will also discuss how to challenge the ‘draconian’ practice of staff not being allowed to have bottles of water in clinical settings.

This debate follows the launch of the RCN campaign Rest, Rehydrate, Refuel in February, which urges staff to take breaks to protect their health.

There is a growing body of evidence linking positive staff experience and good staff health and well-being to improved outcomes for patients, the RCN says.

About 25% of respondents to the RCN Safe and Effective Staffing Survey in 2017 said they were not allowed to have bottled water on wards or at the nurses’ station. Nurses reported being unable to find time to have a drink or go to the toilet during long shifts.

RCN Safety Representatives Committee chair Denise McLaughlin wrote in the campaign toolkit foreword: ‘If nursing staff are not enabled to self-care and have a poor working environment, they are more likely to become unwell, burn out or want to leave the job.’

Argument for body cameras

Delegates will discuss whether the use of body cameras can improve safety for staff and patients.

Body cameras are frequently worn by police officers, but their use in a therapeutic setting is controversial.

Nurses are regarded as being at high risk of work-related violence compared with other occupations.

More than 15% of staff told the NHS 2017 Staff Survey they had suffered physical violence from patients, relatives or the public in the previous 12 months.

Nurses and healthcare assistants provided positive feedback after taking part in a three-month long pilot last year in which body cameras were used in an inpatient mental health setting.


Denise McLaughlin: poor working
environment makes nurses more
likely to become unwell.
Picture: John Houlihan

At a psychiatric unit run by Northamptonshire Healthcare NHS Foundation Trust where staff in five wards use the cameras the level of violent incidents and use of emergency restraints has fallen significantly on three of the wards, in one case by 100%.

A review of literature on the use of electronic surveillance in health and social care settings in 2014 said there were potential benefits, but the use of technology such as CCTV could have a negative impact on staff and patient behaviour.

Recruiting more men

With men accounting for just over 11% of the nursing workforce, according to NMC figures, the question of how to recruit more men to the profession will be on the agenda this year.

The proportion of men among nursing students in the UK has changed little in recent years. Research suggests that stereotypes, for example that women are more caring, and gender bias are keeping men from entering the profession. There is also a lack of guidance on appropriate touching, and few male nurse role models and mentors.

Delegates will be asked to vote on whether the RCN should ‘develop and promote a strategy’ to recruit more men into the nursing profession.

Emergence of private companies

Health trade unions have been campaigning against NHS organisations moving staff into subsidiary companies wholly owned by trusts in an attempt to reduce costs.

Unions have raised concerns that this means staff are no longer employed by the NHS, even if they are promised the same working conditions.

4

days of debate and events at congress

The Unite trade union wrote to Mr Hunt earlier this year calling for an immediate ban on further private limited companies being established by NHS trusts in England.

Nineteen trusts have transferred non-clinical NHS staff into subsidiary companies and 16 more plan to do so, the Guardian in reported February.

Staff protested against plans to move 750 staff from Gloucestershire Hospitals NHS Foundation Trust into a subsidiary company in February.

Congress will debate the ‘long-term effects of NHS trusts converting services into limited companies to reduce the costs of their workforce’.

A dog can be the patient’s best friend


A therapy dog with a hospital patient. Picture: iStock

The first protocol for dogs in healthcare settings, including patting dogs, medication detection dogs and animal-assisted interventions, will be published at congress.

The RCN will launch the publication, which provides a framework for protecting patients, residents, visitors and staff, as well as the animal, so that the maximum benefit can be achieved with minimal risk.

In a 2016 RCN survey of 750 nurses, 90% said animals could improve the health of patients with depression and other mental health problems.

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