FoNS Blog

Celebrating the Role of the Ward Sister* in Contemporary Practice

26 July 2016

Theresa Shaw, FoNS CEO



This week I have the very great pleasure of working with colleagues to lead a IPDC Practice Development School: Fostering Cultures of Effectiveness for Hampshire Hospitals Foundation Trust. The Trusts’ Director of Nursing is leading a pioneering programme of change which includes enabling ward sisters to become more clinically focused and lead practice development and learning. To support this transition, a cohort of 30 ward sisters are participating in this week long residential programme, offering participants the opportunity and space to develop their skills and confidence as facilitative leaders of culture change with a focus on development and learning that enables person-centred, safe and effective workplaces and services. 


Redefining the ward sister role in this way would undoubtedly have the support of the late Dr Sue Pembrey, one of the UK's outstanding nursing leaders of the late twentieth century. Her primary contributions included supporting the academic development of clinical nursing and the development of nursing practice through the strengthening of the ward sister's leadership role and pioneering a commitment to patient/person-centred hospital care. She described the ward sister as:


the key nurse in negotiating the care of the patient because she/he is the only person in the nursing structure who actually and symbolically represents continuity of care to the patient. She/he is the only person who has direct managerial responsibilities for both the patients and nurses. It is the combination of continuity in a patient area together with direct authority in relation to patients and nurses that makes the role unique and so important to nursing.” (In Pembrey, 1980, The Ward Sister, Key to Nursing: A Study of the Organisation of Individualised Nursing. London: RCN).

Moral distress – is it time to start talking?

19 July 2016

Kate Sanders, FoNS Practice Development Facilitator

Last week I joined in an interesting TweetChat about moral distress. Thanks to Ryan Schutt (@ryanschutt) from Canada for initiating the chat, and also to @WeNurses for hosting. There were nearly 60 participants on the night, indicating a good level of interest in this subject.


My interest in joining the chat lies in my PhD study. The initial trigger for my research was a growing concern for the well-being of nurses, which has developed further into an exploration of the impact of nurses not being able to practice in accordance with their values and beliefs – or not able to be authentic. My reading has led me down many avenues; one of the more recent ones has taken me to some literature on ethics and moral distress. It seems feasible to me that if nurses are not able to care for patients in the ways in which they think it is important to, or believe that they should, this could impact on their health and well-being – perhaps due to moral distress.


I was initially intrigued as to why Ryan should be talking about moral distress in the UK, but as I learn more about the concept, I can see that it is a concept that is spoken about much more in Canada and the USA than it is in the UK. One of the first questions during the chat was inevitably – what is moral distress? – and questions were raised about the links between moral distress and burnout, for example. I think perhaps in the UK, we talk about burnout more. I now wonder if this at the detriment of not recognising the moral and ethical dilemmas that face nurses and other healthcare staff on a regular basis and that can potentially cause distress?

Person-Centred Paediatric Care: Capturing the Experience and Collaborating for the Future

12 July 2016

Jo Odell, FoNS Practice Development Facilitator

Are you thinking of applying for the Patients First Programme? Person-Centred Paediatric Care is a project that has been supported by the programme and this great film, entitled Collaboration for the Future : A Patients First Project demonstrates what can be achieved. 


This project describes a multi-disciplinary practice development initiative supporting a clinical team to ‘hear’ the voices of children, young people and their families so that person-centred paediatric care might become a sustainable reality.


For the purposes of this person-centred project ‘experience’ was defined as the individual and personal emotions and feelings of children and parents during their healthcare journey. Methods of gathering patients’ and families’ experiences around their care included workshops, recorded patient stories diaries and a storyboard.

An insight into being a practice development facilitator at FoNS

05 July 2016

Jo Odell, FoNS Practice Development Facilitator

I have had the pleasure of being a practice development facilitator and the lead facilitator for the Patients First Programme since 2011. You may have seen that we recently advertised for a new practice developer facilitator to join our team, so I thought it might be interesting to give you an insight into my role by outlining some of the activities I am involved with, although I have put them in a week for you below, each week I work varies tremendously, depending on the needs of the people I am supporting and on the priorities of the organisation. So here goes:


Day One: Today I commute into our office in central London from home on the south coast. We have a team meeting so today we are all in and it’s good to see each other and catch up on the different programmes of work. We are a small and compact team and we work out in practice, across the UK, often leading on individual pieces of work. Following on from a productive team meeting, I tackle my emails from the project teams I am supporting and discuss future projects with prospective teams over the phone. Later on I work on evaluation evidence and reports for the Patients First Programme.


Workplace learning - a missed opportunity?

28 June 2016

Dr Theresa Shaw, CEO FoNS


I recently had the pleasure of attending the inaugural lecture by Professor Jan Dewing, the first Sue Pembrey Chair in Nursing at Queen Margaret University (QMU), Edinburgh. The title of her lecture ‘Workplace Learning in Nursing: leading at the edge’, could not be more timely and important for contemporary practice. In the midst of the drive to be more efficient whilst enhancing quality, the opportunity that learning through and in practice creates continues to be overlooked. With this in mind, it was great to see some of her messages reach out more widely with a headlining news item in the Nursing Times today:




The article mentions the growing evidence from Practice Development work led by QMU and others including FoNS and so I can’t resist the opportunity to highlight some of the resources we produced last year to help nurses and others think about the opportunities for learning from practice.


There are a variety of opportunities to access training and education within health and social care; however, many of these are pre-planned by others and often focus on the development of knowledge and skills. It is also not unusual for them to take place away from the workplace. Whilst as Jan indicated in her lecture, these opportunities have a place for the development of competencies for example, the nature of these approaches may mean that the learning tends to be more general and not specific to the needs of individual staff and the context within which they are working. This can make it more difficult for staff to translate what they have learnt into their everyday practice and therefore reduce the chance of any impact on or change to practice.


The workplace or practice setting wherever this maybe, makes a great classroom.  Using opportunities arising from everyday practice can make the learning more specific to individuals and teams, and to the context within which they are working – perhaps helping people to connect emotionally with the learning