As some of you may know, as well as being ambulance staff, I'm also a registered nurse. For that privilege I pay the NMC a sum of money every year to be on the professional register. If I am not on that register then I cannot practice as a nurse.
Should I ever have to leave the ambulance service nursing would allow me to pay the rent.
The NMC have the power to strike me off the register, meaning that I would no longer be able to work as a nurse.
Which is why this blog should come to an end.
No longer can I be safe to tell you all about the terrible conditions in some of the nursing homes that I go to. I can't tell you about the problems that occur in A&E and I can't shout about the atrocious state of home/social care.
It's just not safe because to whistleblow like this can result in you being struck off the register.
What this decision means is that all bloggers that have a professional registration are now skating on thin ice. Nurse bloggers, Doctor bloggers, Paramedic bloggers – all these are on a professional register and all end up writing about situations that trusts would rather were kept under the carpet.
Might I also suggest that in the cases of hospital trusts wanting to get rid of a 'troublesome' staff member they may well turn to organisations like the NMC, HPC or GMC to do their work for them. I know I could point you to HPC rulings that appear to do that, not evidential to be sure, but it does look very much like that.
One further suggestion that I'd like to make is that you don't see many managers being taken to the professional registers for malpractice. Are any trust managers from Stafford hospital being struck off any professional register that they might be on?
What I can say with certainty is that, as a nurse, no matter how many Incident Reporting Forms you fill in, nothing seems to change. You end up not filling them in at all, because you know that they will be ignored.
So you want to shout about the situation as loudly as you can. Which can lead to you losing your job or being struck off the register – which results in your career ending.
Which is why most people just try to o the best they can, and avoid 'rocking the boat'.
And this is why I should stop blogging.
But I won't. I, and many others who are braver than me, will continue to try and get the truth of the situation in the NHS out there, out in the public eye because that is the only way that change occurs.
It's the right thing to do.
I am entirely aware that her being struck off was a political move, not a patient care issue, but that doesn't change the fact that she breached patient confidentiality, consent or no, in a manner that was completely avoidable.I support her ideals, but not her methods.
If everyone of the patients seen in the film gave consent, how can she be accused of breaching patient confidentiality. Yes, they didn't consent before, but these patients obviously wanted this situation made public.This is just revenge by the hospital. I sincerely hope that she is able to appeal.
katy
Are there any 'official comments' that the events broadcast on 'Panorama' did not occur? Or that they had been fully investigated, Disciplinary hearings had been held by NHS Trusts &/or the NMC, and the actions of staff depicted were found NOT to amount to malpractice, abuse, or neglect of patients?
Not a healthcare professional – just a MOP – but idont know when I've been more angry. The sick and weak of the UK are in effect being exposed to genocide by target obsessed 'clipboard Nazis' – more concerned with policy compliance than actual care. The NMC are in this case the Vichy police – collaborators – executing the resistance. The right response would have been (possibly) to rebuke Margaert Haywood for the issue of confidentiality but to strike off all NMC registered nurses and managers who perpetrated or concealed the outrages revealed – not simply penalise the one who cared enough to expose them!
I am a second year student nurse. Currently working on A&E. The university and the hospital in which I have placements insist that filling out documentation provides solid proof that good practice has taken place. But I have seen incidents in which patient care has been comprimised by a charge nurse(not so much malpractice more the effects of 80 hour weeks) and the punishment has been laid upon a staff nurse who followed all the correct procedures. Most of these policies, protocols and safety mechanisms are put in place by the senior staff who they are intended to protect.i should note that none of this has disuaded me from either blogging or a career as an A&E nurse.
As long as its doesnt break pt confidentiality you should be ok, i tell people all the time about the “late night accidents” and the wonderful horror stories i get and i dont see anyone coming after me…so rock on dude and fight the power =P
Having read the news story, I was originally disgusted by the decision. I then went and found the video that was broadcast.As a result, I feel that the right decision was made, but for entirely the wrong reasons.
It would have been perfectly possible to ensure that the details of the level of care in this ward were presented, without the breach of patient confidentiality that occured.
It is a simple matter to have blanked out the faces of the patients, and to bleep patient names.
While I respect Margeret Heywood's stand on the conditions, she herself stated the risk of being struck off, due to breaching patient confidentality on the film I saw. It's an important part of any professional working in a medical capacity, from Tom, as both a paramedic and an RN, to radiographers, like myself, and to doctors. She could have done more to prevent herself being struck off so easily, and she should certainly have done so.
The people we work with are often elderly, and quite unwell. If you're in constant and terrible pain, how easy is it to understand the idea of what is exactly you are consenting to. Ask youself this, “If I go into hospital, will I be asked to consent to being filmed as I go through the process of treatment, and possibly my death?” Would that be something you would want a vast number of people to see?
If it meant that conditions may improve for the next lot, then YES!
