On 11 March 2020, Scottish Care issued an urgent letter to all care home members with advice regarding care home closures due to Coronavirus (COVID-19). Please see below for letter:
Covid-19 Advice 11_03
In this the International year of the Nurse/Midwife we can look back in history and see examples of nurses who have been inspirational in encouraging people to make nursing their career.
There are some women and men who have been instrumental in making nursing and midwifery what it is today.
Some historians would argue that as far back as 250AD, men were in fact predominantly the ones who provided nursing care to the sick and the poor, with the first nursing school thought to be all male in India.
St Agatha of Sicily is the most well known patron saint of nurses, with three other patron saints, St Catherine, St Elizabeth with St Camillus de Lellis being a male. In fact, he is one of the first male nurses of the profession. He decided to become a priest only to resign in 1607 to continue to care for people affected with alcoholism. All these saints were known to inspire nurses.
Despite this, many view Florence Nightingale as the founder of modern nursing. However she was thought to hold the view that nursing was more natural to a woman and this was detrimental to the acceptance of males into the profession. More recently there was Clara Barton who was the founder of the American Red Cross and was an inspiration for going into the battlefields to help those needing first aid. Males were also present on the frontlines but were thought to have had less training.
Elizabeth Grace Neill was responsible amongst other things for creating the nurse register that ensured nursing was seen as a profession. In 1919 males also were recognised by a register.
The Nursing Theory was developed by Avenel Henderson, who was considered as the most famous nurse of the 20th Century , with all her contributions and influence to American and international nursing education, practice, research as well as its implications.
There was also Mary Eliza Mahoney who was the first registered black nurse, who continued to work throughout her career to fight discrimination and co-founded the National Asssociation of Colored Graduate Nurses in 1908 .The NACGN became Mahoney’s instrument in improving the status of black nurses in the profession nationwide.
In relation to recognising mental health issues, Dorothea Dix was the first advocate nurse who fought to improve care for people with mental health issues, with Margaret Sangar who was instrumental in ensuring the rights of women and worked for over 40 years to ensure birth control was available to women from the 1950s.
Edward Lyon in 1955 became the very first male nurse to be commissioned in the Army Nurse Corps in the US as a reserve officer.
These are only a selection of international nurses who worked tirelessly to ensure the rights of all people, alongside challenging legislation to establish nursing and midwifery as it is today, which is now devoid of discrimination . Nurses can now work and lead in all fields which offer positive career pathways, regardless of background, race, ethnicity or gender.
Nowadays we often see the young student nurse who has spent their whole childhood dreaming of being a nurse, but for many their decision comes out of a personal or family situation that changed them in such a way that they were inspired to want to be an nurse themselves.
The more I explore this subject, the one thing that can’t be disputed is that those who choose nursing as a profession want to make a difference, to give back, they are determined and genuinely care for people, often going above and beyond.
For me personally, my childhood dream was to be a police officer, not a nurse, because I felt that by joining the police it was the one job I could help people, keep them safe and which would challenge me and make me a stronger person.
I believed this was the job that I would get the most satisfaction from and that would make me a better person in the process.
The year before I applied, my gran suffered a stroke in her late 70s. Post-stroke despite still being mobile, she was no longer able to look after herself and she subsequently came to live with us.
Psychologically she had changed due to the stroke, as did our relationship. My gran was my inspiration and to see her dependent changed my whole mindset and view on what really mattered in life.
I was always close to my gran, but our roles had reversed, having to care for her and hold her hand and comfort her, to help her understand things and still to enjoy life despite its frustrations, as well as being beside her, 3 years later, when she passed away peacefully at home .
Alongside this, I watched my mother with two teenagers take on the role of carer, give up her job and manage all the dynamics of the family.
It made me realise that nursing someone can give so much joy and gave me everything that being a police officer would’ve and more importantly gave me the empathy that ultimately directed me into nursing. Nursing someone you love is different, as its personal, but it gives you the insight to understand what the families of those you nurse are going through. Never underestimate this.
I believe her illness gave me the best gift. I started my training in 1987 and haven’t looked back.
Our patients and residents without question remind us every day why we are nurses, they let us into their lives, tell us their secrets and trust us to provide the care they need, literally for some, putting their lives in our hands.
The nurse-patient/resident relationship differs depending on which area of nursing you choose to work in, but can teach you how to be compassionate, and develop a patient centred approach, which ensures people’s needs and rights are met.
We know these are challenging times and there will be points in your career that you question if you still want to be in nursing, but I ask you to stop and remember why you became a nurse, and maybe consider that you may just need a change of environment, not a change of job.
As the workforce lead for Nursing at Scottish Care I would promote working with older people in care home nursing, as it offers a homely environment to build relationships with residents and families and provides the potential for an exceptional career pathway for you as a nurse. We do need an increase of younger people, men and people over the age of 40 years, as well as more people from Black, Asian and ethnic minority backgrounds to continue to join the profession, to ensure future workforce stability.
