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Opinion

The ever-widening definition of abuse

  • 3 Comments

The currents levels of safeguarding made against our hospitals and nursing homes are staggering.

I expect this is the inevitable back lash against the revelations of terrible abuse in the last decade, but the negative consequences of nursing staff feeling they are constantly under attack are seriously under-estimated.

In my experience overly stressed, overly criticised, defensive staff will not maintain high standards of compassionate care.

The balance has swayed too far the other way and the term “abuse” is bandied about too freely without proper attention to the consequences.

We have started to wonder if the perpetrators of all this safeguarding legislation have forgotten what real abuse means.

Nurses can be suspended and humiliated for the simplest of oversights, often as a consequence of being over-worked and exhausted.

When the majority of nurses are doing their best for patients and working extremely hard in difficult circumstances, an unfair allegation can feel like a kick in the teeth.

It corrodes confidence and enthusiasm and the inevitable casualty is the warmth and human side of nursing.

There is the creation of a defensive culture where staff are more concerned with ticking the right boxes and covering their backs with copious amounts of paper work than actually going the extra mile to care with any real compassion for vulnerable people.

Of course it is essential that we protect patients from abuse. They have for too long been vulnerable to the negative exploits of a few unscrupulous people in positions of authority.  

However, it is not possible to nurse people without making occasional mistakes. This is not the same as abuse.

We put enormous pressure on ourselves and each other by refusing to admit our fallibility. Perhaps we, like the general public, are deluded by our own mythology; idealised as angels and now demonised with the same lack of understanding that essentially nurses are human.

Nurses get tired, emotionally drained, resent it when people unfairly complain and need support to do a very demanding job. Better supported nurses will deliver better care.

Displaced anger is a huge problem for people in the caring professions.

Patients and their families are often struck by life shattering disease and accidents and people will often deflect anger on to those trying to help, especially as nursing staff are not in a position to give the one-to-one care the patients and family would like.

Social workers and investigators into claims against nursing staff need a great deal of wisdom and insight into the dynamics of dependent relationships and the broader political and economic situation in health care before they make unhelpful judgements.

I have witnessed young social workers with very little life experience weald too much power in this area.

Unfortunately social workers, subject to similar pressures, are often covering their own backs by casting blame.

Every time this happens the willingness to care is eroded.

There have already been huge problems recruiting and retaining staff. This situation will only get worse while this defensive climate persists.

As will the diminishing compassion in our nursing homes and hospitals because people, even nurses, find it difficult to care while they feel under attack.

 

Lucy Calcott is a staff nurse

  • 3 Comments

Readers' comments (3)

  • Interesting point and very well put. Nurses are told to be compassionate and human but at the same time told to obey the tickboxes - feels almost contradictory!

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  • excellent article which expresses what many of us think but may not verbalise. would be useful in the national press to show the public that nurses are human too and will make inadvertent mistakes which are not the same as wilful abuse. there is too little understanding of the role of nurses and tolerance when things do not always go right and too little dialogue about mistakes and what can be done to put them right before any related problems escalate out of control.

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  • Albert's Mum

    I don't need to ask the boy genius about this one - it is the usual story of balance and over-reaction.

    'nurses are human too and will make inadvertent mistakes which are not the same as wilful abuse. there is too little understanding of the role of nurses and tolerance when things do not always go right and too little dialogue about mistakes and what can be done to put them right before any related problems escalate out of control.'

    Indeed - you need to sort out the inadvertence from the incompetence, and the unavoidable from the culpable, and also deal with the systemic factors (for example not enough staff) and issues of process itself causing problems: surely someone within the 1.4 million who work for the NHS, could do that ?

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