#WeNurses - Thursday 26th July 2018 8pm (GMT Standard Time)
Professional responsibilities & accountability
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This chat is guest hosted by @maxwele2
Professional responsibilities and accountability of collective leadership by Elaine Maxwell
Sir Ian Kennedy, speaking about his review of paediatric cardiac surgery in Bristol1 (published in 2001) remarked that the surprising thing was not how few people knew of the problems and high mortality, rather it was how many knew. He notes that
“Bristol was a wash with data. There was enough information from the late 1980s onwards to cause questions about mortality rates to be raised both in Bristol and elsewhere had the mindset to do so existed. Little, if any, of this information was available to the parents or to the public.” P.3
This is a recurrent theme in public inquiries into health services and was raised again with the recent publication of the Gosport Inquiry2 into opiate related deaths. Some nurses had raised concerned (as happens in all public inquiries) but the majority had turned a blind eye. Content that their own personal practice met the required standards.
So why do professionals not act on failings, whether through system failure or malign intent? In 1964, Kitty Genovese was stabbed to death outside her apartment in New York while bystanders who observed the crime did not step in to assist or call the police. Psychologists Latané and Darley3 described this as the bystander effect and suggested that when there is a perceived diffusion of responsibility, no one takes responsibility and everyone assumes someone else has taken or will take responsibility to do something.
As healthcare becomes increasingly complex, there are calls for distributed and collective leadership within and across organisations. But do we have a mechanisms for negotiating the division of responsibilities and accountabilities within it?
The Nursing and Midwifery Council is clear that it regulates the actions of individual practitioners not teams or organisations. How do we, as responsible practitioners, therefore decide where our professional duty lies? If, as the Code4 suggests, we are to:
16.1 raise and, if necessary, escalate any concerns you may have about patient or public safety, or the level of care people are receiving in your workplace or any other healthcare setting and use the channels available to you in line with our guidance and your local working practices
then what action should be taken against those who don’t raise the practice of others? What if it is ‘rumour’ or a feeling without hard data? Where is the burden of proof, should it be balance of probabilities or beyond all reasonable doubt? And what if a registrant raises concerns but no action is taken, is their responsibility discharged?
Next year will be the 50th anniversary of the publication of the Inquiry into Ely Hospital in Cardiff5. The report concluded that “there is a more pervasive atmosphere about Ely, summed up in Mrs. “Z’s” phrase about the “perpetuation of inertia”. Can we really say that we have resolved the perpetuation of inertia and as a profession take collective responsibility for patients’ safety and care?
And if we haven’t got there yet, what are we, the profession’s registrants going to do about it?
References
2) https://www.gosportpanel.independent.gov.uk/
3) Darley, J. M., & Latane, B. (1968). Bystander intervention in emergencies: Diffusion of responsibility Journal of Personality and Social Psychology, 8(4, Pt.1), 377-383
4) https://www.nmc.org.uk/globalassets/sitedocuments/nmc-publications/nmc-code.pdf
5) https://www.sochealth.co.uk/national-health-service/democracy-involvement-and-accountability-in-health/complaints-regulation-and-enquries/report-of-the-committee-of-inquiry-into-allegations-of-ill-treatment-of-patients-and-other-irregularities-at-the-ely-hospital-cardiff-1969/
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Chat Summary
In summary here are some of the answers to the questions that resonated most with us:
Question 1:
Lets get going with QUESTION 1
— WeNurses (@WeNurses) July 26, 2018
Should nurses be collectively responsible for all care in their area, not just their own personal practice?#WeNurses pic.twitter.com/hM6MlT9AGl
Are we not responsible for our acts and omissions? So whatever role we play and actions in our area of practice, we are responsible for - RNs and STNs alike. #wenurses
— Rachael Palmer (@PUNCrachpalmer) July 26, 2018
#WeNurses absolutely, we work in a system and we all have to be responsible for the system
— Dr Elaine Maxwell (@maxwele2) July 26, 2018
Well the only person you can be truely responsible for is yourself. But if you lead by example you can have a positive impact on the team as a while and patient outcomes #WeNurses
— PD&E Dept (@PDandE_NNUHFT) July 26, 2018
Question 2:
QUESTION 2
— WeNurses (@WeNurses) July 26, 2018
What stops nurses speaking up when they see practice they are uncomfortable with?#WeNurses pic.twitter.com/IcEQlOWq8m
Fearing the consequences of speaking up... I have been exposed to a colleague being dismissed for raising concerns in practice! #WeNurses
— Shona Brown (@brown1992) July 26, 2018
That's why people are fearful - because you are isolated and ostracised. If we accepted collective responsibility this marginalisation couldn't happen. #wenurses
— June Girvin (@ProfJuneG) July 26, 2018
1. Fear of the name, blame & shame culture
— Ken Spearpoint RN BSc MSc MPhil (@K_G_Spearpoint) July 26, 2018
2. Hierarchy (between nurses) & between nurses and doctors etc.
3. Ego
4. Absence of permission to speak up#WeNurses
Question 3:
QUESTION 3
— WeNurses (@WeNurses) July 26, 2018
Does collective responsibility mean no one is accountable?#WeNurses pic.twitter.com/EUGAWD9yWH
there is a real danger that everyone is responsible so nobody thinks it is down to them so nothing gets done #WeNurses
— Dr Elaine Maxwell (@maxwele2) July 26, 2018
Group supervision and group reflective practice is great! Collective responsibility is not a bad thing cohesive working within an MDT is really rewarding environment to work in! Safety huddles and improving handover and communication increases Seanad of collective working
— Ben (@Benandsebastian) July 26, 2018
Absolutely not #WeNurses it's not a substitute for accountability
— clare price-dowd (@clarepricedowd) July 26, 2018
Question 4:
QUESTION 4
— WeNurses (@WeNurses) July 26, 2018
What should nurses do if they raise concerns but poor practice continues?#WeNurses pic.twitter.com/rp48ZUJH5U
Raise concerns up through the hierarchy and use reporting systems already in place. I suppose if poor practice continues, that's why people go to the media and "whistle blow" - they may have felt it was the only option left #WeNurses
— 🌼#HellomynameisJo🌼 RN (@jomwlever) July 26, 2018
Escalate! Every time. In writing.