As nurses we hope we inspire others to do their best, nothing more or less and others to continue to inspire us in the same way.
Jacqui Neil
Transforming Workforce Lead for Nursing, Scottish Care
@TransformNurse
Gillian McAteer – experienced solicitor and the Head of Employment Law of Preferred Supplier, Citation – will be hosting a webinar discussing The Good Work Plan, dubbed as ‘the biggest overhaul of employment law in 20 years’. This webinar will take place on Friday 20th March at 11:00am. It will specifically discuss how the programme of reforms will affect care providers in Scotland.
As the news agenda of 2019 was been dominated by Brexit and the general election, these legislative changes have somewhat gone under the radar – with research carried out by Citation suggesting one-third of employers are still unaware of the Good Work Plan, some are incorrectly calculating holiday pay, and many are not prepared for the changes.
Notable changes that Gill will discuss include:
Link to join: https://zoom.us/j/694995065
Webinar ID: 694-995-065
Ahead of the webinar, Scottish Care members are free-to-access Citation’s most popular relevant resources:
Citation’s complete archive of free guides and resources can be accessed here.
On 5 March 2020, our CEO, Dr Donald Macaskill gave evidence to the Public Audit and Post-legislative Scrutiny Committee on leadership and workforce challenges in the NHS. Please click here to watch the session and see below for Dr Macaskill’s comments during this evidence session.
Donald PAPLSC
“ I don’t know what people are worrying about. It’s just going to kill the old folks.”
That’s one of the many remarks I have overheard on public transport this week since conversations started to focus in on COVID-19. When you couple these comments with public officials stating in the media that the majority of deaths from the virus have been “just amongst the elderly” you are left with the distinct impression that this is not a pandemic the majority of us need to get too worried about.
But the place where such attitudes have almost become endemic is social media. There are literally hundreds of tweets suggesting that those of a youthful age and who are not immuno-suppressed need not worry – all will be well – just clean your hands! Some of the content on Twitter really doesn’t hold back:
‘Corona virus is killing pretty much just old people. It sounds like Earth is getting revenge for them destroying literally the entire planet and not caring about it.’
‘What I find so funny about this is the corona virus is deadly to old people which are the establishment and conservatives biggest base. If god uses diseases to punish I wonder what message hes saying with this one.’
Not since the AIDS epidemic was painted as the judgment of a righteous God has there been such a negative discriminatory association between a virus and a specific group.
Of course, the reality is that any virus never discriminates by the age of its victim but rather anybody regardless of their date of birth and most especially those with a supressed or limited immune system are disproportionately affected.
I find it immensely despairing that there is both within the wider public and in the media a creeping ageism in the reporting of and discussions around COVID-19. It is almost as if because someone is older in years that their dying is of less impact or importance; that their loss to the community, to family and friends is somehow less painful and distressing to those left behind.
At one level you could say that what we are seeing here is simply classic age discrimination playing out on Covid-19 as it does in so many walks of life from employment to the allocation of public funding. But I suspect at another level what is happening is something much more significant and profound.
What does this say about us as communities and as a nation in Scotland? Is the virus beginning to strip away the polite veneer that hides attitudes and beliefs that are simply ageist and hostile against the old? Are we finally unmasking a popular consensus that considers that to be old means that your worth is over, your contribution complete and your value limited?
The way in which we respond to any challenge marks us out both as individuals and as a community. Are we going to be one which in cold-centred self-interest and protection considers the value of an old person to be less than someone much younger? Are we going to become blasé to the fact that perhaps thousands of our older citizens will be affected by and many will die as a result of this disease?
Over the next few days and weeks thousands of women and men who work in health and social care services will be putting other people, their care and support, before their own needs. We will undoubtedly as we often have in the past witness a selfless dedication and professionalism that doesn’t just go the extra mile but an extra marathon in terms of commitment, compassion and love.
The days ahead will help to shape us as a society. Will we be a Scotland which cares for others, gives value and grants respect regardless of chronology or age? Or will we care less, commit less, consider less because someone is in their eighties or nineties?
Coronavirus will be a test not just of the infrastructures of health and care, of business and commerce, it will be a test which will determine the nature of our nation. Will we be a Scotland that cares for the old or will our compassion be limited by discrimination?
Dr Donald Macaskill
This piece first appeared in The National newspaper on Sunday 8th March 2020.
Yesterday I dropped my children off at school on ‘World Book Day’. Amidst a sea of Harry Potter characters and superheroes I spotted someone else. There over by the door was Frida Kahlo, this girl of about 9 years old had brought the book ‘Good Night Stories for Rebel Girls’, 100 tales of extraordinary women. I purchased our own copy that morning.
