Raising concerns on placement was among one of the most difficult things I have had to do in my life, but I know I did the right thing.
My experiences took place in a nursing home, in a locked dementia unit catering for older adults with moderate to severe dementia.
It was my 2nd placement of first year and my first impressions of the unit were good – on the face of it, it seemed clean with open visiting (always a good sign to me), a manager who spoke convincingly of the need to provide good care, and paperwork that appeared to be kept up to date.
However, over time, the cracks began to show.
“I was left unsupervised to dispense medications”
I had noticed some issues such as staff attitudes to residents: impatience; raising their voices to residents; dirty toilets; and poor food handling practices. I duly brought these to the attention of the unit manager.
Not much changed.
Four weeks in and I was left unsupervised to dispense medications. This concerned me so much that I arranged to meet up with my mentor to discuss how to proceed and in doing so recounted a more serious incident which involved what was, in hindsight, physical abuse of one of the residents.
“I started keeping detailed notes of incidents and dates”
He suggested I speak with the unit manager but, if unable to do so, he wanted the university to take matters further on my behalf. I started keeping detailed notes of other incidents and dates.
After a particularly bad weekend on shift I contacted my mentor again and met almost immediately with the course director and then the placement co-ordinator. By this time my placement was nearly over and I was at the stage of hating it so much I was off sick for two days.
I was stressed and couldn’t sleep.
The whole issue was really affecting me and I was upset because I couldn’t believe how those who were supposed to be in the caring profession could act in such a way to vulnerable adults.
Although I was told that I didn’t have to go back I persisted, gathered more evidence and put it all in writing the day after I left.
All in all I submitted a report with 17 separate concerns/incidents with as much detail as I could remember. Those concerns were wide ranging – from basic hygiene issues right up to what could be termed as abuse of a vulnerable adult, with many levels in-between.
“I submitted a report with 17 separate concerns/incidents”
The university passed this report to the home and it was my decision to forward a copy to the Care Inspectorate. The university liaised with the manager of the home who advised that an external investigation would be carried out.
I was contacted in person by the Care Inspectorate who explained the procedure and advised as to the issues that they would be able to deal with – the physical abuse was referred to the Social Work services who instigated a vulnerable adult inquiry. The Care Inspectorate then sent me a letter detailing the issues they had jurisdiction over seeking my permission to proceed on that basis.
They then carried out an unannounced visit to the home.
It was several weeks before I heard anything further and funnily enough, both reports arrived on the same day. Both quite different reports I might add – the Nursing Home had been investigated by a manager from another home in the same organisation, and was defensive of the staff and the incidents that had occurred. At one point I was almost accused of lying, and blamed for not bringing matters to the manager’s attention.
Fortunately I read the Care Inspectorate Report first – it upheld all of the issues that they had investigated, and had put in place time limits for taking action, one of which was within 24 hours it was considered so serious.
Raising concerns is not easy but I’m so glad I did, if I can encourage even one nursing student to do the same then that would make it worthwhile.
Deanne Turner is in her second year studying mental health nursing at University of Stirling