— Heather Kirton (@heatherjkirton) July 26, 2018
Escalate them in writing. The issues you’ve raised should be answered in writing stating the steps that will be taken. If they aren’t, your union can help communicate your concerns. Nurses have a duty to raise concerns when patients are at risk of harm #wenurses
— Rosi Jones (@rosijones) July 26, 2018
Question 5:
QUESTION 5
— WeNurses (@WeNurses) July 26, 2018
Should the NMC take action against nurses who knew there was poor practice but did nothing?#WeNurses pic.twitter.com/2xi59Rzsiw
Hmmm. Challenging & harsh within the current predominant name, blame & shame culture. Let’s get that right first!
— Ken Spearpoint RN BSc MSc MPhil (@K_G_Spearpoint) July 26, 2018
Hmm. We have a duty of care to protect from harm - BUT, what if we raise concerns but no one listens? Doing nothing is never an option though is it? Always hard to be a lone voice too!#wenurses
— Clare McIntyre #NHSLove (@ClareMcPlus4) July 26, 2018
What kind of action and how would this be enforced? My feelings are there is no way of proving if someone didn't speak up and more work needs to be done on supporting whistleblowers not scaring nurses into speaking up with the NMC. #WeNurses
— Emily Goss RN (@EmilyGoss23) July 26, 2018
Question 6:
FINAL QUESTION
— WeNurses (@WeNurses) July 26, 2018
How do we encourage constant reflection on practice, based on the best available evidence?#WeNurses pic.twitter.com/aeh0RsP8Sr
for me it’s about scheduled, mindful, group clinical supervision sessions. Medics get non clinical SPAs to do this. Is it time all nurses got paid 1/2 day a month for reflection? #WeNurses
— Dr Elaine Maxwell (@maxwele2) July 26, 2018
It’s sad that this is considered out the box. Reflecting & learning from practice benefits employers & should be paid. Instead nurses are expected to do it in their own time #WeNurses
— Grant Byrne StN (@GGByrne) July 26, 2018
Build into work plans, management actively encourage reflective practice and shared learning! Let everyone lead on what is being reflected on, allow reflection to take place without management presence on occasion!
— Ben (@Benandsebastian) July 26, 2018
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#WeNurses transcript
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@AgencyNurse
26 July 2018 20:00
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Hello Teresa here #wenurses |
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@WeNurses
26 July 2018 20:00
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Hi there #WeNurses https://twitter.com/PDandE_NNUHFT/status/1022557223816507392 |
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@lilian_wittman
26 July 2018 20:01
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@WeNurses #WeNurses I'm sat in front of a fan and ready to go ??. |
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@jomwlever
26 July 2018 20:01
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@WeNurses Good evening, Jo here tweeting from Greater Manchester. Would like to be cooler ???? #WeNurses |
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@maxwele2
26 July 2018 20:01
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@AgencyNurse Oops #wenurses |
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@WeNurses
26 July 2018 20:02
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@lilian_wittman great plan #wenurses |
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@WeNurses
26 July 2018 20:03
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Hello there #wenurses https://twitter.com/Deborah35855216/status/1022557539916042241 |
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@WeNurses
26 July 2018 20:03
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@jomwlever hi Jo #wenurses |
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@ProfJuneG
26 July 2018 20:03
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@WeNurses Hi there. June here. Hot. Have a plastic bottle cooler on the back of my neck...it's working...#wenurses |
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@WeNurses
26 July 2018 20:05
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Thanks for joining us June and great plan #wenurses https://twitter.com/ProfJuneG/status/1022558027453538305 |
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@ProfJuneG
26 July 2018 20:05
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@WeNurses A1 I think they are, aren't they? #wenurses |
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@Soby16536799
26 July 2018 20:06
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@WeNurses I think everybody should be responsible for what they are doing...#wenurses |
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@maxwele2
26 July 2018 20:06
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@WeNurses #WeNurses absolutely, we work in a system and we all have to be responsible for the system |
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@lilian_wittman
26 July 2018 20:06
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#WeNurses I think that we are responsible for the care we give to any patient, does this give us collective responsibility ? |
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@maxwele2
26 July 2018 20:07
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@ProfJuneG @WeNurses #wenurses to whom? the NMC only regulates individuals as shown by #isabelamaro case |
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@clarepricedowd
26 July 2018 20:07
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#WeNurses https://twitter.com/clarepricedowd/status/1022558808248406016 |
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@WeNurses
26 July 2018 20:07
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RT @Soby16536799: @WeNurses I think everybody should be responsible for what they are doing...#wenurses |
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@maxwele2
26 July 2018 20:07
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@Soby16536799 @WeNurses but what about for what their colleagues are doing? #WeNurses |
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@WeNurses
26 July 2018 20:08
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Thoughts on this ?? #WeNurses https://twitter.com/PDandE_NNUHFT/status/1022558965304057857 |
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@viccispires
26 July 2018 20:08
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Hello #WeNurses |
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@maxwele2
26 July 2018 20:08
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@lilian_wittman if not, we get Mid Staffs, Morecombe Bay and Gosport scenarios #wenurses |
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@WeNurses
26 July 2018 20:08
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RT @clarepricedowd: #WeNurses https://twitter.com/clarepricedowd/status/1022558808248406016 |
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@maxwele2
26 July 2018 20:09
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@PDandE_NNUHFT @WeNurses disagree, we have to be responsible for the whole team #wenurses |
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@WeNurses
26 July 2018 20:09
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Please elaborate #WeNurses https://twitter.com/Deborah35855216/status/1022559250109874176 |
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@ArmisteadCheryl
26 July 2018 20:09
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Q1: I believe this is explicit in our Codes of Ethics. Reply @WeNurses #WeNurses https://twitter.com/WeNurses/status/1022558256714199040 |
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@clarepricedowd
26 July 2018 20:10
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@AgencyNurse #WeNurses if we see it and do nothing to support to improve or challenge, then we are responsible by colluding. |
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@ProfJuneG
26 July 2018 20:10
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@jomwlever @WeNurses So if someone does something wrong you don't have to worry about it? #wenurses |
