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Practice comment

‘The outlook is bleak  if nurses keep failing to act on frightful conduct’


Am I sickened and shamed by Tuesday’s Health Service Ombudsmans report? Most certainly. How could any normal, decent human being not be. Am I surprised? Not in the least.

This is the most damning condemnation of a sizable section of the nursing workforce I have encountered in a lifetime as a nurse, though I have been fully aware of the gross neglect of countless older patients in NHS hospitals for many years. The ground breaking book Sans Everything by Barbara Robb (1967), the inquiry into the mistreatment of patients at Ely Hospital Cardiff published in 1969 and further reports in the 1970s, would leave anyone concerned in no doubt that nursing faced a massive problem in the second half of the last century. The evidence was staring nurses in the face but little or nothing was learned, no radical changes put in place. If the disturbing history of some nurses callous behaviour over were included in nurses training (as now perhaps it should) we might not have reached the scandalous situation we read about of today.

As late as 1992 The Ashworth Hospital Inquiry reported that such was the neglect, the inhuman treatment and low standard of patient‑care that “the hospital must be a prime candidate for a visit from the European Committee for the Prevention of Torture and Inhuman or Degrading Treatment”.

Twenty years ago I highlighted problems of patient neglect but was treated by the majority of colleagues, every manager, most local and national officials/nurse leaders and politicians (up to Downing Street) and who were in a position to intervene, with rejection and contempt.

So to the ombudsman report. I ask which committee will look into the case of Mr D, who had stomach cancer who was left for several hours in pain and who was so dehydrated that “his tongue was like dried leather”, or Mrs R, whose wound dressings were not changed and who was denied food and drink amounting, relatives believed, to euthanasia?

If history teaches us anything, its not to hold our breath.

I am in no doubt that the vast majority of doctors, nurses and other carers are conscientious and dedicated to providing second-to-none quality of care but we also must accept some blame for the minority who so dreadfully let us down.

Unless nurses as a body are prepared to face today’s inexcusable reality and acknowledge their colleagues’ frightful (even criminal) behaviour then the future outlook is bleak.

A seismic shift in recruitment, training, supervision and discipline of nurses with a regulatory body we can trust and respect (perhaps even fear a little) is required to have any hope of restoring the once acclaimed, inexorable standards of patient care which were handed on with pride to me and those with whom I trained 60 years ago.

Nursing, especially of older people, has been for me, an inestimable privilege.

Graham Pink is a retired nurse. In the 1980s he was sacked after he blew the whistle on management failings that led to poor standards of care provided to older people at Stepping Hill Hospital, Stockport

  • See next week’s practice section for analysis on what nurses can learn from the report



Readers' comments (43)

  • Fantastic post Graham.

    Thank you for what you have done and continue to do.

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  • I fail to understand how nurses put themselves up to continue on the NMC their registration to practice each year having signed a form to confirm that they have met the criteria. Perhaps stricter regulation is required.

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  • Anonymous | 19-Feb-2011 10:43 am

    sorry above, written in a hurry and not very clear. Still in haste but I have amended it below. It is a pity that there is no facility to edit details after they have been sent as on other websites. I have suggested this to NT.

    I fail to understand how nurses can put themselves up every year to continue their registration to practice and sign a form every three years to confirm that the have met the specific criteria to continue this registration in the knowledge that they have provided substandard care which is not in line with their professional ethical code of practice. Perhaps stricter regulation is required.

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  • I fear that nurse registration, introduced in the early 20th century to protect the public from the poor care of unregulated nurses is being severely tested. With such bruising criticism of professional nursing we should be taking a serious look at the culture of modern nursing and whether we are actually maintaining even the basic standards of the first year student nurse taught in the preliminary training schools of the old schools of nursing.
    It is not always the numbers of nurses employed in a ward or department
    that improves basic care but the quality of skill delivered via leaders in the ward directing and teaching skills and insisting that staff are properly skilled to cope with the work load and feel confident to manage when left alone! .

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  • University training for nurses is fundamentally
    important for the development of professional nursing. But are we in danger of putting the cart before the horse ? Perhaps university departments need to be nearer hospital & community units to make basic skills a priority for students to master before going further and deeper to a more advanced stage of nursing? Practice /Lecturers could be more high profile in hospitals & community, covering all the shifts! supporting students, newly qualified and old hands? It may help morale too that leaders want to enable nursing staff to manage busy medical, surgical etc wards.
    There seems to be a bit of a disconnect at the moment . Newly qualified are not confident and some leadership to root out bad attitudes and practice is clearly lacking.

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  • maybe if there was more support and guidance poor attitudes and practice would not develop at all or at least would be greatly reduced, as there are always a few bad apples.

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  • although there could and should be 0 tolerance for any bad apples!

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  • So what has happens in private hospitals?
    And, what happens in dementia registered, CQC, residential care homes with social care workers? That’s if the care worker even have an NVQ level 2?

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  • I'm afraid I blame the return of Taylorism (task based nursing work) which is the direct consequence of LEAN methodology and PRODUCTIVE WARD when ennacted in a finance driven environment. The released time to care is equated to nursing hours and cut from establishments.
    We have allowed ourselves to be led by the nose into time and motion task based care. Look at all the patient experience surveys and they tell you in the clearest terms that what patients want is our time. Sadly that is the least available commodity we now have.
    This reductionist approach to care giving leads individuals who entered the profession to either normalize less than adequate care or leave.
    There is no reasonable excuse for lack of humanity, care and compassion but we should be studying the results of inquiries into Nazi Germany, concentration camp behaviours and more recently treatment of prisoners in Guantanamo to properly understand how inhuman conditions and working practices give rise to inhuman acts

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  • maybe the people mentoring the students should take a look at their nursing care!!After all their the teachers.

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