Two incidents come to mind from my own experience working in private-sector Care of the Elderly. In two separate institutions I was severely concerned about the care being given, health & safety, staffing levels, hygeine, you name it.So I did what the NMC says we should do: I approached my line manager, formally, with written documentation of failings observed. To take some examples, unqualified staff left in charge all shift, unlocked drug and instrument cupboards, broken or inadequate equipment, used inco pads left in heaps on floors, broken toilets left unmended for weeks, inappropriate food (how's a woman with no teeth supposed to eat the salads that were the only food offered day after day?), overdosing of patients with powerful tranquillisers to disguise the inadequate staff levels……In both cases, I was not the first nurse to raise concerns, but the others contented themselves with grumbling quietly, all except for one brave CA who had unwisely contacted Social Services direct, and when that didn't work, the local Press. She was vilified and stitched up.
In both cases, immediately after the managers received the concerns, my contract was terminated, for specious reasons. Now get this. In one case, the Home was closed some months later, by Social Services who up to that point had been turning a blind eye because, I think, it was cheap. Reason given: patients discovered to be at risk.
In the second case, the Matron of the Home was removed from post by the owner some months later. Reason given: incompetence. I like to think my protests did some good, if only in gingering up those who could make a difference, but these were small operations with simple chains of command and accountability. I have every sympathy with Ms Haywood, who found that “nothing was done” when she tried the tangle of official channels.
But I would say, to anyone contemplating doing the same, Watch Your Back. Ms Haywood left herself vulnerable, as was said in previous post. In my experience, managers facing this kind of scandal pull strokes that would gain the admiration of Damian McBride.
I would imagine in this day and age you are recorded in hospitals most days with the in house cctv systems. You are never asked to provide your consent for this filming to take place. The recording has probably been out sourced to a third party. Yet in this case it has been reported that the relatives of the individuals concerned gave their consent. So I am at a loss if client confidentiality was not breached as she had consent, why was she struck off?Is it another failing of the system?
I wonder what will happen if she decides to take it further and go legal.
What will we have next in nanny land – censorship?
I think it's despicable that this woman was struck off. Having said that, whistleblowers often get shafted and no one seems to care. I hope she appeals and gets her job back.
Losing this nurse is a mistake.Being fair, yes, she breached confidentiality by filming patients without their knowledge, irrespective of her intentions – and that is of course a bad thing…
But, taking the wider view, why did she do it? You have to take account of the fact that her motivation was her concern for the patients – and while this doesn't excuse what she did, were I sitting on a panel hearing this case I'd view it as a rather sizable chunk of mitigation…
Other things that wouldn't have escaped my notice would be that:
So, did she deserve to get her wrist slapped? Yes, in my opinion she did. But did she deserve to lose her career? Absolutely not…
All that has happened is that a nurse who actually cared enough about the patients to stand up for them has had her career terminated, while those nurses who were prepared to continue to operate in an environment of sub-standard care will remain in place.
Another glorious victory for NHS management…
Martin
I haven't seen the film, but I'd tend to agree with you. There's fine line between doing something rightfully with the patient's best interests and breaching a trust in doing so. Without specifically asking for consent from each patient, she's violating their rights – even though (in her opinion) it's for a good reason. Who gets to make that judgement call ? That's what laws are for. I agree that we should all advocate for our patients, and vocally so if they are being maltreated – but where to draw the line if we all decide on our own what's right and wrong ?
The question might come down to this.Is consent broken if you are filmed without being asked first?
or
Is consent broken when *someone else* views the video without the person filmed being asked?
(Simply, do you need to sign the consent first, or only if it is going to be seen by a third party?)
I suspect that this is something that filmmakers have to tackle with should a bystander wander into their shot – have they just broken consent, or is it only broken if the bystander doesn't sign a release and you show it anyway?
One for more legal minds than mine – and depending on your decision it might make CCTV cameras illegal…
Tom,You go to significant pains to ensure you don't identify your patients, so you have no need to worry. But then again you weren't really worrying you were making a point about freedom to act without censorship. Sometimes though censorship has value. Patients in hospitals are by definition vulnerable. They should not be the subject of covert filming, particularly not by those who are in a position of trust.
Do the media have a role in exposing the failings of the healthcare system? Absolutely.
Should a nurse (or anyone else in healthcare) exploit their position and their patients to covertly make a point ? Absolutely not.
Failing to deal with this issue would have left a very dangerous precedent and on behalf of patients everywhere I'm glad this action was taken.
DSO
It's simple really. We concentrate on looking after patients; the people who run the NHS concentrate on targets and arse covering. Our place of work is the streets, peoples homes and the wards. Their place of work is the office and the courtroom. They create the culture in which we work but when it goes wrong, like the money trail in a dodgy financial deal, they ensure that the route back to them is invisible and they are untouchable.
Sorry, but I can see another line of consent here – how about when it is in the patients' best interests to do something for which they can't consent to at the time? I can't find the right words to explain it, nor (off the top of my head) do I know the section of the law this falls under.As I'm not sure maybe someone could clarify this….is a library/hospital/swimming pool/local government maintain highway all for public access and isn't there a law that allows any filming to be legal – like if someone stands on your street and takes a picture of you in your house, it's perfectly legal?