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@maxwele2
26 July 2018 20:11
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RT @clarepricedowd: @AgencyNurse #WeNurses if we see it and do nothing to support to improve or challenge, then we are responsible by collu… |
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@AgencyNurse
26 July 2018 20:11
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@ProfJuneG I see but if i have raised concerns over others practice where does my reponsibility for the collective end ? #WeNurses |
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@becksherrington
26 July 2018 20:11
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@WeNurses You can lead b example, but culture has a incredibly strong influence #WeNurses safety influenced by multitude of factors |
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@Soby16536799
26 July 2018 20:11
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@maxwele2 @WeNurses I think we can only supervise and raise concerns if any...we can't be responsible for somebody else's faults...#wenurses |
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@ProfJuneG
26 July 2018 20:11
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I would say we share that responsibility of we choose not to do anything about it. #wenurses https://twitter.com/AgencyNurse/status/1022559768999813125 |
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@maxwele2
26 July 2018 20:12
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@ArmisteadCheryl @WeNurses it is sort of in our Code, but is it enforced? #WeNurses |
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@AgencyNurse
26 July 2018 20:12
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@clarepricedowd yes but if we do something and raise concerns where does our responsibility end ? #WeNurses |
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@lilian_wittman
26 July 2018 20:12
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#WeNurses @PDandE_NNUHFT I think we can certainly influence others but we should be responsible not only for our ow… https://twitter.com/i/web/status/1022560304130142210 |
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@vsweeney431
26 July 2018 20:12
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#WeNurses hello, Vanessa here A1 - most definitely our accountability spans beyond the patients we directly care fo… https://twitter.com/i/web/status/1022560395846983681 |
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@maxwele2
26 July 2018 20:12
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@Soby16536799 @WeNurses so the poor patient just gets pot luck? not really patient advocacy #wenurses |
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@ArmisteadCheryl
26 July 2018 20:13
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Ah now that is where personal courage does come into play. Reply @maxwele2 Reply @WeNurses #WeNurses https://twitter.com/maxwele2/status/1022560211603738624 |
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@ProfJuneG
26 July 2018 20:13
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@AgencyNurse When something is done about the issue, or when your tolerance runs out and you leave? #wenurses |
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@AgencyNurse
26 July 2018 20:13
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RT @ProfJuneG: I would say we share that responsibility of we choose not to do anything about it. #wenurses https://twitter.com/AgencyNurse/status/1022559768999813125 |
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@maxwele2
26 July 2018 20:13
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@lilian_wittman @PDandE_NNUHFT if the rest of the team is giving poor care, can mine be good (given its only part of the whole) ? #WeNurses |
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@maxwele2
26 July 2018 20:14
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RT @ArmisteadCheryl: Ah now that is where personal courage does come into play. Reply @maxwele2 Reply @WeNurses #WeNurses https://t.co/weyj… |
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@AgencyNurse
26 July 2018 20:14
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@ProfJuneG I don't know the answer June ... perhaps it's not black and white .. perhaps there are multiple answers here #Wenurses |
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@maxwele2
26 July 2018 20:15
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@AgencyNurse doesn’t our duty to the patient persist? nurses like saying they are patient advocates but are they really? #wenurses |
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@Soby16536799
26 July 2018 20:15
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@ProfJuneG @maxwele2 @WeNurses I agree...??#wenurses |
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@clarepricedowd
26 July 2018 20:15
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@ProfJuneG @AgencyNurse This is the sad thing #WeNurses , good nurses leave as they are not supported when raising concerns |
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@ProfJuneG
26 July 2018 20:15
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Oooh, that's a good question....#wenurses https://twitter.com/maxwele2/status/1022560677431525378 |
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@maxwele2
26 July 2018 20:15
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RT @ProfJuneG: Oooh, that's a good question....#wenurses https://twitter.com/maxwele2/status/1022560677431525378 |
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@WeNurses
26 July 2018 20:15
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QUESTION 2 What stops nurses speaking up when they see practice they are uncomfortable with? #WeNurses https://t.co/IcEQlOWq8m |
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@maxwele2
26 July 2018 20:16
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interesting view, responsibility linked to position #wenurses https://twitter.com/lorraine_tinker/status/1022561058328850432 |
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@gillsmac1
26 July 2018 20:16
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@WeNurses hello #WeNurses |
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@ProfJuneG
26 July 2018 20:16
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@AgencyNurse I think when it comes to patient safety perhaps it has to be more black and white? #wenurses |
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@WeNurses
26 July 2018 20:17
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RT @becksherrington: @WeNurses You can lead b example, but culture has a incredibly strong influence #WeNurses safety influenced by multitu… |
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@lilian_wittman
26 July 2018 20:17
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#WeNurses the fear of being labelled as whistle blower and maybe upsetting the routine. |
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@PDandE_NNUHFT
26 July 2018 20:17
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@WeNurses Fear of reprisal from their colleagues, feeling that they are ‘ sticking their head above the parapet ? ‘ #wenurses |
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@AgencyNurse
26 July 2018 20:17
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RT @vsweeney431: #WeNurses hello, Vanessa here A1 - most definitely our accountability spans beyond the patients we directly care for, incl… |
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@WeNurses
26 July 2018 20:18
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RT @lilian_wittman: #WeNurses the fear of being labelled as whistle blower and maybe upsetting the routine. |
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@tracyPSC
26 July 2018 20:19
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Lack of psychological safety #WeNurses |
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@clarepricedowd
