Conflict of interest is something that will likely impact all of us, perhaps if we have worked as HCAs or if an acquaintance has been admitted to a ward on which we are administering care
Sometimes, as in my case, it is completely unexpected and your reactions may not have been as you might have hoped.
The attending medic introduced the mother as a paediatric nurse. Her child required observation on the neonatal unit where I had been placed. She did not appear familiar to me, even when it was mentioned that her workplace was a hospital where my own child had spent extended periods of time as a patient. As such I did not see - and so didn’t declare - a conflict of interest. This was proven to be an error when I was recognised.
“This recognition put the colleague I was working with in an uncomfortable position”
I learnt several things from this interaction, the first of which was that I should not take a situation at first glance, and should always appraise myself of all details in order to make the most informed decision and take appropriate action from there.
A second (and important) outcome to learn from this was that this recognition put the colleague I was working with in an uncomfortable position.
I had been called in to assist a doctor in siting a cannula. Due to having adopted the philosophy of only informing people that I felt should be aware of my personal history, the doctor was not cognizant. When she picked up the conversation, she asked what might be considered to be a normal conversational question regarding my child. I then had to explain details, which made her feel uncomfortable. I am eager to avoid a repeat.
“I have changed the way in which I approach situations where I recognise that there may be a conflict of interest”
After the event I spoke at length to my mentor to discuss how I had handled the situation, and to ask for any feedback. I was told I had acted professionally and not allowed the situation to impact on my care of the child and his mother.
As the feedback reflected that I acted professionally, I am be looking to build upon that and further enhance my performance going forward. With a view to improving my practice, I have changed the way in which I approach situations where I recognise that there may be a conflict of interest. If there is any indication and I am unsure, I will always assess fully - with input from colleagues if need be - so as to be confident of whether or not I should be the person to offer care.
All of these are very relevant to the NMC code of conduct, as I could have compromised safety due to the previous nurse/carer relationship I had with the baby’s mother.
“I could have declared a conflict immediately and gone forward from that point”
My professionalism, which was praised, may have actually not been in evidence had I handled the situation incorrectly. If I had asked more questions, knowing there was a strong likelihood of me knowing the baby’s mother, I could have declared a conflict immediately and gone forward from that point.
Finally, the trust my colleague had in me was also in danger of being compromised with a potential for ongoing patient/carer/staff safety becoming compromised due to loss of team cohesion. Whilst I am not sure I would change my decision not to inform everyone of my personal history, I would perhaps speak to the unit manager for guidance on how best to approach those staff members who are not part of the nursing team.
In conclusion, I realise that not all situations are going to be as extreme as mine. However, preparing yourself for the possibility of a conflict of interest situation can only be seen as best practice - a foundation of our profession.
Jane Green is a first-year children’s nursing student at Anglia Ruskin University, Chelmsford