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'The patient or carer is always right until proven otherwise - I have seen nurses forget this'


We talk to Vicki Leah, consultant nurse for older people at University College Hospital, and lead dementia nurse at NHS London, who has been a nurse for 30 years.

Why did you become a nurse?

My school friend’s mother was a nurse and she said that if I applied myself I might make a good ward sister some day, so I thought I would give it a go.

Where did you train?

King George Hospital, Ilford.

What was your first job?

Staff nurse on the female surgical ward. I asked to work on the male medical ward.

What is the trait you least like in yourself and why?

Impatience. I want everything yesterday. I have learnt that I can’t have everything yesterday, but I still don’t like it.

From whom have you learnt the most in your career?

A clinical tutor, Joanie Wellington, at King George. She was the first person to ask me to think about how others perceived me and the effect I have on how patients feel. I try to impart this lesson to others.

What advice would you give someone starting out?

The patient/carer is always right until proven otherwise. I have seen nurses forget this, resulting in serious errors of judgement.

What keeps you awake at night?

I tend to do a ward round in my head after a busy day. I think about what I need to do first when I get into work the next day, who I need to call and what decisions I need to make.

What’s the most satisfying part of your job?

Working with patients who behave in a way that challenges us and working out what they are trying to communicate. I don’t always get it right but when I do it is very satisfying.

What is your proudest achievement?

My first ward sister post on the critical care unit at the Royal London Hospital. It felt like a big step at the time while my other promotions have felt like more of a progression.

What do you think will change nursing in the next decade?

There are many factors - politics, demographics, financial stability. What is vital is that nurses take control of the nursing agenda and determine our own future.

What would you have done if you hadn’t become a nurse?

If I were 18 today, I would like to be a TV producer working on a show like Strictly Come Dancing.

What job would you like to be doing in five years?

A national role influencing the care of older people.

What makes a good nurse?

Good observation skills and the ability to see patients’ physical and emotional changes and needs.

If you could change one thing in healthcare, what would it be?

Only one? In nursing I would change 12-hour shifts. Whoever thought that would work?

Not enough time for a comprehensive handover and no continuity of care. Poor communication is at the core of most complaints and 12-hour shifts compound this issue.

What is your ideal weekend?

Oh, a trip to see Liverpool Football Club beat their biggest rivals, followed by dinner in one of the city’s great restaurants and a night in the Hilton Hotel on the docks. Perfect.

If you could spend an hour with someone, who would it be?

Bill Shankly, the manager of Liverpool FC at a time of high unemployment. He united the club and the city and took them on an incredible journey, the legacy of which remains.


Readers' comments (9)

  • michael stone

    'The patient or carer is always right until proven otherwise - I have seen nurses forget this'

    For patients who are at home, paramedics are not told that the carer is always right as the default position - although I want them to be told that !

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  • The pateint or carer is not always right but they remain the patent and carer. if they are not right it is the role of the nurse to ensure that they undertsand the situation, have a detailed explanation by the nurse using those skills or asking an appropriate other to do so. Tthis is important if it involves a person being compliant with a treatment regime. If all else fails the nurse must record that in spite of detailed explanation the person chose not to comply etc.
    Far too many comnplaints are taken personally, it is not a personal attach always if an episode of care is not a good experience for someone. Again communication with people to explain why things are being done and some compassion for unpleast experiences often helps the person to be able to accept this.
    If a pateint or carer thinks that staff have been rude or brisk, this should be taken seriously and investigated and a respnse given to that individual. They will not let iyt go until you do.

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  • patients and carers are under no obligation to be compliant but it is the role of hc professionals to explain the needs and benefits of any treatment and care so that they can make well informed decisions. if then they refuse for any reason of their own, which they do not have to disclose, that is their choice. However, if they do share their reasons and are willing to discuss them nurses can help to dispel any reservations or fears they may have.

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  • Anonymous

    Anonymous | 20-Jul-2012 12:57 pm

    A very concise and accurate description of the law - in particular, you point out that patients do not have to explain why they are consenting to or refusing offered treatment.

    The problem is that everyone feels unhappy, with only partial information - that seems to be pretty true in general.

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  • doesn't everybody think they are 'always right until proven otherwise'?

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  • Anonymous | 20-Jul-2012 6:04 pm

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  • If you want to know the truth cease having an opinion ...

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  • This "consultant" nurse" should visit her local A&E Dept. and ask to see the "Hospital Hopper" file ! It contains details of "clients" who must be treated with heightened awareness and great suspicion.

    These are the "clients" who are very accomplished at deceiving Doctors and Nurses. These " clients include drug seekers and Munchausen "suffers". Often a refusal to provide the "care" demanded will result in verbal and/or physical abuse.

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  • Pirate and Parrot

    Jenny Jones | 25-Jul-2012 3:09 am

    But surely you are referring to a situation when there is already some reason to doubt people ? Isn't the argument that patients/etc should be trusted as the default position, and only distrusted when there is some specific evidence to justify suspicion ?

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