26 July 2018 20:19
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@WeNurses #WeNurses depends on who is doing the bad practice, can be a personal cost if the person is senior or has… https://twitter.com/i/web/status/1022562053549158400 |
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@maxwele2
26 July 2018 20:19
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@lilian_wittman @PDandE_NNUHFT but what if the culture is such that I don’t have influence? #WeNurses |
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@PUNCadp
26 July 2018 20:19
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@lilian_wittman @WeNurses Definitely #WeNurses |
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@Like47
26 July 2018 20:19
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RT @lilian_wittman: #WeNurses the fear of being labelled as whistle blower and maybe upsetting the routine. |
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@AgencyNurse
26 July 2018 20:20
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Nicely said #wenurses https://twitter.com/K_G_Spearpoint/status/1022562126525816837 |
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@gillsmac1
26 July 2018 20:20
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@lilian_wittman @WeNurses I agree #wenurses |
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@WeNurses
26 July 2018 20:20
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What are peoples thoughts about this ? #WeNurses https://twitter.com/maxwele2/status/1022561912826028037 |
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@maxwele2
26 July 2018 20:21
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@AgencyNurse theme only get normalised when everyone accepts them, collective action #WeNurses |
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@clarepricedowd
26 July 2018 20:21
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RT @AgencyNurse: Nicely said #wenurses https://twitter.com/K_G_Spearpoint/status/1022562126525816837 |
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@maxwele2
26 July 2018 20:21
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RT @WeNurses: What are peoples thoughts about this ? #WeNurses https://twitter.com/maxwele2/status/1022561912826028037 |
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@WeNurses
26 July 2018 20:21
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#WeNurses https://twitter.com/rosijones/status/1022562518194171905 |
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@Soby16536799
26 July 2018 20:22
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@WeNurses Nothing been done about previous concerns or not taking it seriously..#wenurses |
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@jomwlever
26 July 2018 20:22
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@ProfJuneG @WeNurses What I meant was we have responsibility as a team to ensure patients are safe as well as individual practice #WeNurses |
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@PUNCadp
26 July 2018 20:22
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@AgencyNurse We've always done it that way... the most dangerous phrase #WeNurses |
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@WeNurses
26 July 2018 20:23
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QUESTION 3 Does collective responsibility mean no one is accountable? #WeNurses https://t.co/EUGAWD9yWH |
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@clarepricedowd
26 July 2018 20:23
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@WeNurses #wenurses how much time do we actually spend building our teams and fostering a collective feel? Fragmentation common when busy |
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@redadd9719
26 July 2018 20:24
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RT @lilian_wittman: #WeNurses the fear of being labelled as whistle blower and maybe upsetting the routine. |
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@AgencyNurse
26 July 2018 20:24
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So does this mean they were no longer responsible ?? #WeNurses https://twitter.com/EllzSummary/status/1022562901800968193 |
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@maxwele2
26 July 2018 20:24
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@lilian_wittman @PDandE_NNUHFT not sure that worked in Mid Staffs or Gosport. Hope is not a plan #WeNurses |
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@EllzSummary
26 July 2018 20:24
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@AgencyNurse @clarepricedowd However all registrants have professional accountinility for both their actions & omissions #WeNurses |
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@WeNurses
26 July 2018 20:24
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#WeNurses https://twitter.com/JeanetteMulher1/status/1022563259805822977 |
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@WeNurses
26 July 2018 20:25
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An excellent question ... we fear the answer may be "not enough!" #WeNurses https://twitter.com/clarepricedowd/status/1022563160526610439 |
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@maxwele2
26 July 2018 20:25
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@EllzSummary @AgencyNurse @clarepricedowd yes, people forget omissions are as significant as acts #wenurses |
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@WeNurses
26 July 2018 20:25
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RT @maxwele2: @EllzSummary @AgencyNurse @clarepricedowd yes, people forget omissions are as significant as acts #wenurses |
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@maxwele2
26 July 2018 20:26
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RT @clarepricedowd: @WeNurses #wenurses how much time do we actually spend building our teams and fostering a collective feel? Fragmentati… |
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@ProfJuneG
26 July 2018 20:26
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Not at all. It means no-one can escape the accountability. #wenurses https://twitter.com/WeNurses/status/1022563052917583873 |
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@gillsmac1
26 July 2018 20:26
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@WeNurses someone is always responsible be it the person themselves or the person in charge. #wenurses |
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@clarepricedowd
26 July 2018 20:27
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@WeNurses Absolutely not #WeNurses it's not a substitute for accountability |
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@maxwele2
26 July 2018 20:27
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@WeNurses there is a real danger that everyone is responsible so nobody thinks it is down to them so nothing gets done #WeNurses |
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@lilian_wittman
26 July 2018 20:27
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#WeNurses of course not, we must all stand out and take responsibility whether collegiate or individual. |
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@ProfJuneG
26 July 2018 20:28
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or anyone who was aware and did nothing...#wenurses https://t.co/CgCEaMJsxx |
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@maxwele2
26 July 2018 20:28
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@gillsmac1 @WeNurses how do you decide who though? esp when patients recieve care for teams of people? #WeNurses |
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@WeNurses
26 July 2018 20:29
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RT @ProfJuneG: Not at all. It means no-one can escape the accountability. #wenurses https://twitter.com/WeNurses/status/1022563052917583873 |
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@maxwele2
26 July 2018 20:30
