We already pretty much know what to do

We already know what to do but are prevented from doing it by… lack of time or by ‘Them’ – funders, politicians, government, cutbacks, the hospital, the network, managers. Carers, the influx of agency nurses, the pharmaceutical companies, the threat of litigation… etc.

We don’t really need to be told how to do our jobs

Managers and the department tell us what to do quite enough as it is – we don’t need patients doing it too

Reforms are already in place, we have already worked out what to do and are getting it underway

If we are meant to be professionals then we already know what to do

We already observe, monitor and pretty well guess pretty accurately what consumers think and need

Things seem to work well enough without it

We did all that in the 70s

Nothing really matters except for waiting for the drugs to work

To be honest, things work more efficiently without it

There’s no time for talking here, they’ll get that in the community

Consumer participation is just another management fad imposed on us

We’re not actually hearing about any problems, our patients don’t seem to complain

We did ask but no one had much of a problem

There can’t be any real problems, they’d tell us if there were

They tell us their problems all the time, we don’t need to hear more

I’m sure we would hear if there was something really big like a rape or an assault

Patients are too ill/too confused/too paranoid to give accurate/valuable feedback

1

We just haven’t got the time

2

This is not a very good time at present – perhaps in another year or two

3

We haven’t got anywhere near enough staff

4

There are a lot of competing demands

5

All we’ve got time for is processing people in and out

6

Eight our shifts don’t give you enough time to speak to patients as well as everything else – review meetings, admissions, discharges, transfers, reports, arranging for patients to see everyone – doctors, consultants, the social worker, procedures, tests, it just goes on and on…

7

Other things always seem to be more important, urgent, pressing

8

We have to go really slowly with introducing this idea

9

We’ve had a lot of changes and need to let them settle first

10

There doesn’t seem to be any point because there really aren’t any solutions

11

It’ll just be a Catch 22 – and it will raise patients’ expectations

12

I’m not sure we have management support

13

They’re only going to want the impossible anyway

14

We can’t give them what they want

15

I don’t like it either but I can’t challenge it on my own

16

I would like to ask consumers but the other staff would talk about me behind my back/ think I was breaking ranks

17

This is new, staff don’t really understand it yet

18

They might find it a bit threatening

19

It’ll only make staff defensive

20

We can’t force consumers to give their feedback if they don’t want to

21

Staff aren’t ready to hear it

22

We have to maintain a secure environment

23

We haven’t found consumers who are available/ representative enough/ keep attending meetings

1

We are doing the best we can

2

We have to do ‘certain things’ to people

3

There are no other choices that anyone has been able to identify

4

Its what is expected by the job – by managers, by the institution, by my profession, by my job description, society at large

5

We do a good job really

6

We’ve tried everything else

7

This is the way it has to be – and when consumers become more well/ get insight they usually accept it too

8

There have to be rules and procedures

9

Of course they’ll be critical – it’s an acute ward

10

They magnify things because of their illness

11

If we made it any nicer they wouldn’t want to leave

12

Who made that criticism?

13

They’re not here long – we turn them around as fast as we can now

14

I’m just doing my job

15

We have to keep control, you can’t be too soft – especially in a crisis

16

This is an acute ward – there are always crisies

1

Morale is low enough here as it is

2

You think I like all aspects of my job? – get off my back per-leeze

3

You think I think this is good nursing?

4

It would only stir things up

5

I like to focus on the positive

6

It might clash with things we already believe/are committed to/from which we gain respect in team meetings/from which we gain status as professionals/have to say and do to be listened to

7

I already feel bad enough as it is – I don’t want to feel even worse

8

I don’t deserve it, I’ve always stuck my neck out for consumers

9

I have a hard time too

10

I suspect consumers wouldn’t want us if they had the choice

11

Consumers give us a hard time – I’m not allowed to talk about that

12

I get abused but I don’t complain – its part of being a professional, its up to me to hold together/get it right/not wimp

13

Actually I’d prefer thanks rather than criticism

14

We never get much appreciation

15

No one else wants to do this

16

We’ve the ones who have stayed in the public sector – the private send us there ‘too hards’

17

I couldn’t bear to think they never forgot some of the things that get said and done to them

18

I’m getting out of acute as soon as I can

19

You should criticise – ‘Them’ … funders, government, politicians, the hospital, the network, managers, carers, lawyers … etc.

20

Its too hard and too big to change

21

I just need to survive