Would you put yourself in the firing line and raise your concerns about a colleague’s poor practice?
It is scary raising concerns about your colleagues’ poor practice; terrifying in fact! But it is important to recognise the need to address such concerns.
I’ve written about the nurse who came in laden with a pillow, slippers, and a big blanket every night shift. Once patients were in bed she made herself comfortable on the sofa where she slept ’til around six a.m. She wasn’t the only member of staff who slept during their break. But the majority at least woke after an hour or two and returned to duty.
I don’t believe staff should sleep while on duty on busy acute mental health wards. There was one qualified nurse and one nursing assistant on duty during the night shift, on a twenty (plus) bedded ward. If someone was sleeping that only left one member staff to deal with any admissions or any emergency that might occur. It felt unsafe but, as a student, I was advised by colleagues not to rock the boat.
It wasn’t easy raising concerns about my colleagues
I’d returned to studying at the grand old age of thirty-six and was classed as an adult learner. An adult who knew right from wrong. Therefore I didn’t feel I could ignore the ‘sleeping’ as it made the shift unsafe for both patients and non-sleeping staff. The NMC Code of Conduct 2015 states ‘work with colleagues to preserve the safety of those receiving care.’ I’d share this to the nurse in charge and would many times hear ‘Look it’s just what we do.’ or ‘Everyone does it.’ and ‘We all take two-hour breaks here and if you want to sleep, that’s okay.’
I’d already raised concerns that were largely ignored so I stood my ground and explained to senior staff that if it continued and they ignored it, I’d have no option but to escalate. Subsequently, there were no ‘sleepers’ whenever I was on duty. Later, I heard that I was a ‘splitter’; someone who ‘split the team’ by complaining about colleagues.
I completed another placement with a community mental health team (CMHT) and I hated it. I had to work with several miserable burnt-out nurses, those who’d left the hustle and bustle of the acute wards for quieter and easier nine-to-five jobs in the community. I’ve previously mentioned, my Supervisor was regularly thirty to forty minutes late so I asked other staff if I could accompany them on patient visits.
I was often met with belligerence and tutting and came across some staff with a chip on their shoulder. ‘They should have got promotion.’ ‘They didn’t win any awards.’ ‘They shouldn’t have to be walking the streets at their age.’ ‘They’re fed up with students.’ Blah blah, flippin’ blah.
Impacting on patient care
How could they not know that their attitude impacted on relationships with patients? They clicked their teeth, tutted and whinged during patient assessments at home. “Tsk, George why is this flat such a mess? If you can’t look after yourself you’ll be admitted (to hospital).” They’d do a quick ‘How are you? You sleeping well? Eating well? You better be taking your medication, yes? Okay, don’t you get into any trouble. You hear me? See you next week George.’ Then they’d leave. There was rarely any encouragement or real conversation, always negative or condescending comments. Oh my word… give it up. Leave the job. Change career. Retire! Ffs!
Many times, on my days off, I’d spot community staff in Tesco around three or four p.m. They’d be doing a large shop then sitting down for coffee and cakes when they should have been at someone’s home. That’s when you see in patient’s notes “Knocked two or three times and patient not in.” and you can see the same comment documented for weeks at a time! Some nurses/social workers/support staff would at least have the good grace to look away embarrassed when they spotted me.
During one ward round, the Consultant Psychiatrist was discussing a male patient who’d recently been admitted to hospital. The young man was malodorous and unkempt, with long matted dreadlocks, cigarette-stained fingers and dirty nails. He was one of those patient’s who’s notes read ‘Patient not at home’ for 6 consecutive months so he’d clearly not been seen by community staff. It made me cross, and I raised concerns about seeing staff shopping during working hours. Later, once the attending Community Psychiatric Nurse (CPN) returned to her office she told her colleagues and boss what I’d said. I got a short, sharp, round-robin email telling me to speak with the community team manager before complaining in meetings. Ah! — the relief when I saw that the Consultant Psychiatrist had responded to said email before I could. He wrote that I had done the right thing and to leave it at that.
Your role in raising concerns
The following is an abstract from the NMC’s Guidance on ‘Raising concerns‘
1 As a nurse, midwife or nursing associate, you have a professional duty to report any concerns from your workplace which put the safety of the people in your care or the public at risk.
2 The Code (section 16) states the following.
2.1 Act without delay if you believe that there is a risk to patient safety or public protection.
2.2 To achieve this you must:
2.3 Raise and, if necessary, escalate (take further action on) any concerns you may have about patient or public safety, or the level of care people are receiving at your workplace or any other healthcare setting and use the channels available to you in line with our guidance and your local working practices.
Okay, nobody likes a complainer, but did they really think I liked having to raise concerns? As a student learning how to become a good mental health nurse, I felt it was necessary to address issues in order to improve nursing standards. But it wasn’t something I enjoyed.
Moving on
Some time later and having worked on my first acute mental health ward for about six months, I was awarded the Trust’s ‘Most excellent Newcomer of the Year‘ which came with a nice cheque for £500 (donated by a local company), flowers and a lovely piece of inscribed crystal that now sits proudly in a dusty cardboard box somewhere. As I walked through my colleagues to the lecturn to receive my award I heard the whispers behind covered mouths ‘Tsk. That’s her. That’s the splitter!” Talk about taking the shine off my lovely new award, and that’s my main memory of what should have been a special moment.
I appreciate that many of my posts have highlighted the poor practices and the lack of care I witnessed, and they have their place. But there are many more reasons for the decline in quality and safety of mental health services in the UK. One of which is political and my next post will explain a little further.
Over to you
Have you ever had to raise concerns about a colleague? How did that go? If you haven’t raised any concerns yet, would you?