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@Jo3_NHS Do you think duty of candour has made people take their responsibility more seriously? #WeNurses |
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@WeNurses
26 July 2018 20:30
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#WeNurses https://twitter.com/liavelvargas/status/1022564646459465738 |
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@ProfJuneG
26 July 2018 20:30
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@maxwele2 @WeNurses To themselves, to eat other, to the patient? #wenurses |
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@Soby16536799
26 July 2018 20:30
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@WeNurses To me it means everyone accountable ..#wenurses |
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@maxwele2
26 July 2018 20:31
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@ProfJuneG or as Ian Kennedy pointed out at the Bristol inquiry, everybody knew and no one did anything #WeNurses |
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@WeNurses
26 July 2018 20:31
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QUESTION 4 What should nurses do if they raise concerns but poor practice continues? #WeNurses https://t.co/rp48ZUJH5U |
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@maxwele2
26 July 2018 20:31
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#WeNurses https://twitter.com/vsweeney431/status/1022564692936548361 |
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@maxwele2
26 July 2018 20:32
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#WeNurses https://twitter.com/vsweeney431/status/1022564855369396226 |
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@WeNurses
26 July 2018 20:32
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RT @maxwele2: #WeNurses https://twitter.com/vsweeney431/status/1022564692936548361 |
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@maxwele2
26 July 2018 20:32
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@vsweeney431 @ProfJuneG @drury297 add the hashtag #wenurses and we’ll all hear your pearls of wisdom ?? |
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@AgencyNurse
26 July 2018 20:32
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RT @maxwele2: #WeNurses https://twitter.com/vsweeney431/status/1022564855369396226 |
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@brown1992
26 July 2018 20:33
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@WeNurses Raise the concern to a higher level of authority within the service and/or other local relevant authorities! #WeNurses |
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@JeanetteMulher1
26 July 2018 20:33
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@WeNurses #WeNurses |
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@AgencyNurse
26 July 2018 20:34
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For me this is where the problem lies .... that we may raise concerns ... but what then ?? #WeNurses https://twitter.com/WeNurses/status/1022565129928499203 |
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@ProfJuneG
26 July 2018 20:34
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@maxwele2 @Jo3_NHS Nope. #wenurses |
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@PUNCadp
26 July 2018 20:34
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@WeNurses Raise it to the next level and put it in writing if it continues and nothing gets done #WeNurses |
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@maxwele2
26 July 2018 20:35
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#WeNurses https://twitter.com/nhs4free/status/1022565758600142851 |
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@AgencyNurse
26 July 2018 20:35
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I think this is a very good point indeed #WeNurses https://twitter.com/maxwele2/status/1022565704388816896 |
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@ProfJuneG
26 July 2018 20:35
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Raise them at a higher level. Put the concerns in writing with evidence. Canvass sport from other people. #wenurses https://t.co/9xQ9R3Gfid |
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@PUNCadp
26 July 2018 20:36
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@WeNurses Don't let it go. Speak up until something is done #WeNurses |
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@vsweeney431
26 July 2018 20:36
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@PUNCadp @WeNurses Agreed! Take it to the next level, no response, the next level ... #WeNurses |
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@maxwele2
26 July 2018 20:36
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@AgencyNurse the Public Interest Disclosure Act allows for people to raise with the press as @ShaunLintern will attest #WeNurses |
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@lilian_wittman
26 July 2018 20:36
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#WeNurses @maxwele2 I totally agree with that, I've seen it happen a few times. |
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@maxwele2
26 July 2018 20:36
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RT @AgencyNurse: I think this is a very good point indeed #WeNurses https://twitter.com/maxwele2/status/1022565704388816896 |
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@gillsmac1
26 July 2018 20:37
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@brown1992 @WeNurses exactly what I would do too until someone listened #WeNurses |
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@clarepricedowd
26 July 2018 20:37
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@AgencyNurse #WeNurses the thing is not to think 'job done' & expect others to act, they may not, find allies if… https://t.co/iZ1HajkCLN |
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@AgencyNurse
26 July 2018 20:37
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Mmmm interesting ... this i did not know #WeNurses https://t.co/RxIkSHmzp4 |
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@ProfJuneG
26 July 2018 20:37
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that would be 'support', although sport is good too... #wenurses https://t.co/2HLhIhcfKB |
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@AgencyNurse
26 July 2018 20:37
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RT @clarepricedowd: @AgencyNurse #WeNurses the thing is not to think 'job done' & expect others to act, they may not, find allies if not… |
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@maxwele2
26 July 2018 20:37
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@AgencyNurse united we stand, divided we fall. True collective leadership means all for one and one for all #WeNurses |
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@WeNurses
26 July 2018 20:38
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RT @ProfJuneG: Raise them at a higher level. Put the concerns in writing with evidence. Canvass sport from other people. #wenurses https://… |
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@WeNurses
26 July 2018 20:39
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RT @maxwele2: @AgencyNurse united we stand, divided we fall. True collective leadership means all for one and one for all #WeNurses |
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@lilian_wittman
26 July 2018 20:39
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#WeNurses if their concerns are not listened to, they need to repeat http://them.as often as they need to until things change. |
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@AgencyNurse
26 July 2018 20:39
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@PUNCadp I would hope that i would be too ... lets hope we never find ourselves facing these things though #WeNurses |
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@PUNCadp
26 July 2018 20:40
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@ProfJuneG @AgencyNurse I was always taught that if you see something bad, you're just as guilty if you don't speak up #WeNurses |
