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This poster on an NHS ward shows why the way we speak to staff has to change

Dr Dev Gakhar

An NHS healthcare professional sent me a notice from an acute medical unit (AMU). It contains demeaning language, reflecting a culture that this ward needs to change. This is just one ward, and some wards share this culture. We need to improve how we speak to our staff.

A laminated notice headed AMU 2 Shift Expectations. It lists 8 rules: no one goes on a first break until all morning tasks are done across the whole unit, not just your own area; it is unacceptable to tell patients or family members you are too busy to help or to send them elsewhere, and bundles are to be done at the bedside at the time care is given; no breaks for staff during patient mealtimes; when fully staffed, remain in the bays rather than gathering to talk and socialise; no inappropriate phone use such as selfies or social media; break time starts when you leave your allocated work area, not once you have collected three other staff members, made a coffee, got your coat and stood at the main desk for 10 minutes talking; keep the area clean and clutter free; stock the trolleys in each bay every night without fail.

What it says

These are some of its statements:

  • "No one is to go on a 1st break until all morning tasks have been completed, across the whole unit not just your own area."
  • "It is unacceptable for anyone at the workstation to tell patients or family members that they are too busy to help or to send them elsewhere after a direct request, I don't expect to hear I need to put my bundles on (this is to be done at patients bed side at the time care is given)!"
  • "No breaks for staff during patient mealtimes."
  • "When we are fully staffed you should remain in the bays at all times, not gathering to talk and socialize."
  • "Your break time starts when you leave your allocated work area not once you have collected three other staff members made yourself a coffee, got your coat and stood at the main desk for 10 minutes talking."

The core concept may have some credibility, but the way it has been portrayed and addressed is, in my opinion, inappropriate. In the 2025 NHS Staff Survey, only 43% of staff were satisfied with how much their organisation values their work. Almost 3 in 10 often think about leaving. It's stuff like this that doesn't help. Last week I launched Ward on the Street, an anonymous review platform where resident doctors (junior doctors) can share what it was like. Maybe it's time to expand this to other healthcare professionals so they can share their experiences in hospital departments, because a culture shift is necessary. If this is something you'd like, let me know here!

Source: NHS Staff Survey: 2025 national results briefing (12 March 2026)

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