Just some thoughts that spring to mind – I'm not saying that any are right before people start jumping down my throat!
Maybe I'm missing something here but there doesn't seem to be much outrage about the original reason the filming was done; maybe we all just feel powerless in the face of such breathtakingly poor standards of 'care'? Compound this with incompetent/uncaring management and I guess that leaves us all colluding to one extent or another.I didn't see the programme when it first aired though have had the opportunity to see it since. Whilst I accept that there may have been an issue about confidentiality before filming (since informed consent wasn't sought) it appears that it was both sought and granted prior to broadcast. I take on board the comments people have made and understand some of the points but I do feel that there is a wider issue of 'the greater good' at stake here.
If it had been my mum I would have wanted to be made aware of what was going on and think that I (and she) would have sacrificed her right to privacy if it meant something was done to improve the situation. Therein lies the rub I suspect – insight without action equals madness which seems to be where we are right now.
I'm no lawyer, but in my mind and with my EMS specific education it comes down to a breach of trust. She was in a position of privilege as a healthcare provider and abused that privilege by sharing patient information (in this case images) without their expressed OR implied consent (I am assuming this, since I don't know this lady or the surroundings of her film being made). It's different to film someone in a PUBLIC place without their consent.I don't know what the specific laws are in the UK, but in the US this would be a massive breach of HIPAA. It's also good to think of this personally – being shown on national television in some nasty hospital in terrible physical shape in one of the most vulnerable moments in a patients life may not be what they would want…
They got consent before the programme was broadcast.(i.e. recorded without consent, but consent was sought before it was made public).
With respect, I think you're missing the point here. As far as I can see, no-one is disputing that she breached patient confidentiality, and no-one is downplaying that. Irrespective of her motives. So obviously the NMC had to act.The issue to my mind is, was their response reasonable and proportionate in striking her off. I recall that not a million years ago, that same BBC made a series about nurses in training, in which they filmed within Care of the Elderly units to show the kind of work nurses are required to do, and this displayed patients (with dementia) unclothed, being lifted on and off commodes, bed-bathed, catheter care etc.
A formal complaint was made to the (then) UKCC by, I think, the RCN. Whether any consent had been sought from the patients' next of kin or guardians, I can't remember. What I do remember is that the UKCC issued a stinging rebuke to those concerned, but no-one was disciplined, let alone struck off.
Seems to me that a strong rebuke would have been appropriate in the case of Margaret Haywood. Her real crime seems to have been to embarrass her managers. Damian Green case, anyone? Whether the NMC intended to or not, they have sent an unmistakable warning to whistleblowing nurses: you present unarguable evidence of your case and we'll have your job.
As a nurse and a paramedic I am appalled at what has happened to this nurse, this is little more than the system sending a warning to any others who wish to speak out.In the words of Edmund Burke, “Evil prospers when good people do nothing”
While I am not legally trained I believe there is is defence at law of necessity, and if these people were at risk and other measures had been attempted then I am with her. These Machiavellian bureaucrats who do this to patients need to be answerable , and people should not be left in situations like some of our dodgier nursing homes.
You seem to think that she was just out to make a point, in my opinion if that point was that these patients are at risk then good on her.
The consequences of inaction are often high. A whistleblower informed NASA of problems with the space shuttle more than a year before the Challenger disaster; a whistleblower informed regulators of the problems at Enron more than a year before its collapse. Those who dont take action rarely pay a price.
In my experience there are too many people in this world happy to whine, but when it comes to standing up they are always right behind you if you get my drift.
Regardless of whether you or I agree with her at least she had the courage of her convictions which is more than most.
Taken to its extreme, if voluntary euthanasia was ever bought in would it be a breach of confidentiality if a nurse did the same if the bureaucrats were applying pressure to clear beds, in Queensland in Australia there is currently a surgeon facing manslaughter and grievous bodily harm charges largely as a result of an ITU nurse who just wouldn't go away, had the press not got hold of it when they did I'm quite sure she would never work again either.
Why is it that Health professionals are so darn quick to have a go at one another, and not the root cause of the problem?
To be fair “Whistleblowing” is good, no crime there!Why can't you just do it without infringing other peoples rights! Go to the papers, go to TV, appear on TV, blog about it, raise the matter with your MP. All of these and many more are perfectly acceptable options. Abusing your position is not and given that she states in the doccumentary that she knew the risk (of being struck off) I'm not sure why the fuss!
DSO
It still doesn't clarify the rights for taking photographs and/or video footage in a public building?Anyone actually know?
The reason it interests me, is that, if it was a panorama reporter who had made connections to visit and secretly film some of the bad practice, would that have been legal (provided they obtained consent etc?).
I still feel that she did the right thing, I have flagged up bad practice on my ward and I've basically been told to conform or look for a new job…..Ill leave it up to you to guess which I've decided to do.