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@maxwele2
26 July 2018 20:41
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@AgencyNurse @PUNCadp I have and I had to leave the job, but the guilt of going when it’s not sorted is immense #WeNurses |
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@MHNAbertay
26 July 2018 20:42
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@WeNurses Let's also ask Nurses who spoke up what they did and what impact they had. #WeNurses |
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@lilian_wittman
26 July 2018 20:42
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#WeNurses ensure that all concerns are documented, use you freedom to speak up guardians. |
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@AgencyNurse
26 July 2018 20:42
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@maxwele2 @PUNCadp one thing seems to be clear ... more support is needed ! #WeNurses |
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@PUNCadp
26 July 2018 20:42
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@maxwele2 @AgencyNurse It must have felt awful, but I'm sure you did all you could #wenurses |
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@vsweeney431
26 July 2018 20:43
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#WeNurses (new at this!) https://twitter.com/vsweeney431/status/1022567918247264257 |
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@Papajoe1407
26 July 2018 20:43
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RT @maxwele2: @AgencyNurse united we stand, divided we fall. True collective leadership means all for one and one for all #WeNurses |
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@maxwele2
26 July 2018 20:43
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@AgencyNurse @PUNCadp i think we need more support from peers rather than calling for it from managers though #WeNurses |
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@ProfJuneG
26 July 2018 20:43
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@AgencyNurse absolutely. and if you're leaving it's easier. I think . #wenurses |
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@WeNurses
26 July 2018 20:43
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QUESTION 5 Should the NMC take action against nurses who knew there was poor practice but did nothing? #WeNurses https://t.co/2xi59Rzsiw |
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@AgencyNurse
26 July 2018 20:44
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This sounds interesting #WeNurses https://twitter.com/vsweeney431/status/1022567918247264257 |
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@maxwele2
26 July 2018 20:44
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@ProfJuneG yes, need fair blame not no blame #wenurses |
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@AgencyNurse
26 July 2018 20:44
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@maxwele2 @PUNCadp yes i think you are right #WeNurses |
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@maxwele2
26 July 2018 20:45
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so, so true #WeNurses https://t.co/tTkP7hgsOH |
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@AgencyNurse
26 July 2018 20:45
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@ProfJuneG yes i think so too #WeNurses |
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@lilian_wittman
26 July 2018 20:45
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#WeNurses I think that maybe a warning or file note could be issued to prove that standing by and doing nothing isn't an option. |
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@AgencyNurse
26 July 2018 20:45
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@PUNCadp @maxwele2 i think it depends on where you work .... as with anything good and bad exist #WeNurses |
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@EllzSummary
26 July 2018 20:45
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@AgencyNurse @maxwele2 @PUNCadp Courage to stand up and be counted #WeNurses |
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@maxwele2
26 July 2018 20:46
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@EllzSummary @AgencyNurse @PUNCadp but as a nurse, are you abandoning your patients if the final voice of opposition goes? #WeNurses |
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@AgencyNurse
26 July 2018 20:46
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ooh interesting question #WeNurses https://twitter.com/WeNurses/status/1022568229221359625 |
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@K_G_Spearpoint
26 July 2018 20:47
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@WeNurses And continue to role model best practice #WeNurses |
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@4AdsthePoet
26 July 2018 20:47
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RT @AgencyNurse: ooh interesting question #WeNurses https://twitter.com/WeNurses/status/1022568229221359625 |
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@vsweeney431
26 July 2018 20:47
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@maxwele2 @AgencyNurse @PUNCadp But we have to ?nurture / create the culture to enable this to happen #WeNurses |
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@WeNurses
26 July 2018 20:47
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RT @K_G_Spearpoint: @WeNurses And continue to role model best practice #WeNurses |
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@ProfJuneG
26 July 2018 20:47
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This is reality for many people, I think. #wenurses We circle the wagons. https://twitter.com/PUNCadp/status/1022568226453106688 |
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@WeNurses
26 July 2018 20:47
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#WeNurses https://t.co/vexud3izyV |
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@PUNCadp
26 July 2018 20:47
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@maxwele2 @EllzSummary @AgencyNurse Difficult one... I'm sure you didn't take your decision to leave easily @maxwele2 #wenurses |
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@WeNurses
26 July 2018 20:48
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#WeNurses https://t.co/pXlYud10Dl |
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@ProfJuneG
26 July 2018 20:48
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I think they should, if it's clear no action was taken and they knew. #wenurses https://t.co/aiYyKb2ogB |
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@Soby16536799
26 July 2018 20:48
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@WeNurses Tough one..#wenurses |
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@JeanetteMulher1
26 July 2018 20:48
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@WeNurses We are professionally accountable for our acts and omissions, surely we are duty bound to speak up?? #WeNurses |
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@WeNurses
26 July 2018 20:48
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RT @ProfJuneG: I think they should, if it's clear no action was taken and they knew. #wenurses https://twitter.com/WeNurses/status/1022568229221359625 |
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@maxwele2
26 July 2018 20:49
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RT @vsweeney431: @maxwele2 @AgencyNurse @PUNCadp But we have to ?nurture / create the culture to enable this to happen #WeNurses |
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@maxwele2
26 July 2018 20:49
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@vsweeney431 @AgencyNurse @PUNCadp how though? #WeNurses |
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@WeNurses
26 July 2018 20:49
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A differing perspective here #WeNurses https://twitter.com/EmilyGoss23/status/1022569419745181696 |
