A Serious Post

[lemonbella]

I very rarely post about serious things and even more rarely about the work I do, but this is important.



Some of you may have seen the news in the last week that the Nursing and Midwifery Council struck off a nurse who recorded, for Panorama, the abuse of elderly patients on a hospital ward.

I work in Adult Protection. The horrific suffering she highlighted goes on across the country on a daily basis. It is significantly more widespread than many of you will realise or that many of us want to acknowledge. That it happens in hospitals is perhaps a worse crime, if these things can be graded.

Without people like this nurse being willing to speak out we will never be able to tackle abuse sufficiently. Whistleblowing should be applauded, not penalised.

The Royal College of Nursing is sponsoring a petition in support of this nurse. Please sign it. And if you need any more pursuading or information let me know...

Petition

Comments

[make-a-move.livejournal.com]

I've signed it. My Grandmother is in care, so I support the nurse wholeheartedly.

[lemonbella.livejournal.com]

Thank you

[beautifulworld.livejournal.com]

Signed. I was so angry when I heard about her being struck off given what she highlighted.

[lemonbella.livejournal.com]

Thank you

[heatherbelles.livejournal.com]

This is going to have to be an area where we agree to disagree, my friend! I can't sign it in good faith.

I agree that the conditions are appalling, and whistleblowing should be applauded - however, doing if for a TV programme, and not taken directly to the RCN, was wrong. Consent from those elderly patients was not obtained until after filming was done, which is also not proper consent (Consent info given by my nursing parents).

I think that people should be aware of it, and made more so, but the way she went about it was against the Nursing ethics she agreed to when she registered. I sympathise with her aims, but not her methods - from what I can gather she focused on 'filming evidence' to the detriment of her nursing.

I do hope however, that it will highlight how important it is for people to whistleblow if situations/care are unacceptable, but for goodness sake don't do it by breaching other ethics!

[lemonbella.livejournal.com]

apologies, this is probably going to end up in your inbox several times as I had to remove random commas!

[heatherbelles.livejournal.com]

I did wonder for a moment. I was starting to cower...

ETA on a complete tangent - I have been wrestling with Excel all day, but I do see what you mean about it being quite fun when you get it to behave the way the way you want it (even if Dad kept adding more requests...)

[lemonbella.livejournal.com]

Excel or Access? Access is my baby, Excel makes me want to kill people.

[heatherbelles.livejournal.com]

Excel. Although you will be proud to know that I have completed my ECDL the beginning of this month, so am able to wrestle Access as well. (I did find it confusing occasional, but mostly I can make it behave).

Excel was making me gnash my teeth a few times, but at the moment, dad is now being able to try out rotas for his team and see how it affects things (hours worked as compared to contracted hours, how many on late/early/weekend/how many, so they can try and cover longer hours (no more funding for staff however, which is typical!).

I am considering listing it on my cv as an achievement! (and will be keeping a copy on my computer for future reference/tweaking for other places

[lemonbella.livejournal.com]

definitely an acheivement!

[lemonbella.livejournal.com]

Do not cower! Unless from my over-zealous use of punctuation.

[heatherbelles.livejournal.com]

I never would cower from that - I stand in awe. You know grammar and I have never been the best of friends! (was that even grammatically correct?)

I keep trying to get online to chat (we've not chatted for ages!) but MSN is not letting me in. *woe*

[lemonbella.livejournal.com]

It's not letting me in either - so now I am giving up and going to bed..... We had an LJ argument, it's almost as good as MSN

[heatherbelles.livejournal.com]

True!

Am waiting to see if my brother is coming home tonight - he's not rung to let us know either way, am a tad annoyed. And then I'm going beddy-byes - I've earnt it - dusted and polished his old flat ready for a viewing, ventured into Sainburys for various things (but not the one thing I really wanted, typical), came home, did housework, and the aforementioned excel exercise.

Speak to you soon.

[lemonbella.livejournal.com]

We can agree to disagree, but that's not going to stop me arguing your points. This is the cause I have devoted my life to.

She did raise the issue through several official whistleblowing routes and was shut down by her superiors and the PCT (the responsible body outlined in Whistleblowing procedures and Public Interest Disclosure Act). To say there are "appropriate" channels ignores the reality of whistleblowing, abuse and institutional cultures, particularly within the NHS. It takes extraordinary measures to break through them.

If exposing the abuse suffered was contrary to nursing ethics, we really have to start questioning the basis of those ethics don't you think? And the fact the RCN is supporting her suggests that many don't have the same narrow and procedural view of nursing ethics as you do.

She did not film anything to the detriment of patients. She continued to provide care whilst filming. When she did not it was because she could not, (administration of medication to a patient screaming in agony, for example, because the responsible staff member was not available).

