Letter

Relationships are the key

Dear healthmatters — Charge nurse Barry Clifton hit the nail on the head in his article about managerialism in the NHS (issue 4, June 1990). As he argues so clearly, human relationships are the keystone of good health care. Yet the performance of managers is currently judged not by how well they facilitate such relationships, but by their ability to contain costs and ‘maximise throughput’. The resulting climate makes it difficult for nurses to value other people, or even themselves, as individuals.

This is a gloomy picture. However, there are many bright spots where nurses are succeeding, despite the system, in creating warm and happy environments where they work in partnership with patients. Barry mentions nursing development units (NDUs) as places where this kind of supportive, participative care is the goal. Tragically, the Oxford unit was closed last year — mainly because of opposition from a few powerful doctors — but other NDUs are growing and flourishing, even in today’s adverse conditions.

A good antidote to feeling downcast about what is happening is to seek support from others with similar values and ideals — and there are many nurses who share Barry’s views. My programme at the King’s Fund supports a network of around 50 actual or potential NDUs, in hospitals and community, and in specialities ranging from intensive care to mental health. Any nurse interested in finding out more is invited to contact me.