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@WeNurses
26 July 2018 20:49
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#WeNurses https://twitter.com/rosijones/status/1022569436920864775 |
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@RN_Emily_HPN
26 July 2018 20:50
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@WeNurses But I completely agree - nurses have a duty to speak up. #WeNurses |
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@WeNurses
26 July 2018 20:52
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#WeNurses https://twitter.com/dionne_whiteNUH/status/1022569943701839876 |
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@lilian_wittman
26 July 2018 20:52
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#WeNurses @EmilyGoss23 at some point poor care always comes to light and we're all responsible for patient safety and prevention of harm. |
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@WeNurses
26 July 2018 20:52
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#wenurses https://twitter.com/K_G_Spearpoint/status/1022570173352566784 |
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@ProfJuneG
26 July 2018 20:52
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Exactly this. A million times. #wenurses https://t.co/Ij9S4eWPWy |
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@tarailes
26 July 2018 20:52
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@WeNurses Always escalate. The standard you walk past is the standard you accept @WeNurses #wenurses |
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@WeNurses
26 July 2018 20:53
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RT @tarailes: @WeNurses Always escalate. The standard you walk past is the standard you accept @WeNurses #wenurses |
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@maxwele2
26 July 2018 20:53
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RT @lilian_wittman: #WeNurses @EmilyGoss23 at some point poor care always comes to light and we're all responsible for patient safety and p… |
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@brown1992
26 July 2018 20:53
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Yes of course! If there is clear evidence to support it! #WeNurses |
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@ProfJuneG
26 July 2018 20:53
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@WeNurses In some ways, it shouldn't need to be encouraged. If nurses aren't doing this, then they are failing...#wenurses |
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@AgencyNurse
26 July 2018 20:54
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If there was a breech of the code then 100% yes #WeNurses https://twitter.com/WeNurses/status/1022568229221359625 |
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@clarepricedowd
26 July 2018 20:54
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RT @ProfJuneG: Exactly this. A million times. #wenurses https://twitter.com/maxwele2/status/1022570075595923458 |
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@NatashaRolls1
26 July 2018 20:54
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RT @tarailes: @WeNurses Always escalate. The standard you walk past is the standard you accept @WeNurses #wenurses |
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@WeNurses
26 July 2018 20:54
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RT @ProfJuneG: @WeNurses In some ways, it shouldn't need to be encouraged. If nurses aren't doing this, then they are failing...#wenurses |
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@tarailes
26 July 2018 20:55
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@WeNurses We all have accountability and this includes ignoring or turning a blind eye to poor practice @WeNurses #WeNurses |
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@K_G_Spearpoint
26 July 2018 20:56
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@WeNurses Role model, discuss, educate to demonstrate the value of reflective practice in our development at every opportunity #WeNurses |
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@tarailes
26 July 2018 20:57
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The opposite, it means everyone is accountable. As RNs we all have a code to adhere to @WeNurses #WeNurses https://twitter.com/wenurses/status/1022563052917583873 |
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@lilian_wittman
26 July 2018 20:57
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#WeNurses I think reflection is an important way of changing the culture providing we learn from the event. |
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@Soby16536799
26 July 2018 20:57
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@WeNurses Self reflection,trainings,discussion with colleagues...#wenurses |
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@WeNurses
26 July 2018 20:58
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#Wenurses https://twitter.com/Benandsebastian/status/1022571272859992065 |
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@maxwele2
26 July 2018 20:58
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@tarailes @WeNurses agree, but how do we make sure accountability doesn’t fall between two stools? #WeNurses |
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@maxwele2
26 July 2018 20:58
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@RivkahMiar @AgencyNurse @PUNCadp how do we do that Rebecca? #Wenurses |
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@AgencyNurse
26 July 2018 20:59
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@EllzSummary @maxwele2 @PUNCadp eek !! #WeNurses |
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@gillsmac1
26 July 2018 20:59
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@EmilyGoss23 @WeNurses totally agree, it's part of a nurses duty to speak up #WeNurses |
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@maxwele2
26 July 2018 21:00
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@EllzSummary @AgencyNurse @PUNCadp true, but if you do leave, what’s your duty to the patients? #WeNurses |
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@PUNCadp
26 July 2018 21:00
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@maxwele2 @RivkahMiar @AgencyNurse Duty of candour? #WeNurses |
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@WeNurses
26 July 2018 21:01
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It's 9pm and thats all for tonight everyone ... thank you all for your fascinating tweets this evening #WeNurses https://t.co/6NVqSalNuM |
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@maxwele2
26 July 2018 21:01
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@vsweeney431 is this written up yet ? ??#wenurses |
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@WeNurses
26 July 2018 21:01
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Thank you especially to @maxwele2 who suggested and developed tonights discussion #WeNurses |
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@brown1992
26 July 2018 21:02
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@WeNurses Through group and individual supervisions!! With regular reflection practice built into nursing duties! @WeLDnurses #WeNurses |
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@maxwele2
26 July 2018 21:02
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@PUNCadp @RivkahMiar @AgencyNurse suspect it needs a bit more #Wenurses |
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@maxwele2
26 July 2018 21:02
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@Benandsebastian @WeNurses gosh where do you work?! #WeNurses |
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@WeNurses
26 July 2018 21:03
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Before we go .... if you want to reflect on tonights #WeNurses for your CPD then here is a link to our FREE MyWe to… https://twitter.com/i/web/status/1022573257424297986 |
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@vsweeney431
