The management of poor performance in nursing and midwifery: a case for concern.

摘要

AIM(S): To examine the evidence of how poorly performing nurses and midwives are managed in the UK National Health Service (NHS). BACKGROUND: Nurses and midwives form the largest clinical group in the NHS. There is little evidence, however, about poor performance and its management in nursing and midwifery literature. METHOD(S): The present study comprised a literature search, analysis of recent Nursing and Midwifery Council (NMC) data and observation at NMC fitness to practice hearings. RESULT: Nurses and midwives are the clinical groups most likely to be suspended in the NHS; Trusts do not report data on suspensions therefore no data exist on numbers, reasons for suspensions, managerial processes, gender, area of work, or ethnicity of those suspended; the few major research projects identify variable management practices, the significant financial cost to the NHS and the personal cost to those suspended; there is evidence that inexperienced, poorly trained, or poorly supported managers use suspension inappropriately. Our observation supported this. CONCLUSION(S): There is a need for robust data gathering and research in the field of NHS managerial practice. IMPLICATIONS FOR NURSING MANAGEMENT: Managers should refrain from adopting punitive forms of performance management. Frontline staff and management need better training and support for dealing with poor performance.