Skills for evidence-based nursing

In the last few weeks, following the publication of the Francis report there has been a lot of discussion in the UK nursing press about why the nurses at Mid-Staffs did not whistle blow about the poor practice that was taking place in the hospital. We will probably never understand this completely but I think there are several things it is worth reflecting on. Firstly, even when nurses did report poor practice nothing seemed to happen. Managers did not seem to act on what was being reported to them. I do not think Mid-Staffs is unique in this regard. I have heard many friends and colleagues talk about how they have reported quite serious concerns to their managers and nothing has happened. The whole NHS needs to reflect on this. Secondly, whistle blowers have historically been treated badly and often lost their jobs which makes people think twice about doing so, even if they know they really should. This is another area where cultural change is needed.