26 July 2018 21:04
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@maxwele2 ??.... not yet #WeNurses what’s fab is that it’s spreading across nursing ... it’s part of language, wasn’… https://twitter.com/i/web/status/1022573290009882624 |
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@lilian_wittman
26 July 2018 21:04
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#WeNurses @ProfJuneG use of appraisals to set goals for improvement, revalidation, the use of a confidential reflec… https://twitter.com/i/web/status/1022573364966313984 |
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@ProfJuneG
26 July 2018 21:04
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Excellent stuff! Thanks all. And exspecially to @maxwell2 for suggesting. #wenurses |
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@maxwele2
26 July 2018 21:04
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@Benandsebastian @WeNurses wow, we need to learn from that @vsweeney431 #WeNurses |
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@maxwele2
26 July 2018 21:05
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RT @vsweeney431: @maxwele2 ??.... not yet #WeNurses what’s fab is that it’s spreading across nursing ... it’s part of language, wasn’t the c… |
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@AgencyNurse
26 July 2018 21:05
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RT @WeNurses: Before we go .... if you want to reflect on tonights #WeNurses for your CPD then here is a link to our FREE MyWe tool that wi… |
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@ProfJuneG
26 July 2018 21:06
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@EllzSummary @maxwele2 @AgencyNurse @PUNCadp It's possible. Most organisations should respond to a request fro an exit interview. #wenurses |
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@WeNurses
26 July 2018 21:06
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Nursing people with dementia > https://buff.ly/2La0vrG Coming up NEXT THURSDAY #WeNurses with guest… https://twitter.com/i/web/status/1022573948037472256 |
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@maxwele2
26 July 2018 21:07
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@AgencyNurse agree, would reduce burnout, improve safety and save far more money than it cost #WeNurses |
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@AgencyNurse
26 July 2018 21:07
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@maxwele2 absolutely ... seems like a no brainer ! #WeNurses |
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@WeNurses
26 July 2018 21:08
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We agree ... most thought provoking and definitely something to relfect on ... thank you Elaine #WeNurses https://twitter.com/EllzSummary/status/1022574224588857357 |
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@derekfisher2907
26 July 2018 21:08
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RT @WeNurses: Nursing people with dementia > https://buff.ly/2La0vrG Coming up NEXT THURSDAY #WeNurses with guest @derekfisher2907 https… |
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@katblossom
26 July 2018 21:09
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RT @WeNurses: QUESTION 4 What should nurses do if they raise concerns but poor practice continues? #WeNurses https://t.co/rp48ZUJH5U |
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@AgencyNurse
26 July 2018 21:10
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Worth knowing #WeNurses https://twitter.com/supportNHSCIC/status/1022574696091578368 |
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@KYLegalnurse
26 July 2018 21:10
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RT @AgencyNurse: I think this is a very good point indeed #WeNurses https://twitter.com/maxwele2/status/1022565704388816896 |
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@vsweeney431
26 July 2018 21:10
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@WeNurses @maxwele2 Thank you @WeNurses & @maxwele2 ... my first twitter chat! Lots of thought-provoking points #WeNurses |
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@RivkahMiar
26 July 2018 21:10
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@maxwele2 @AgencyNurse As you would say It's about presenting the evidence base. ;-) #wenurses |
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@maxwele2
26 July 2018 21:11
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RT @RivkahMiar: @maxwele2 @AgencyNurse As you would say It's about presenting the evidence base. ;-) #wenurses |
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@supportNHSCIC
26 July 2018 21:12
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#wenurses Your views are being sought on #NHS #Safe #Staffing Bill before the 1st August can respond to survey & al… https://twitter.com/i/web/status/1022575526106554370 |
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@tarailes
26 July 2018 21:13
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@maxwele2 @WeNurses It needs to be multi professional #Wenurses |
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@jomwlever
26 July 2018 21:13
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@PUNCadp @WeNurses That would be very useful where I work #WeNurses |
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@supportNHSCIC
26 July 2018 21:15
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#wenurses Please respond with your views #patientsafety #safestaffing https://twitter.com/RCNScot/status/1022143722279067650 |
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@maxwele2
26 July 2018 21:16
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@Ramen91528506 @WeNurses that’s great, can you tell us the impact? #wenurses I’m wondering if @charlottemcardl… https://twitter.com/i/web/status/1022576466486288392 |
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@PUNCadp
26 July 2018 21:18
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@WeNurses @derekfisher2907 Looking forward to this one, my passion #WeNurses |
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@4AdsthePoet
26 July 2018 21:25
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RT @AgencyNurse: For me this is where the problem lies .... that we may raise concerns ... but what then ?? #WeNurses https://t.co/BFeEHR… |
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@maxwele2
26 July 2018 21:25
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#WeNurses https://twitter.com/shaunlintern/status/1022577453125038080 |
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@maxwele2
26 July 2018 21:26
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#wenurses if you can’t get your concerns acted on, you can go outside the Trust. Goof guidance here https://twitter.com/shaunlintern/status/1022577898228736001 |
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@supportNHSCIC
26 July 2018 21:33
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@EmilyGoss23 #Wenurses Always think & do #WhatMattersToYou @WMTYScot #WMTY https://twitter.com/tommyNtour/status/1022557210969292800 |
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@supportNHSCIC
26 July 2018 21:38
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@EmilyGoss23 @WMTYScot #WeNurses You reminded me of very touching moment, it is often the small things that can mak… https://twitter.com/i/web/status/1022582054981128192 |
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@VardeepDeogan
26 July 2018 21:43
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RT @tarailes: @WeNurses Always escalate. The standard you walk past is the standard you accept @WeNurses #wenurses |
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@tommyNtour
26 July 2018 21:48
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RT @supportNHSCIC: @EmilyGoss23 #Wenurses Always think & do #WhatMattersToYou @WMTYScot #WMTY https://twitter.com/tommyNtour/status/1022557210969292800 |
Stats
Total contributers:
35
Total tweets:
226
Total reach:
6,061,743
