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'Bad apple nurses need to be named and shamed', says former Mid Staffs nurse

As an A&E nurse at Mid Staffs Helene Donnelly tried to blow the whistle on care failings but was ignored and then bullied. Sarah Calkin asks her how nursing needs to change in the wake of the Francis report

The publication of the Mid Staffordshire Foundation Trust public inquiry report earlier this month was a big moment for nursing with many of its 290 recommendations focused on the profession.

However, it’s fair to say that for one Staffordshire nurse it was more significant than for most. Helene Donnelly spent six years working at the hospital whose failings have become a byword for poor care and which sparked the public inquiry that produced the report. She was the only nurse whistleblower to appear as a witness.

 

A&E concerns were ignored

Ms Donnelly told the inquiry she had repeatedly raised concerns about appalling care standards in Stafford Hospital’s accident and emergency department – only for them to be ignored by management and lead to bullying and intimidation by other nurses.

She told the inquiry she’d seen people die, “needlessly in some cases”, and “certainly with a lack of dignity or respect” on a relatively frequent basis.

More than four years after leaving the trust she says her only regret is that she did not speak out earlier.  

“The reason I didn’t initially was because I was a relatively junior nurse. There was also a feeling of this is just how things are done. People make you feel that if you criticise you’re being negative or not a team player,” she says.

After submitting “tens and tens” of incident forms since joining A&E in 2004, a particularly fraught shift in 2007 prompted Helene to make a formal statement setting out her anxieties about care standards to managers.

The inquiry heard her concerns involved two sisters who ran the department who encouraged falsifying of patient waiting times and created a culture of bullying and fear.

Ms Donnelly also approached her local Royal College of Nursing representative for support after she was threatened by other staff members, but was disappointed by the response she received.  

“At the time you feel almost like it’s a conspiracy, which sounds a bit dramatic, but that’s how it felt. I spoke to the RCN and was told to ‘just leave it, there’s no point in rocking the boat’. You get to the point where you feel that nobody’s going to listen.”

She later found out the RCN rep was also representing the sisters she had complained about. Other nurses came forward to support her claims but did so anonymously and the trust dropped the matter.

After the events at Mid Staffordshire were exposed, the RCN subsequently took a number of steps to improve support for its members when raising concern including setting up a whistleblowing hotline.

RCN director for England Tom Sandford told Nursing Times the college now ensured each side had their own representative in a dispute between colleagues.

 

Need for recognised pathway for raising concerns

Ms Donnelly’s experiences have unsurprisingly left her with strong feelings about whistleblowing.

She says: “There needs to be a recognised pathway for raising concerns that tells you where to go. I would like to see posters in every ward, in every hospital setting that out. Hospitals should be proud to support the awareness of whistleblowing and that in turn would give patients confidence.”

Where nurses see something wrong, it should be “expected and accepted” that they speak out, she told Nursing Times.

“That would raise people’s professional conduct. If you think the colleague you’re working with – even if they’re a friend – is going to speak out if you’re doing something wrong, then it’s going to make you think there is going to be comeback.”

Stafford Hospital’s A&E was so short staffed during much of Helene’s four years there that there was no proper triage system. However, she is clear that while poor staffing levels can be a factor in poor quality care, they should never be an excuse for care that lacks compassion.

“Just ignoring patients and expecting them to know what’s going on isn’t appropriate and it’s unacceptable. Just by explaining to patients what’s happening, and why, can reassure them. A lot of it is down to communication and common courtesy,” she said.

“So many nurses feel so undervalued… But you cannot explain away some of the terrible things that are going on and the unprofessional behaviour: swearing, abusive comments about patients, laughing about patients, talking about what you did on a Saturday night with your mate while you’re dealing with a patient instead of talking to the patient.

“If we as nurses don’t seem to care about the profession and don’t seem to respect ourselves, how can we expect other people to?”

Ms Donnelly now works as a nurse practitioner at a walk-in centre in nearby Stoke-on-Trent where her experience has been a world away from that at Stafford Hospital. She says: “It’s completely different… The trust has been really supportive of me speaking about my experiences at Stafford.”

 

Some still in denial about Mid Staffs

Ms Donnelly told Nursing Times she was encouraged by many of the Francis report’s recommendations for nursing, including calls for the registration of healthcare assistants and national evidence-based tools for safe staffing levels.

She was particularly pleased the report recommended more thorough appraisals for nurses – possibly including 360 degree anonymous feedback – as this was a suggestion she made in her evidence to the public inquiry.

However, she is cautious about relying too much on recommendations for nurse education and training. The Francis report itself called for greater focus on the values of nursing recruits.

In its wake, Health Education England revealed to Nursing Times that it had plans to assess all applicants to nursing courses for their values and behaviours.

But Ms Donnelly says: “Even if you’ve had very good training, you can still come somewhere and be placed under a mentor or manager who will have an influence – and a bad influence potentially.”

She worries that some nurses are still in denial about what happened at Stafford Hospital and think the media has sensationalised its reporting of events there, which has subsequently spilled over into more negative coverage of the profession.

“I do understand that nurses are concerned about the negative press, but I really do feel – certainly in terms of Stafford – what they’re reporting is what happened.

“There are still nurses who are bad apples, who are delivering poor care, and who need to be named and shamed. The only way poor care is going to change and give patients confidence back in the profession is for good nurses to speak out.”

  • DH whistleblowing hotline 0800 072 4725
  • RCN whistleblowing line (members only) 0345 772 6300

 

Readers' comments (44)

  • tinkerbell

    Well done Helene. Agree with your entirely.
    Lies hurt, honesty heals and we are entrusted with a great responsibility because peoples lives at are stake.

