#EndPJparalysis is about trusting nurses and valuing patients’ time

A global movement to get patients up, dressed and moving started with a conversation in a hospital in the Australian outback.

A global movement to get patients up, dressed and moving started with a conversation in a hospital in the Australian outback

Picture: iStock

Broken Hill Hospital in New South Wales is in a health district the size of England with a population of just 30,000 people. It’s also the unlikely birthplace of #EndPJparalysis, a global social movement that has garnered more than 100 million impressions on Twitter since January this year.

In November 2016, I was in Broken Hill doing leadership development and coaching with senior nurses. I spoke to a ward manager from the sub-acute rehab unit who had started encouraging inpatients  to wear their own shoes and then later their own clothes. She told me she had soon noticed an improvement in cognitive and physical function as well as a shorter length of stay.

This conversation occurred a few weeks after I’d visited Nottingham University Hospitals (NUH) to give a talk on patient time and why it’s the most important currency in healthcare. It was with Broken Hill in mind that I wrote a response to a tweet from NUH's deputy chief nurse, Ann-Marie Riley, and Tim Gillatt from the Emergency Care Improvement Program (ECIP) that said: 'Nursing was born in the church and raised in the army, so leaving patients in pyjamas is their "uniform" #Letsfixthat'. Within days this became #EndPJparalysis.

NUH quickly became a follower and the campaign started to spread across the NHS. Together we (Ann-Marie, Tim and another ECIP colleague Pete Gordon; we are all nurses) became its stewards and promoters.

A blog written in February by England’s chief nursing officer Jane Cummings amplified the message and encouraged others to sign up. This was the movement’s tipping point.

Patient dignity

#EndPJparalysis is not about key performance indicators, targets or graphs. It’s about trusting clinical staff to do what works best for them.

It’s about dignity, autonomy and choice. It’s about valuing patient time, since patients who are up, dressed and moving get home to the ones they love sooner and safer. It’s about improving patient and staff experience and well-being.

I trained in the 1980s and we routinely used to do this. Somewhere along the way we stopped; now we are revisiting the best bits of what we did back then.

An unexpected and welcome feature of #EndPJparalysis is the level of engagement at all levels of clinical and clerical staff. Ward clerks, CEOs, medical staff and particularly allied health colleagues are actively involved.

The Last 1000 days/EndPJparalysis Facebook page has led to lots of idea sharing, with downloadable posters and support for one another. I’m sure that because no one officially owns #EndPJparalysis it’s now owned by all of us, breaking records from Broken Hill to the NHS and back.

Brian Dolan is director of Health Service 360, visiting professor of nursing, Oxford Institute of Nursing, Midwifery and Allied Health Research, and honorary professor of leadership in healthcare, Salford University, Manchester


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