Solicitors

NHS organisations appoint solicitors to act and advise on their behalf in respect of legal issues. If you require legal advice regarding a problem that has arisen or may arise at work, most organisations have a procedure in place through which you can access these solicitors. This procedure is there to ensure that they are not being asked the same questions from different areas within the organisation. The solicitors can usually be accessed through the person who deals with litigation and claims, known as the litigation and claims manager, legal services manager or clinical governance manager.

It is advisable to locate the appropriate person within your organisation and to keep a copy of their contact details available at all times both for you and your staff. Your director of nursing should be your first port of call for any professional issues. They have more experience and may be able to advise without calling on the solicitors.

If you have an emergency out of hours, contact the duty manager who will have access. Some solicitors provide a 24-hour helpline for advice on clinical issues, but this number would usually be restricted for the use of a ‘named’ senior manager or on-call managers. Some organisations hold contracts with solicitors that include free training for staff, which is well worth accessing, but often you will have to ask first. This service is not usually widely advertised.

Trade union representatives

Every NHS organisation has a number of trade union representatives as well as a lead steward whose role is to protect members’ rights and ensure they are treated fairly. They are specifically trained for the role. They will provide help and guidance with issues concerning employment rights, discrimination, health and safety legislation and concerns about poor practices. You can also get advice regarding legal or potential legal issues directly from your local regional office.

Both the Royal College of Nursing (RCN) and UNISON provide members with online advice services where you can get information on legal issues (RCN 2011, UNISON 2011).

The director of nursing

One of the key responsibilities of your nursing director is to provide professional leadership to all nurses and midwives within the organisation. They will provide advice personally or direct you to the appropriate place to find the information you require. If you have a non-clinical line manager and need advice on a professional matter, there is no reason why you cannot contact your director or deputy director of nursing directly. Use the phone if it is an emergency; otherwise use e-mail. Directors of nursing may be the most senior nurses within your organisation but they recognise that ward managers are a vital asset and will ensure you can access the appropriate professional advice and support.

Most nurse directors have at least one deputy director plus a small team of senior health care professionals to assist them in their corporate-wide role. The nursing director, together with their team, provides a support system for nurses, midwives and allied health professionals to help maintain high standards of care across the organisation.

The nursing and midwifery council

The main aim of the NMC is to ensure that registered nurses and midwives provide high standards of care, and to protect the public. This is achieved by:

The advice service is free and confidential. It is provided by a team of professionals qualified in various specialties such as mental health nursing, paediatric nursing, adult nursing and learning disabilities. You can e-mail or call one of the professional officers with your query or access information from their Web site: http://www.nmc-uk.org.

In addition, you can access all current NMC publications such as Raising and Escalating Concerns: Guidance for Nurses and Midwives or Guidance for Continuing Professional Development for Nurse and Midwife Prescribers. These can all be downloaded free from their Web site.

University lecturers

Your link lecturer is the obvious choice for advice regarding issues in your specialty, but there is no reason why you cannot access other university lecturers for expert advice. Most would be only too happy to provide information within their specialty. E-mail is usually the best approach to use as lecturers can be difficult to contact by phone due to their Monday to Friday working pattern and tight teaching schedules.

Keep a copy of the annual course prospectus from your local university’s department of nursing studies or health and social care. This will contain all the contact details of the lecturers in each specialty. You will find most lecturers helpful in professional matters and if they do not know the answer, they will usually refer you to someone who does.

Bereavement

Part of the role of the chaplaincy department is to educate staff in dealing with bereavement (Department of Health 2003). They can also provide support to members of your team who suffer a personal bereavement. However, they will not come to you; you have to access these services in times of need. It can be difficult if you do not know them very well. It is better to prepare by building up a good relationship with your chaplaincy team before you get to the stage of requesting their services.

Staff support

It does not matter if you or members of your staff are not religious. Hospital chaplaincy services do not impose their religious beliefs. Their role is to meet both religious and spiritual needs and they are not concerned about whether or not staff members go to church.

It would be wise to include a meeting with a member of the chaplaincy service as part of your induction programme for new members of staff (if your trust-wide induction programme does not already include this).

Staff training and development

Chaplains working in health care receive specialist training, education and experience in working with people in challenging situations. They can contribute to your staff training programme in a number of subjects such as:

Their skills may also be helpful in the facilitation of clinical supervision groups for your staff.

Consider inviting one of the chaplaincy team to some of your ward meetings. Their skills may be particularly useful in debriefing sessions following distressing circumstances such as serious incidents requiring investigation, accidents or mistakes.

Increase staff awareness

Make sure all members of staff are fully aware of how to access the chaplaincy service and that they do not have to be religious in order to do so. Ensure they know they can call on the chaplaincy service for advice on a range of matters including advance directives (living wills), palliative care and even personal support for individual staff, including bereavement or relationship issues. The chaplains are increasingly being used as someone to talk to who will listen and help individuals to reflect in absolute confidence. They also have the advantage in that they are not part of any internal hierarchy.

Obviously it will be far easier to call on their advice if you have built up a good working relationship with them in the first place. This is what networking is all about. It is a major part of your role as a manager. It is best not to leave it until your chaplaincy service contacts you or when you feel in need of their help and assistance.