Yet in doing so, I felt discontent. Of course I want my son and daughter to hear about the impact that women throughout history have made, but I could not overlook that twinge of disappointment and perhaps also a bit of rage that in 2020 we are still having to create our own platform to do so. Given the recent decisions and discussion around immigration, with a UK Government irresponsibly and incorrectly describing social care as low skilled, this is a theme sorely and dangerously evident in social care. Intersectionality makes this worse.
The reality is that social care staff are highly skilled, professionally registered and regulated. They spend their working hours (and often more given that a significant proportion have personal caring responsibilities) supporting our loved ones, some of whom may require palliative or end of life care, have multiple co-morbidities, advanced neurological conditions or dementia and so on.
SSSC data shows that 86% of our care home workforce and 81% of our homecare workforce is female. Anecdotally from previous Scottish Care focus groups, we believe that many of those who do work in social care often take on ‘male-dominated roles’ such as handyman or chef. That there is such a gender divide should not really be surprising, it mirrors other sectors – 83% of primary school teachers are female.
We have a his-and-her-story of working with peers of our own gender; one of the contributing factors to the gender pay gap. A recent report by the Kings Fund[1] states ‘Jobs done by women are undervalued’ both in terms of the value society places on the jobs and the wage people are paid. Jobs with a higher percentage of women tend to be lower paid, and if, over time, the proportion of women increases average pay goes down further.’. Sadly I can evidence this from my own experience. I first worked as a paid carer in 2000 earning around £8.75 per hour. In 2020, social care is purchased by local authorities (usually) on the premise that social care workers are paid the Scottish Living Wage of £9.30. That makes a rise of 55p over 20 years.
One of the suggestions to counter this imbalance is to encourage more men to work in the sector as if balancing the gender of the workforce, would increase the value of the job. Of course having a more diverse workforce is welcome and a positive proposition, and from an academic perspective, this move makes perfect hypothetical sense, but a cultural shift takes time, and in many ways dilutes the issue to hand. The other solution is simply to recognise and value the workforce for the registered and highly skilled people they are.
Another example, to use the term coined by Carolina Criado-Perez in the same-titled book, of ‘Invisible Women’ is that social care contributes £3.4 billion to the Scottish Economy, which is more than agriculture, forestry and fishing. It seems no coincidence that the latter is a sector traditionally dominated by men.
Yet there are positive changes and opportunities. Whilst women are less likely to be company owners or shareholders, this trend is bucked in social care. Where other Boards are implementing 50:50 rules for the make-up of their Board, the Scottish Care Executive required no design to meet that criteria, it happened naturally as a result of the significant number of women in those roles.
At middle manager level, it is still the majority of staff who are women. Bringing their frontline leadership skills with them – social care staff are very often lone workers adept at making decisions in what can sometimes be challenging situations, they are well-prepared and qualified for the responsibility. As evidenced in the Scottish Care report ‘The Experience of the Experienced’ others have entered the sector bringing skills from elsewhere. We must also recognise that many have taken a reduction in pay or conditions to pursue this career where they can make a difference every day. But why should they have to?
We have also recently seen Project Lift, a leadership programme which started in the NHS open its doors to social care staff, growing our leaders of the future and potentially opening doors across health and social care. In addition, the current campaign to encourage more people to work in the sector and the Adult social care reform programme both have potential to promote the value of social care.
And so in raising the profile, we raise the value. Today is International Women’s Day. The theme for 2020 is #EachforEqual a statement of ‘Collective Individualism’ pointing out that it is as individuals we challenge, but only together that we can achieve change. This is not simply a call to women, or even to create the conditions for a counter-movement calling for an International Men’s Day. In collective individualism we work together and for mutual benefit. In this industry we might use the words collaboration and co-production.
Equality brings health and wealth to whole communities. So I ask you to channel your inner Frida Kahlo or whom-ever your inspiration might be. Perhaps they are a care worker.
Share this message wide and if you feel as I do, turn your disappointment (and rage) into action. #EachforEqual is for all of us, but to achieve it we must recognise and raise the true value of social care incorporating the value of our care workers, managers and owners of all genders who devote their time with skill and compassion, and who inspire us every single day. #careaboutcare #independentcare
Karen Hedge, National Director, Scottish Care
[1] https://www.kingsfund.org.uk/blog/2018/06/gender-pay-gap-what-now
You may be aware that May 12th is National Nurses Day, marking the birthday of Florence Nightingale, the founder of modern nursing.
As 2020 is also the #YearoftheNurseandMidwife, Scottish Care will be celebrating this occasion by encouraging care homes to hold a coffee morning on 12 May to show their appreciation of nurses and to tweet using the hashtag #carenursescot.
