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'Universities must stop students becoming part of a culture of poor care'

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SOS Student Ambassador, Caroline, reflects on the role universities play in teaching students the importance of questioning poor care

When student nurses start their courses they do so with the best of intentions. Most of us come into the profession with aspirations of providing good care and making patients’ experiences better.

It’s not the most well-paid job in the world, nor is it the least stressful, but other reasons make us pursue this career, and wanting to make a difference is a huge part of that.

With this in mind, it seems ironic that reports of poor care make it into the media daily, and that nursing as a profession is often publicly criticised, perhaps more so than any other vocation.

However, speaking out about poor care is a complex concept.

Sometimes it is obvious that the care we are observing is not right. Perceptions of care quality are subjective, and poor care is what a patient says it is. But at other times we may not, as students, fully understand the implications of why things occur, or what the rationale is for a nursing intervention. We often lack knowledge or insight, so sometimes our opinions can be ambiguous; we simply are not sure.

We are all different and our views will be influenced by our backgrounds and experiences. But one thing we do have in common is the ability to ask.

We can question what we perceive as poor practice, even if we do not fully understand it, and questioning is a vital skill in nursing. While we learn to question evidence, we must also learn to question the actions of other professionals.

Most important of all, we must learn to question ourselves. Are we doing the right thing, is it the best option, or are there other ways that may work better? The ability to question is what will make us the best nurses we can be.

This is where our universities come in. We cannot instantly learn what optimal care is for every area of nursing, and we cannot know everything by our first placements. Often student nurses arrive straight from school and may have been taught that they should respect the actions of those older than them. Others will lack the confidence to question, or think it is rude to do so.

Universities need to show their students that asking is always a positive thing.

It is what we learn from, and if we are criticised for asking, then that is the problem of the person being questioned, not us. Universities must give support if our questions are not welcome, and we must be educated in what to do when patient care is simply below par.

We must not be allowed to become part of a culture where poor care is not just tolerated, but accepted as the norm. If universities support this from the outset, then they will create nurses who have the potential to change care, to challenge poor practice, and to improve outcomes for all patients.

Poor patient care is never acceptable, and we should learn that from the first day of our courses. There are never excuses, there is always enough time to try our best.

As students, we are the future of the NHS and we need to be able to Speak Out Safely, for the remainder of our careers.


Caroline Estrella is in her third year studying adult branch at Nottingham University, and an SOS Student Ambassador


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