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Blog: Vulnerable patients need our constant attention


'We know only too well, and to our great shame, that not all doctors and nurses are good honest folk'

How do we make sure that professionals - such as doctors and nurses who have considerable opportunity to harm members of the public - are safe, competent, and practice in line with doing good unto others? This tricky and exasperating issue exercises the most intellectual among us, but it is one we must take seriously and work towards improving patient safety systems.

The fact is that human beings are imperfect, have bad hair days, are not always good humoured and even the best of a mediocre bunch perform below par on occasions. While there is a belief that doctors can be far more dangerous to patients than nurses, we need to constantly remind ourselves that every day vulnerable patients in the care of nurses are neglected and, on rare occasions, abused.

It is painful to hear the many stories about patients who have asked for nursing help and not received it and about the poor levels of patient nutrition and skin integrity which shout of severe cases of neglect.

Good nursing takes time, patience, forbearance, self-discipline, kindess, compassion – on top of skills and knowledge. Florence Nightingale once said that if she was given the good character she could make the good nurse. In other words, education and training was the easy part, far more complex and challenging was ensuring that the young ladies (and it was only ladies in Florence’s time) had the character and temperament essential to making a nurse who could be trusted with the lives of others.

So, we move on to more modern times and we have the regulated professional. People who have acquired a level of knowledge and competence, plus the integrity to make the public trust the professionals who care for us in our hour of need. But systems, along with humans, are highly imperfect and without wonderful revalidation processes, becoming a regulated professional on a certain day does not guarantee ‘fitness to practice’ 12 months later.

We know only too well, and to our great shame, that not all doctors and nurses are good honest folk who live lives according to the highest principles. Many a regulated professional has performed in ways to damage rather then enhance another’s life, meaning that we are challenged to find ways of improving rather then tolerating existing standards.

Regulation is here for nurses, but truly effective revalidation is not. We need to do much better. While appraisals can be effective in a number of ways, they tend not to confront complicated human issues that have a negative impact on behaviour and performance.

Much work is currently taking place on developing effective revalidation processes, which is proving to be difficult, frustrating and exhausting. Ensuring that professionals are well behaved, considerate to colleagues as well as patients, clinically up to date and competent to carry out the many delicate procedures available in our modern society is a must-do. The how-to has not yet been discovered, let alone agreed, but we continue to learn, keep calm and carry on the good work.


Readers' comments (2)

  • George Kuchanny

    This article tackles a fundamental and very difficult to address issue. Well done author! Unfortunately my wife was delberatetely killed 'for the best' after a suffering a series of mishaps because she was left in the care of a team that had neglible experience of looking after someone with a subarachnoid haemhorrage. The team that should have been looking after her unloaded the task because poor management left an empty neurosurgcal ward on a Bank Holiday. The nurse who killed my wife deliberately by sedating her and then turning off a ventilator has never explained why she did it or who told her to do it.

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  • My father died three years ago from a Zeikins diverticulum. He walked into hospital weighing 90kg and died three months later weighing 50 kg. During that time he was fed via a drip of dextrose saline
    He had a naso gastric tube for 2weeks . Unfortuantely he pulled the tube out. THey could not put the tube back in due to the diverticulum and they would not put a gastrostomy in until the week before he died .It was too late and he haemorrhaged. I was constantly reminding the nurses about nutrition somehow it was left up to the doctors and dieticans.

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