Dr Graham Pink reflects on what’s changed since he became nursing’s best known whistleblower in the 1980s.
I read with interest the health secretary’s expressed concern for whistleblowers. This follows nurses and midwives repeated unease that speaking out can seriously damage your health, not to mention employment prospects. Yet the appalling situation which I was involved in twenty years ago – patient neglect, bullying, oppressive and lying managers and eventual dismissal (by kangaroo court) apparently continues, as I read on nursingtimes.net. This not only from lay administrators but, to their eternal disgrace, nurse managers, the very people who should be the first to expose unacceptable practice.
In the late 1980s, when my predicament received national attention, while some bedside staff were arraigned before the UKCC on disciplinary charges, it was unheard of for a nurse manager ever to be so dealt with. In fact, my case starkly highlighted the then council’s costly bureaucracy, secrecy, blatant acceptance of dreadful standards of patient care, and its total disregard of managers’ reported malpractice. I do hope the present NMC bears no resemblance to its former useless self.
In 1992, basing my observations not just on the Stockport revelations but on the evidence of thousands of letters received from nurses, doctors and members of the general public, I wrote of ‘submissive and powerless nurses with national leadership which could hardly be more insipid if it tried. At all levels, it seems, no one is prepared to accept responsibility, to say “the buck stops here”. As a body, nurses (and I use the word to include midwives) are two thirds of a million strong but our mouse like demeanour ensures that we are too often treated as a dormant, easily pushed around bunch of handmaidens, the tame gofers of the health service.
Would such a comment, eighteen years later, be an inappropriate anachronism? I would be delighted if that was the case. The Mid Staffordshire scandal, however, suggests otherwise.
Mr. Andrew Lansley is to be heartily commended for his directive but will it change anything? Until nurses are prepared to stand up and be counted, en masse if need be, the prospect is bleak. Clearly nurses must think twice before stepping out of line. But are there no limits to compliance? Has nursing yet come into the 21st century? I neither understood nor accepted the widespread subservience to authority. The whole induction into nursing, the training, experience and mentation were designed to lead to a compliant, uncomplaining, uncritical worker – at worst an automaton and at best a caring person but one constantly frustrated, whose job was to manage no matter what the circumstances and never, never to complain. Good nurses did not complain, moan, remonstrate or appear unhappy. It was just infra dig in such a genteel and respected occupation (the word ‘profession’, I suggest, is pretentious and inappropriate). Nurses like to be liked; they need to be liked and some behaviour, such as exposing poor quality care, is (at least was) really beyond the pale. Am I way outdated expressing such notions? Please tell me I am.
I do not for a moment doubt that the vast majority of nurses are dedicated, honest and fully committed to their calling but a few can become careless, uncaring, even dangerous. The problem is that colleagues are most reluctant to report an incompetent member of staff – managers unwilling to tackle their failings.
When invited to advise nurses what they ought to do if they witnessed patient neglect (or, as in my case, were reduced to actually abusing frail, helpless, elderly ladies and gentlemen) I can do no more than say you have a conscience; listen to it, and do what you know to be right and proper. Once every single nurse in the country accepts this responsibility, this duty, this hard earned privilege come what may, we may have made a start in consigning the inelegant word ‘whistleblowing’ to the archaic section of the nursing dictionary.
Sadly, I suspect it won’t be in my lifetime.
Dr Graham Pink