Nursing in the European Working Time Directive

by Gerry Bolger MHM, RN, former project director for HaN and Council member with the Royal College of Nursing (RCN)

The NHS will be on the final stretch to meeting the EWTD requirements for junior doctors in training.

It will be a historic moment because for the first time all NHS personnel will be treated equally under the legislation, as all employees will be expected to have the same maximum working hours, rest and safety assessments as directed in the legislation. It is something to be welcomed, as why shouldn't a junior doctor have the same expectations about hours of work and rest as not only nurses and allied health professionals (AHP) administrators but also as air traffic controllers? In effect this is health and safety.

To ensure that the NHS meets this requirement, a shared responsibility for those who are already covered by the EWTD regulations such as nurses, midwives and AHPs must be taken.

The NHS will quite rightly spread activity across its workforce to focus on high quality care with a positive experience from the patients' point of view. Who better to lead from the front than nurses (including midwives). They provide round-the-clock care, recognise subtle signs of both improvement and deterioration in their patients and clients, rapidly assess, escalate, and in many cases, where permitted by training or protocol, prescribe and administer medicines or commence advanced procedures, while senior support from medical staff is summoned.

Nursing is upping its game, not just to support EWTD but to improve quality and work smarter, through the 'Productive Ward' approach which systematically changes how care is given, and reorganises processes in a way which makes working easier not just for nurses but also for doctors.

However, trust and nurse managers need to realise that to ensure EWTD compliance happens for junior doctors the legislation still applies to nurses who have been covered by the regulations for the last 10 years.

With this I mean there is now a trade off. Nurses want good outcomes and are very adaptive to change. They have adapted their role to become HaN coordinators, both leading care and teams at night as well as adapting this role during the day in many NHS trusts.

The trade-off I refer to is equality. It will no longer be acceptable to have nurses and other health care professionals treated differently around working hours but more importantly around rest hours which form the fundamental principle of the EWTD regulations and are what contribute to accidents, errors and omissions in care.

So the NHS has less than five months to get its house in order, not just to meet the rights of doctors but to ensure those rights are equally applied to others.

To do less could be construed as discrimination.