Her registration was not queried by any of the patients or relatives of patients appearing in the film. It was queried by the Trust she exposed; that says a great deal. Consent was gained retroactively, which is an acceptable (and necessary) form of consent in many fields.

Quite frankly to start arguing the issue of consent when you've seen footage of an elderly women lying covered in her own faeces shows a little blindness as to the reality of abuse. She didn't consent to that either, which is the lesser?

The decision by the NMC illustrates that they consider the "integrity of the profession" to be more important than the care of vulnerable patients. Nursing has no integrity unless the care of the vulnerable is at the core.

If you want more details of the case, Action on Elder Abuse have all the details of exactly what did and didn't happen. Don't be blinded by spin from the NMC

[heatherbelles.livejournal.com]

Consent was gained retroactively, which is an acceptable form of consent in many fields. But is not considered acceptable in Nursing/Medicine, which was the issue -

There are nurses and staff raising these issues - this is what incident forms etc are used to raise concerns and highlight unacceptable actions (Lord knows I've heard my parents mention filling them in often enough!).

But, she didn't approach her union either - if she was getting no success in raising these concerns with her superiors or the PCT, then that was the next step, so why straight to the journalists?

Don't be blinded by spin from the NMC I'm not - I am being guided by information regarding consent (amongst others) by the two trained nurses that I live with> Neither of whom agree with her actions, whilst deploring the situation with which she was faced.

"integrity of the profession" to be more important than the care of vulnerable patients. Nursing has no integrity unless the care of the vulnerable that is at the core. I agree, and I see the frustration cause by not being able to provide the standard of care they would like because of lack of staff, but, breaking the code of conduct that is in place to protect the patients, isn't the way to go about it.

Please don't think that I'm defending the (lack of) care provided, or abuse of the vulnerable, I'm really not!

ETA: I will go and have a look at the information anyway!

[lemonbella.livejournal.com]

Consent in this issue is not as clear cut as you are making out. Consent to medical procedures is about informed pre-consent. This is not a consent to a medical procedure. In research, in psychiatry, in many situations when working with vulnerable people (particular those who may be unable to give informed consent due to a lack of mental capacity - as all of the patients in this situation would be considered under the Mental Capacity Act) retroactive consent is perfectly appropriate.

Moreover, I repeat my point that to argue the issue of consent in this situation is a little disingenous to say the least. When faced between the choice of consent to being neglected and ill-treated and the consent to being filmed, which do you think should take precedence?

The fact that "there are nurses and staff raising these issues" tells you something. Think about it. These things are being raised on a daily basis and very little changes. She did also report to her union, but the union can do little more than follow the same whistleblowing routes an individual does, if with a little more verve. In addition, to think that it is right to go through a fourth, fifth, six level of reporting when nothing has been done at the other levels, illustrates exactly the problem with existing procedures. Keep focussed on the reality here: Whilst you ring your union rep and fill out another form and go to another meeting an elderly lady is lying in her bed screaming in agony and her skin rots away beneath her from a pressure sore.

Ask yourself where the "incident reports" go. Following correct and the best (that we have so far) safeguarding adults procedures means that all incidents of abuse should be processed through local authority safeguarding adults policies as defined in No Secrets (2000). Very few PCTs use this process because they consider themselves able to "police themselves" - this is one of the reasons the standard in care provided by many hospital wards is so poor - to a standard that would have a care home shut down. Because No Secrets is government guidance rather than legislation, there are no punitive powers to force PCTs to engage in the safeguarding processed.

This is the context in which all of this takes place. To think that an "incident form" is an appropriate response to seeing an issue like this shows an ignorance of reality and more importantly a devaluation of the reality of abuse.

Let's be clear on something here. This isn't just about "lack of staff". I hear that excuse an awful lot. It is about an institutional culture in place which allows this sort of treatment to occur. Abuse happens because we let it happen. That culture also shuts down and isolates staff. It takes extraordinary individuals and measures to stand out against abuse, and the idea that unions, forms and incident reporting can solve those problems flies in the face of reality.

I don't think you're a terrible person: everyone is entitled to opinions. It's just that I'm hearing from you the same excuses and discussions I hear every day, and abuse still happens. I think it's time we stopped saying how bad it is and filling out forms about how bad it is and started actually doing something. Sending a message to institutions (the NHS being the biggest institution of them all) that whistleblowing is central to good care, and that if you do not respond in a timely fashion then an employee will be considered justified in going to the media (incidently a form of media known for balanced reporting, supporting by the nation's leading charity against abuse of older people) will go a long, long way to achieving that. Currently, the NMC has just put safeguarding work back 10 years.