In the afternoon, our Transforming Workforce Lead for Nursing – Jacqui Neil, will host a celebratory event/conference in the Marriott Hotel, Glasgow from 1:00pm – 4:00pm with a range of different nursing speakers. This event is free to attend and we would like to invite nurses working in the social care sector to come along. Programme and more details to follow.
Today (2 March) Scottish Care and UKHCA has issued on open letter to every Health and Social Care Partnership, Local Authority/Lead Agency calling for them to take into consideration of the independent care sector when setting their budget. This letter also highlights the concerns surrounding funding for the homecare sector.
You can read the open letter here.
For further information or to request an interview please email [email protected]
Workforce Matters would like to invite you to attend our upcoming April event focusing on the challenges facing managers and supervisors working in social care. This event will take place on Wednesday 22 April from 9:30 am to 3:30 pm at The Marriott Hotel, 500 Argyle Street, Glasgow, G3 9RR.
This event will take forward the conversation that has begun with the recent focus groups and will use the feedback provided to create a discussion paper on the various themes that have been raised. The event will have sessions delivered by both the Care Inspectorate and SSSC on the specific initiatives they currently have to provide support to those working in manager and supervisors’ roles.
There will also be opportunity to prioritise the areas that have been determined to be causing the most problems when delivering social care services both in care homes and the community. Due to the vast and complex nature of the challenges facing the sector we see this as an opportunity to highlight these issues as advised by Scottish Care members and for care providers and the workforce to decide what pressure areas require to be addressed first.
Please contact [email protected] to register your interest and book a place at the event.
A career in care is one where every day you can make a difference. Yet everyone who has any contact or connection with social care knows that we have a workforce shortage. In short, we’re talking about 29% nursing vacancies and a steady turnover for frontline care staff with a 24% attrition rate. If you fancy a deeper dive into the intelligence, both the SSSC and Scottish Care have written plenty on the subject and it’s available on their websites.
It is a critical time to raise the profile of the sector, recognising it for the vital role it plays in supporting the human rights of our some of our most vulnerable citizens and recognising its workforce for the skilled role they play in that as registered and regulated staff. Social Care enables people to stay healthier for longer, able to contribute to their communities and easing pressure on the NHS. I heard only yesterday about an 87 year old lady from a care home in Dumfries and Galloway going to local primary schools to teach German and French.
There is currently a national recruitment campaign for the sector, devised by Scottish Government and with contribution from many across the sector. It includes a campaign website and clear examples of career progression expressed by the SSSC, PR in the form of advertising and the promotion of case studies. A real opportunity to promote the many positives so often overlooked.
But this positive promotion has just had a coach and horses driven right through it by the Migration Advisory Committee and UK Government. Their complete and utter ignorance and underestimation of the critical role of the sector despite repeated warnings has led to the creation of a migration system which will see the care sector lose significant numbers of staff from the EU and beyond.
This is an action which has ripped apart families and caring relationships undermining the concept of continuity of care and the critical role which the sector plays. Whilst between 6 and 9% of our care staff come from the EU, this rises to as much as 40% in some parts of Scotland. Places where families have settled into local communities, where several members of that family might work in one care home taking on a variety of roles from nurse to carer, to handyperson and gardener.
Last month, the Scottish Government launched a report seeking for the option to introduce local solutions to address local challenges, this proposal was drawn from local evidence and systems which already exist in Australia and Canada, and could be implemented in any country or region of the UK.
Yet, by lunchtime the paper had been rejected by Westminster.
What is clear is that decisions around immigration need to be based upon facts and evidence, removed from any political rhetoric, whilst focussing on prosperity and wellbeing. There needs to be a move towards a more flexible policy which recognises social care as the skilled and vital service it is. It needs to accommodate the reality of regional difference such as the demographics of rural and remote areas, adjusting income thresholds to recognise a lower rate of pay outside of London, and also to allow for families to immigrate which means recognition of the contribution made by part time staff too. The system must not rely on funding from employers – the care sector is mostly funded by the public purse and this effectively produces bureaucratic duplicity.
There is also a need to consider the context for staff who may bring their qualifications with them come from abroad for instance, in supporting projects such as the one at Glasgow Caledonian University on migrant skills recognition to enable people to work in the care sector more easily, whilst also offering protection both to the workforce and those they care for.
The situation for social care is critical. Simple and effective solutions exist but cannot be implemented because of political jurisdiction made by those who are far from the frontline. To add another 9% to the social care vacancy rate risks blocking the whole system, an issue fundamentally of human rights given the catastrophic risk to people and their families.
Whilst our NHS colleagues have raised significant concern about what a reduction in social care would mean for acute services including NHS 24, the ambulance services and hospitals, I urge you also to share this message. For social care, for the people who access care and support, and the workforce affected by the proposals, we need to act now – time is running out.
Karen Hedge
National Director, Scottish Care
Read Scottish Care’s response to the UK Government’s immigration plans here.
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