Well a few inches, and the whole place comes to a complete standstill. It is difficult to understand how, even when snow is fully and accurately predicted by the weather forecasters that traffic should come to a standstill, schools close and people’s interviews get postponed to another day. I wouldn’t mind, but on the day that people just turn over in bed rather than struggle to work, I have already taken a day’s annual leave to help me remain calm and prepare for interview. Now though I have a whole day to myself, not that there isn’t plenty to keep me occupied, what with a lecture to 250 students to prepare for and college work to do.

My topic for monday’s session at the local university is Leadership in the NHS. The event is a 3 day student conference, and I have 25 minutes to cover this massive topic. I think I am going to be looking at the kind of leadership behaviours seen in the NHS, how a newly qualified professional (these are nurses, therapists and paramedics) can demonstrate leadership and the barriers he or she might face. This topic makes me think of the difficulties many of us face early in our careers, trying to be heard, trying to do what seems to be right, while facing opposition from those who consider themselves older, wiser and perhaps better than us.

In the 1980’s it certainly wasn’t the done thing to challenge our more senior colleagues. The word of the ward sister was gospel, and doctors were there to be bowed and scraped to. Generally we were expected to do as we were told, this included making sure the pillow cases faced away from the door and the bed wheels were straight. If a doctor said we should put egg white and oxygen or eusol onto a wound, then we did it. Even if we had known the evidence base for these treatments was beginning to suggest neither were particularly useful and might even have been detrimental to our patients, we would never have had the nerve to challenge the word of either sister or the doctor.

Somewhere though things changed, more research applicable not only to medical practice, but also that of nurses was carried out and increasingly nurses have been able to challenge their own practice and that of others. It is ok to ask why we do things the way we do them, even if it is uncomfortable to do so. We are accountable for our actions and ignorance is no defence to challenge we must. We must acknowledge and embrace change, we must try and imagine (or vision) how we can change and mostly we must think about the needs of patients before the needs of ourselves. Of course, not everyone wants us to think like this, and at times we find ourselves doing things because that is the way we do them, and sometimes changes seem to being introduced for their own sake or merely to save money.

We must however stand up and be counted, if we are willing to challenge practice we must know why we are doing it and we must be accountable. As nurses and other health professionals we must actually be able to see that what we are doing is for the benefit of patients and not because the government says they think it is the best and cheapest option.