Nurses and Midwives – it’s time to Break the Rules!

Posted by: NHS Horizons - Posted on:

Originally published by Bev Matthews – 1st August 2018

Do you find yourself asking “why do we do that?” and the only answer is “because we always have” or worse still … “I don’t really know”? Do you despair when you hear staff feeling unable to take the initiative and start even small improvements without filling in forms or see the eyes rolling at the prospect of asking for a decision? 

Then the August challenge from the Transforming Perceptions of Nursing and Midwifery programme may be just what you need! 

It’s time to break the rules 

August is the month to blow out the cobwebs and clear out the clutter because it’s time to Break the Rules. This is the month to bring your colleagues together and have a really good look at what gets in the way of getting things done.  

Why break the rules? 

Most rules are important: they protect us, and our patients, keeping us all safe from harm. But there is a downside to rules. Often they have an unintended impact on us and the people we serve. They can make us feel that we cannot innovate or improve things because we don’t have “permission”. Rules sometimes contribute to a culture of conformity and get in the way of intelligent judgment and actually doing what is right. 

A way of looking at it is that there are essentially two kinds of people that we work with, the compliant or the contributor

A Gallup Global Research survey tells us that Contributors create six times the value to an organisation compared to the compliant - butonly 13% of the workforce are engaged and contribute to positive change. 

Let’s create more contributors! 

Some Ambassadors are already planning their session; they are booking agenda items for this month’s existing meetings, creating opportunities for flexible involvement such as over lunch breaks, and taking time out as part of their team development. 

To support Ambassadors to deliver this month’s 30 day challenge, we have created a bumper resource pack for you to run your own event. It’s got a raft of resources including, templates, notes, slide deck, a map and facilitator’s guide. It’s everything you need to run a creative, open thinking session – and we are here to support you too! 

The first stage is known as divergent thinking so the only boundary is the NMC Code of Conduct! To get the thinking started we asked Ambassadors who joined the July virtual community forum for some examples to share in the pack.  

Here’s what they said: 

  • Not being allowed to have a bottle of water on the ward 
  • Only band 7 or above can use the lifts (we think this is an old one!) 
  • People doing only tasks appropriate to their banding – no one is above making the tea! 
  • Calling student nurses ‘the student’ 
  • Duplication of paperwork 
  • Flexibility of break times 
  • Planning off duty only a few weeks ahead 

Do you recognise any of these? Trust me, once you get together with your colleagues you will be amazed at how many emerge! 

I won’t give away the next steps but enough for now to say that you and your team will then follow a process called convergent thinking and will make sense of all the ideas that have come forward and collectively identify how you flip them into becoming permissions. 

What’s not to like? 

There is more information on the perceptions platform and you can claim your resource pack there too. If you would like to become an Ambassador and take part do sign up today! 

“In suggesting that you “break the rules” for the August 30 day challenge, we aren’t asking you to create havoc in your organisation! Rather, we are asking you to think about the rules, customs, ways of working, habits, policies, and procedures that get in the way of great care and great team working. “Rules” that restrict more than they enable deserve to be broken” Helen Bevan