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OPINION

'The BBC Panorama programme awakened memories for me'

  • 15 Comments

‘In my experience people can blow whistles until they are blue in the face – not a lot will be done unless you have someone willing to sacrifice their position for the sake of the patient.’ says Linda Jane McLean

To the many people who think of care giving as a positive contribution to society, the BBC Panorama programme will have come as a severe shock. 

For me, the programme awakened memories: the stories I could tell you, the utter distress I have witnessed. Some of this was caused by the staff being too unaware to realise that they were even causing distress.

I remember when elderly patients were forced to sit beneath a radio blaring Radio One all day, because that is what the staff enjoyed when they were working. The very real discomfort of a generation not brought up with blaring radios was of no consequence. The patients would obey their rules. The very real opposition I came up against at the suggestion of a change of programme or volume was quite revealing.

“From a hidden position, I watched the member of staff eat the patient’s meal – all of it.”

I believe it showed to me the mind-set of people who were at work to earn money. After much turmoil and confrontation, I managed to alter the programme and volume for my shifts – so that it was changed to Radio 3 – or something that there was a possibility the patients could enjoy. But the taunting I endured; the faces, the scowls, the comments; were very difficult to bear. This experience allowed me to see the power that sheer weight of numbers of auxiliary staff wielded, although I was the Nurse in Charge.  The real acrimonious retaliation they possessed was a force to be reckoned with. 

There was one auxiliary who always wanted to feed the same patient. Eventually, puzzled as to her motives, I decided to pay her extra attention, as the patient was in a setting not easily observed. From a hidden position, I watched the member of staff eat the patient’s meal – all of it. The patient was unable to complain because she was unable to speak, following a stroke. I spoke to the Auxiliary in question, hoping to let her see the error of her ways: that this was a bad example to set; that it was uncaring; that her first duty was to the patient.

She completely took my breath away when she informed me that her first duty was to herself. Moreover, she went on to announce gleefully, I could do nothing about it because I had no witness.

That was as much as I was willing to take. The next time I caught her, I wrote down a statement which I sent to my nurse manager – explaining the situation.  The auxiliary was spoken to – and it was discovered that she was a drug user – and so had no money for food. This is the level of caregiver that we employ – and this was NHS.

Thinking aloud at the end of the Panorama programme, I asked my husband: “What other profession can you think of, where, if you try to drive up standards, you lose your job?” He answered: “Ah. But they have a whistleblower’s hotline now.” That will be the problem sorted, then.

“In my experience people can blow whistles until they are blue in the face – not a lot will be done about it unless you have someone willing to sacrifice their position for the sake of the patient. “

In my experience people can blow whistles until they are blue in the face – not a lot will be done about it unless you have someone willing to sacrifice their position for the sake of the patient. That is not always an easy call. There is not a lot of work about, or at least not so much that you can afford to give up a well-paid job on a principle. Personal finances and circumstances may overrule your moral standards.

Most people, I have found, will make any problem like this known. They will attempt to educate auxiliaries – they will take it to management. It is at this stage that the system struggles: management, in my experience, usually fails to listen, understand or act. There is not normally the courage to continue such a battle unsupported.

Then the trained nurse has to decide – to lower their own standards and get paid – or to attempt to improve the lot of the patients, and lose their employment.

Linda Jane McLean is studying for a post graduate MSc in Clinical Leadership and works as a coordinator for the Charity, Arac.

  • 15 Comments

Readers' comments (15)

  • Well said!!!! I totally agree!!! This is an article that should be sent to the chief exec of the NMC in the discussion about why Nurses do not whistleblow, no support and the very real chance of losing our own careers as a result!

    On a further note, I absolutely agree with you on the HCA front too, I have come across many similar instances where the sheer attitude against being told 'that is wrong' or 'it needs to be done this way' (with a variety of transformative and transactional leadership techniques) is overwhelming! HCA's need to be regulated and trained to a basic level. But as you say, there is a vast difference between most of us who are working in a profession and work hard to gain and keep professional qualifications, and someone who can simply get a job and see it as a way to earn a wage, nothing more.

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  • I agree with your comments too, although, and I hate to say it, these attitudes are not just confined to auxillaries, there are so called professional nurses out there with similar attitudes. As a student nurse in her final year, this concerns and saddens me a great deal.

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  • I agree with all the above I am at an age now where I am not too bothered about promotion hence I let my views be known about bad practice. I have had the experience of an HCA dictating what should happen on the ward because they were friends with the manager i.e how certain patients should not be admitted to the ward etc. But I quickly put a stop to that happening when I am shift coordinator I pointed that at the end of the day if something goes wrong on the ward it is the qualified nurse who is held accountable, as for the powerful HCA this person was told as staff we all have to treat everyone with dignity/equality and if they had any problems with this way of working was free to make complaints to their manager, this was three years ago so far no complaint has been submitted.