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  • I agree with her comments but naming and shaming seems to be becoming the norm which can be a form of bullying.

    People may think it's right to name and shame individual nursing staff but where are the names of the RCN rep who didn't do anything, the managers who ignored her concerns, the staff who subsequently bullied her for speaking out, the management department who ignored her incident forms. They all displayed poor care and a lack of respect towards the patients and the staff.

    Where I work we are being threatened with 'naming and shaming' if we don't get certain tasks done. Our manager isn't interested in the reason why work gets left, offers any support in helping us do it, or has the maturity or professionalism to speak to staff individually but is happy to 'name and shame' us into humiliation.

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  • tinkerbell

    Anonymous | 27-Feb-2013 11:25 am

    get together as a group, you and your colleagues and sign a petition outlining your concerns about 'unrealistic expectations' and the effect it will have on patient care, all sign and hand it back to management.

    Unless nurses get out of this 'victim' mentality they will be forever bullied and patient care will suffer. Everyone will suffer. Say 'No'. There is no one who is going to rescue you and your colleagues other than yourselves.

    Stand together, united.

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  • “…some may seem themselves as victims of circumstances beyond their control, reinterpreting events to fit this perspective. Another could take the same set of circumstances and cast themselves as the resilient hero, triumphing over adversity to get where they are today.”

    Bruce Hood, “The Self Illusion”, Constable, London.


    Everybody in this world affects their social environment and the more action they take, the greater their influence on change, for better or for worse, but no man is an island and the better groups organise their actions towards their specific goals the more likely they are to achieve them.

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  • health care staff who don't care should get out and get another job. managers who don't care should get out and get another job.
    i am fed up working with band 6,7 and 8's who don't give a damn about their patients or their staff and think it acceptable and 'normal' to be rude, it's time to get back to basic high standards of care supported and led by senior staff who know what they are doing and are loyal to their profession.

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  • Tinkerbell, you are so right! I have personal experience of complaining about poor care when following on from more senior staff - I enlisted support from another nurse on duty with me however the upshot was I got moved to another ward so I went higher up the management ladder - i's not easy to complain however much more important to raise concerns when worried about poor patient care than to watch patients suffer needlessly.

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  • George Kuchanny

    Hmm... RCN? What does the N stand for in this appalling case of letting any semblance of professional standards be swept aside in a"'don't rock the boat" travesty of being a Royal College?

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  • We need more nurses cast in the mould of Ms Donnelly.

    Professional nurses who are prepared to stand by the professions Code of Conduct.

    Nurses who are prepared to stand up against corrupt "managers" and bullies.

    Nurses who will not tolerate the provision of poor care.

    However it is easier to pretend to be a poor, helpless victim, someone who has no choice but to go along with the crowd !

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  • One of the easiest ways of drawing attention to poor staffing levels. inadequate care and managerial bullying is to make an anonymous report to the CQC stating that "patients are at risk"

    Judging from the number of anonymous comments made to the NT contacting the CQC should not prove to be an onerous task for those skilled in the art of making anonymous reports !

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  • is there any need to be sarky with the 'anonymous' comments - we choose to remain anon for our own reasons.

    i too have been bullied after raising a concern which was ignored, it is a terrible feeling knowing that others are not caring for their patients properly, why are they there, they obviously don't like nursing.

    out of all the bullies the band 6 and 7 were the worst.

    where were the senior staff at mid staffs when all this was going on?

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  • just because some choose to put a name or pseudonym to their comments it does not give them the right to bully other commentators, something constantly witnessed on this site. even those who do have a user name are still anonymous to the majority of readers.

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  • Jenny Jones | 28-Feb-2013 3:39 am

    any user registered with the NT to comment here has the right to anonymity. Kindly respect this right.

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  • Anyone can remain "anonymous" if they so wish -----I merely observe there are many !

    So now get complaining "anonymously" to the CQC about the alleged bullying and poor care.

    The facility is there for you to use == use it !

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  • Have you ever considered why there are so many anonymous's Jenny Jones. Nothing to do with maybe the fear of speaking out and putting your name to it.
    I know of two people within my trust alone who have been sacked for saying things on social media which were pretty mild complaints about the trust they worked in.
    Maybe we dont want someone to have the ability to search for our names and our comments, that could potentially be used against us.

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  • michael stone

    Where I work we are being threatened with 'naming and shaming' if we don't get certain tasks done.
    ____________

    THAT IS 'bullying' !

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  • DH Agent - as if ! | 28-Feb-2013 11:31 am

    that it is bullying is obvious and not permissible but the question is what can be done about it. Those who are bullied in this way risk job loss if they try to say anything or report it.

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  • Bullying is alive and well in The NHS.
    People. Nurses in fact are to frightened to speak out about things that are happening in there area of work.
    There are scared for their jobs, their living and all the recriminations that would come their way.
    It is a brave nurse to take all of that on. Believe me.

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  • Jenny Jones is not that person's real name. I remember reading a post by him/her some time ago where this was admitted. So he/she is as anonymous as anyone. The frequent sneering remarks, by him/her, about anonymity on this site are pretty hypocrtical.

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  • tinkerbell

    Just read a statement by our trust CEO to all staff, an email informing that following the francis report if any staff have any concerns we should raise them. I thought that a positive move in the right direction.

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  • Audit Trails of concerns and complaints should be introduced.
    Who blocks, who victimises, who acts properly should be made clear in regular feedback, monthly or at least quarterly.
    Obligation for all staff to report should be mandatory.
    We need whistleblowers to be listened to and protected.
    Well done Ms Donnelly

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