Nigel Jopson and Ian Pierce-Hayes discuss the issues surrounding whistleblowing.
It is never easy to blow the whistle but, at times, it is the only way to move things forward. We surely did not come into nursing to tolerate seeing people abused or damaged, deliberately or by neglect.
We need to be fully prepared to stand up for our patients. It is easier to stop an individual who is causing harm intentionally or by a lack of training than it is to change the way an institution behaves.
The death and suffering caused by institutional abuse and neglect makes Shipman look like an amateur. The damage caused by a lack of training and updating, understaffing, a lack of resources, outmoded practices and procedures, and staff’s willingness to let them continue should be a source of shame to us all.
We know that working understaffed and with insufficient nurses on duty damages outcomes. We know that we need to be constantly updated if we are to deliver the best care.
Why then are staff working overtime without being paid and staying at the end of shifts to catch up on paperwork? Why are staff paying for their own training or doing it in their own time?
If we are not willing to stand up for ourselves, will we stand up for our patients? We are very privileged to do our job and, with privilege, comes responsibility. If we see something wrong we simply must do something to put it right. While we have the NMC code of conduct to guide us, surely we know that as responsible human beings we cannot condone abuse or neglect?
If you have concerns about anything that you consider constitutes unsafe practice, it must be raised with a line manager. If there is no resolution, then the matter should be taken higher.
It is not always easy to do the right thing but patients must be protected and that is our job. Always put things in writing and keep copies. If nothing seems to be happening, don’t be put off – keep asking what progress has been made.
It may not be a comfortable thing to do, and it may cause you worry, but think how you would feel explaining to relatives that the reason they are grieving is that you knew something was wrong but you did not want to cause yourself any discomfort by speaking out.
Nigel Jopson is the manager of a nursing care home for people with dementia in Surrey
As nurses, our first consideration must be the interests and safety of patients. However, the whole notion of whistleblowing is often far from clear-cut and the recriminations for those who have been brave enough to raise their concerns can be so severe and bitter that it can lead to an atmosphere of fear and intimidation that prevents any discussion – let alone criticism – of practice.
It is not individual nurses acting in their own interests who are the problem but the failure of managers and employers in preventing honest and open discussion that is letting down patients.
Under the 1998 Public Disclosure Act, workers who disclose information of a specified nature are protected from being dismissed or penalised by their employers. Furthermore, the Department of Health has stated that all trusts must have policies and procedures on whistleblowing. However, in reality, we work in a climate governed by costs and targets. Nothing can stand in the way of meeting targets.
If anyone feels the law has made a difference, the cases of two nurses – Graham Pink and Karen Reissmann – demonstrate how little has changed.
Graham Pink was a charge nurse who wrote a string of passionate letters – to his employers, the health authority, the health secretary and finally the press – about the inadequate care on his elderly care ward at Stepping Hill Hospital in Stockport. He told of elderly patients lying in bed in their own excrement and the chronic lack of staff to care for them. He was sacked for gross misconduct in 1991 after writing his letters.
Karen Reissmann, a community psychiatric nurse, was sacked last November after leading protests against possible cuts to NHS mental health services. She and her colleagues felt that service reorganisation would leave too few staff to deal with a large number of clients. Two months after her initial suspension, the trust accepted that client numbers were higher than it first thought and put in extra staff. Karen is still campaigning against her sacking.
So despite all the talk of open and accountable cultures and ‘listening’ managers, as well as whistleblowing legislation, the reality of raising concerns has changed very little. Until we have a stronger and empowered nurse leadership, it will continue to remain that way.
Ian Pierce-Hayes is cardiac specialist nurse at Wirral University Teaching Hospital NHS Trust