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  • michael stone

    'not a lot will be done about it unless you have someone willing to sacrifice their position for the sake of the patient.'

    I have said this before, and it is the only solution to many (not all) of the 'whistle-blowing' problems.

    You need to separate the person who raises the issue, from the person(s) who decide if the issue is valid, and those persons then need to be able to 'push the issue' without the risk of being disciplined or sacked. So you need need someone between the nurse and management, who is relatively impartial and is neither a nurse nor part of management, and who can push the issues without 'being scared'.

    It needs more anonymity for raising issues which are basically failures of management - so allow those issues to be raised anonymously with what I will call the 'complaints group'. The 'complaints group' must then be the people who decide if it looks as if there is a problem to address, and they should have powers to tackle management over these issues, and also be 'immune from comeback': it is pointless to expect nurses to challenge their own management !

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  • ..just also be aware that the opposite can and does happen.
    People can use the' 'whistleblowing' technique if they have a grudge against someone.

    This happened to 2 people I know. Excellent nurses with excellent records Their team had won an award for their good practice the year before they were lied about by a member of staff with a grudge.
    Without any evidence to back up allegations made ( and they dont actually need any apparently!) these 2 were subsequently put through years of hell and subsequently removed from the register. Their good names trashed and careers gone... The person who caused it all is now out there practising

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  • michael stone

    Anonymous | 18-Jun-2011 2:14 pm

    I have discussed this elsewhere, and there needs to be a difference between complaints about people, and complaints about 'procedures'.

    Anyone who is complaining about the behaviour or competence of a specific individual, obviousy must raise that directly with a line manager, or someone higher in the chain - that cannot be done anonymously.

    But many complaints, are effectively about procedures which managers have put into place - it is madness, to complain to those very managers, about preceived problems which they have a vested interest in defending !

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  • I am sad to say that this is also what I have observed in practise. There is both apathy and fear. The NHS is a closed shop and you will not get another job without a reference.
    Too few managers walk the job, they do not like the discomfort of hearing all is not well. They favour the reports of those that report what they want to hear.
    The NHS is NOT a learning organisation and there is no incerntive to make change, just tick the boxes and stay comfortable.
    Also the regulators often ignore the obvious and unfortunately the most vulnerable in our society have to rely on the press to expose years of abusive and neglectful care.
    Of course it is not all bad. The majority of staff work so hard agianst unsympathetic managers imposing cut after cut without inviolving the front line staff for ideas about effective savings and ways to preserve patient care.
    Sadly I have opted to be anonymous on this occasion because on a previous occasion I offered a view the comments that followed were bullying and rude and failed to address the original topic. The blame culture and inability to make or accept constructive comment is what perpetuates the protection of poor practise..

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  • michael stone

    Anonymous | 19-Jun-2011 12:38 pm

    I don't work in the NHS, but I feel sure you are spot on. It is impossible to progress 'constructive criticism' of many NHS bodies, from my own experience.

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  • I was saddenned and sickened by your experience. It emphasises the crying need

    1 to regulate HCA's which will weed out some of the idiots and

    2 Put in place some 3rd party at patient/client level to immediately decide if complaints and concerns are viable.

    I don't work in the NHS any more and don't want to. It nearly broke me but don't kid yourself that things are any better in the private sector in the UK where the need to be seen to be doing the right thing
    means that nurses are the handy scapegoats for the big 3 employers when anything goes wrong.

    And of course the NMC is always a willing partner because it's the front line nurses who are responsible for the care aren't they?

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  • I contacted our Chief Nurse once to highlight my concern that a couple of patients had been NBM, no NG or PEG for 7 and 9 days following a stroke. They spoke to the Speech and Language Therapists to address the problem. I had no reprisals. It had taken that long for the patients in question to get a bed on the Stroke Unit. I'm glad to say everything has improved, not only to raising concerns, but to the implementation of the Stroke Strategy.

    However, on the other hand, I have also experienced situations such as Anonymous | 18-Jun-2011 2:14 pm and
    Anonymous | 19-Jun-2011 12:38 pm have highlighted.

    I know my subject well, with 21 years experience in that area, keeping updated and always say my piece when I see something not done correctly. I have gained a lot of respect (from those that count), but have also faced adversity from the few, where I have had to take evasive action on a few occasions to protect my career, dignity and self-worth.

    I don't mean to come over as patronising at all (I do hope not), but if we all stood up for what we know is best for our patients, we could alleviate this bullying divide and rule culture.

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