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'It's hard remaining a professional at all times'

  • Comments (14)

While on placement at an emergency ward last year I was conducting my routine observations when I heard a commotion behind the nurses’ station.

Apparently, one of the healthcare assistants had come across some images on a patient’s mobile phone. Indecent images of children.

Now I know what you’re thinking, firstly what was a member of staff doing with a patient’s phone. Well I’m not sure, it wasn’t my place to get involved. Regardless of how the pictures were discovered, the patient was then nursed with a police accompaniment while the allegations were investigated.

But how did it feel for the nurses to have their patient transform before their eyes? I could visibly see the way they felt conflicted. A patient had gone from being somebody that we felt sorry for, for being involved in an accident, to someone that could be involved in criminal behaviour.

I had to conduct the patient’s observations and I hope I managed to hide any internal discussion I was having about what this patient was accused of doing. It got me thinking about how as nurses we will often find ourselves in situations where we have to care for patients whose actions and lifestyles we disapprove of.

Have there been any incidents that have tested your ability to remain professional?

  • Comments (14)

Readers' comments (14)

  • Anonymous

    My "internal discussion", came about when nursing a woman who had taken an overdose! It was the look of desperation and misery on her teenage sons face that caused the conflict. Having sons that age myself, it broke my heart. The expression on his face still haunts me. I hated what she did to him!

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  • eileen shepherd

    Adam you raise a very important issue. I remember many years ago meeting a patient's daughter. We felt sorry for her elderly father who was rarely visited by his children. It was very distressing to discover that he had abused his children systematically over many years. Yet our job was to look after our patient in a non judgemental way. It is not an easy thing to do

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  • Adam Roxby

    Hello everyone.

    I always liked making time to respond to comments so here I go.

    Anonymous–I can understand how you feel in that regard. It must be a similar sort of emotion that people have towards people who choose to commit suicide by throwing themselves in front of the train. Yes it is highly effective but it causes an immense amount of trauma to the poor train driver who has to witness such an event. Obviously we all have the freedom to make selfish choices in life but from a personal perspective I just wish that more people would consider the implications of their actions.

    Thanks for your comment.

    Eileen–that’s quite a stark turnaround. I have never been in a position to have my sympathies so quickly tested wife that. I suppose the mark of a great nurse would be if the patient could discern no differences in his or her care both prior to and after the revelation.

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  • eileen shepherd

    I agree Adam. I think general nurses can probably learn from those who work in the prison service and to some extent mental health. We don't necessarily like all our patients but we have a duty to care. it is dangerous to make value judgements but this can be a challenge. That is why debriefing and clinical supervision is so important.

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  • Anonymous

    I feel it is a little harsh to condemn suicide or suicide attempts in simplistic terms such as 'selfish'. As a mental health professional, and one who has experienced deep bouts of depression and ongoing social anxiety, I know that many who do this do so with the strong conviction that they are people of little value and those who are close to them would be better off if they were gone. The thought of being a burden on others and the thought of dynamics changing in close relationships due to mental illness (e.g from love to tolerance, duty, pity and eventually resentment) can be too much to bear. Getting help from MH services sometimes helps and, sadly, sometimes it doesn't.

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  • Anonymous

    We are professionals but we are also human. Professional: Non judgemental. Human: Judgemental. Nurses will always have to deal with this contradiction. We can use our professionalism to cover up our feelings. We can also use our knowledge about SOVA and child protection to act if it is deemed to be in the wider public interest.

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  • Adam Roxby
    The hospital that I work in covers 2 category A prisons and a secure mental health hospital, and as a result have nursed some of the most (in)famous prisoners/ patients in the country, and I can honestly say that I have never treated them differently than any other patients. You have to have an idea about the risk that they may pose to yourself and your other staff, but as to their actual crimes they are immaterial. In fact, many have had little chance to have been treated humanely during long terms of incarceration, and a little bit of kindness is appreciated immensley by them. I would go as far to say that I have never been abused by a prisoner whilst at work, whereas the medics, other nurses and the general public can occasionally make your life very difficult. Also, as a rule of thumb, the shorter the chain to the guard, and the higher number of guards, the greater risk there is.

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  • Anonymous

    I haven't met any criminals (to my knowledge) but I am sure that I would be able to look past their "crimes" and see the human being underneath. In the community we don't know who has a criminal record etc. As someone with spiritual beliefs, I know that we all share a mass consciousness, which means that we are all part of the whole and therefore ought to treat each and every person we meet with equal compassion and respect. Granted, in action that is not always easy!

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  • tinkerbell

    It's not easy to be totally non judgemental but its do- able. You can fake it until you make it. Being a mental health nurse for many years with young adults, sex offenders, forensic patients, drug/alcohol abuse, nursing on locked wards, visiting prisoners, drug dealers, i have heard others and been subjected to some of the most articulate insults i have ever heard. Some have made me wince, some have made me laugh, some have left me speechless, some have made me consider it an art form but i have become much less easily offended in the process, mostly it is water off a ducks back to me now.

    To those who are easily offended i can only suggest they get out more or spend a period of time in an acute psychiatric ward or with the younger, severely cognitively impaired but still physically fit aggressive, mostly ex military men. We have a unit full of ex forces and ex SAS. As our consultant says we have our own army. I have learnt to deal with an insult without taking it personally.

    Some of the relatives don't visit their elderly relatives much because their childhood was less than perfect. It is not my place to take sides or get involved in the family dynamics. If they tell me their mother/father was a right one I will listen then go out and nurse that patient without feeling any differently towards them as we are now dealing with the 'here and now'.

    We are all judgemental but it is being aware that this should not hinder our delivery of care and make us discriminate against anyone. We might not agree, we may intensely dislike their crime, but then if we want to pass sentence we are in the wrong job and should have become judges. It is not for me to punish someone.

    I think my experiences in mental health have made me a much more tolerant person towards others and in turn more tolerant of myself and the staff i work with. Rather than judging everyone and everything i try to see us all as doing the best we can where we are. I can't change others i can only change myself. If i am being nasty to someone i don't like, for whatever reason, does that make me a better person?

    Of course there may be initial shock amongst staff if a patient has commited an awful crime but they can express this disgust to each other and get it off their chests in private and then get out there on the ward and be professional and rise above their judgement.

    As much as i despise this government and in particular Lansley i would still nurse him with a smile and be able to fake it. I would still make sure no harm came to him - am i going too far?

    Someone who is about to commit suicide is ususally not able to intellectualise the pain they are going to cause others, they are mostly feeling like a burden to others and think people will be better off without them. They are usually experiencing feelings/delusions of guilt & unworthiness/worthlessness and they are usually in a very dark, lonely place.

    We are all transmitters and receivers, we can all sense and see judgement in anothers approach towards us but as nurses we can learn to rise above it and carry on treating that patient unconditionally.

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  • Tinkerbell,
    Wouldn't you love to nurse Lansley? The queue to give him an injection would be a long one, whist his enema would be kept in the fridge until my turn, and given a liberal dose of tabasco for lubrication. ' Think warm thoughts, because this is gonna be mighty cold'. I truly would have a smile on my face and it wouldn't be affected.
    All joking aside.

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