Support for whistleblowing nurse struck off by NMC

[Marmora Man]

Marmora Man, am I not right in saying that you're against all the CCTV, cameras going up and invading our privacy? If so, then I'm surprised you're so supportive of this lady.

I initially wanted to get behind the whole thing, but then hearing about the filming of patients without consent, I suddenly lost some sympathy, even if it was for a "greater good".

Wouldn't some argue that keeping the streets safe is a greater good, over your personal right to privicy?

I don't see any paradox here. I am against random surveillance cameras that monitor the everyday goings on in an area with no aim or objective greater than deterring (or more often simply shifting) minor crime. In this case the whistleblower, with the aid of the Panorama programmers, filmed certain individuals and the appalling treatment they were receiving to highlight a problem that was not being taken seriously, despite formal complaints by staff and relatives by the management. The abuse and poor care goes against every tenet of healthcare and, I believe, making it public in this way was justified and overrode the need to obtain consent from individuals before filming. Two very different cases.

[bignumber5]

making it public in this way was justified and overrode the need to obtain consent from individuals before filming

to journo's, tv producers and apparently a lot of forumites, perhaps, but NOT to a nurse or a doctor: that's just not how it works...

[Marmora Man]

to journo's, tv producers and apparently a lot of forumites, perhaps, but NOT to a nurse or a doctor: that's just not how it works.

Why doesn't it work for doctors and nurses? How does it work?

Remember, formal channels of complaint had been tried to no avail. How is making the facts of poor treatment and abuse public more wrong than partially compromising the abused patient's confidentiality. Should the poor treatment have been kept confidential? How were patients harmed by the publicity? Have any complained?

In many ways it was a hard and brave decision on the part of the nurse concerned. DEliberately compromising her professional standards in order to right a wrong - or if you like disobeying an improper order, something that is explicitly required of the armed forces.

[Keef]

Obviously very different things MM, but to deny the paralells is just blinkered.

I wasn't looking for an arguement about the merits of CCTV, you may well be right about them, but the very simple fact is, that whether it's for a good cause or not, someone does not have the right to go and break all the rules! Those rules are there for a reason, and those reasons are sound.

Unfortunately, like any rules, there are side effects, but does that mean that they should just be ignored?

Mans gotta have a code yo!

So do nurses.

I actually support wholeheartedly what this nurse was trying to do, but can't support the methods.

[antijen]

Yes bnf she fuct up by caring to much and could not carry the abuse in her conscience. In other threads regarding decisions made by individuals who are working with the public/people eg police, army, on expressing my thoughts on this forum, about people who can only follow orders, I've been reminded of Nueremburg, please refer to my link above and read the NMC code of conduct(there is a link within the code going into the confidentiality clause in more detail), this seems to be contradictory at best. To give an example of someone in court for drink driving, is nno comparison.

[annaj]

Oh dear, I go away for a few hours of hands on patient care and look what happens.

Let's be clear here, I started by saying, and have said several times, that I'm not sure what the answer should have been in this particular case and I'm neither supporting nor condeming the panel's decision. What I was trying to say is that it's a bit more complicated than the ends justifying the means in that it involves a complex and important ethical principle which was breeched.

Ted Max, interesting. The panel's statement certainly does seem to contradict itself, or at least make a major U-turn, but as I say, I'm neither supporting or condeming their decision as I wasn't there and didn't hear all the evidence.

Antijen, your post seems to imply that anyone who doesn't entirely support this nurses actions doesn't care about their patients which is unfair on those of us who spend our lives caring, but also believe in the underlying ethics of what we do. As for your emotive tales of patients waiting untreated in A&E corridors, I'm fairly sure I spend more time than you in our local A&E department and have more first hand experience of the standard of care provided and I have to say I'm fairly proud of it.

And then you went and compared everyone who doesn't agree with you to nazis which is, well, nonsense.

On a personal level I feel deeply saddened that this nurse felt she had no choice, but to take the action that she did and that the system failed so completely to care for it's most vulnerable patients, but was the decision right, I still don't know.

[bignumber5]

Thanks for the link, antijen, but as I have said, I know the NMC code of conduct. When you're on the NMC register, it's sort of a good idea. Nobody is suggesting it's an easy set of regs to follow, but that's bugger all reason to abandon them.

And Godwin's Law, anyone?

[annaj]

Just two more things, then I think I'll leave this alone...

One elderly man is not featured, but is glimpsed in the background in a handful of shots. Suddenly the panel decrees that the fact that he is on a ward is confidential

But it is confidential information. So an elderly man, whoses consent was not taken, is shown in the background. He's not just an anonymous old guy on a ward he is a person with a right to privacy and confidentiality. What if no-one knew he was on that ward or even ill and he didn't want them to? What if he finds his illness and infirmity embarassing and was humiliated to see himself on TV? There are numerous reasons why that could've caused harm and the fact that fortunately, as far as we know, it didn't doesn't mean it didn't break the rules. It's not ok to break the law as long as there are no consequensces, is it?

And antijen, back in your original post you mentioned The Hippocratic Oath which, just FYI, nurses have never sworn and doctors haven't, in this country, for years (have a careful read of it and you'll probably see why, it's pretty dubious in places by modern standards), but if you read it you'll see that even that ancient document recognises the importance of confidentiality...

Whatever, in connection with my professional practice or not, in connection with it, I see or hear, in the life of men, which ought not to be spoken of abroad, I will not divulge, as reckoning that all such should be kept secret.

[cdonline]

I'm glad confidentiality was upheld in this case as being paramount.

I wonder about the behaviour of the BBC journalists in this matter, who must have been aware that they were putting this nurse's career at risk. Could the story have been reported without the images. Or is that a complete no no in BBC land now.

[antijen]

Annaj, who do you think you are? Accusing me of comparing every one to a nazi that doesnt agree with me. Firstly I avoid ED's and the hospital establishments like the plague, but please tell me what hospital you work in cause I'd love to visit your utopia. And as for the "emotive stories" of the patients waiting in A&E's a click on the link below will tell you it's a fact! How emotive is it when 8'500 people are directly affected in a small country like South Wales? People need to bear in mind that the NHS is a NATIONAL business and while things may be managable in your Utopia, why is it emotive to acknowledge the biger picture? Maybe i'm wrong but that sounds kind of unfeeling to me, it's always easier to bury your head in the sand and ignore the real issues when thet're not directly affecting you as an individual, and the real issue is not confidentiality. Confidentiality is broken regularly and has been for years, as soon as your name is called out in a hospital or clinic waitng room, is that not a breech of your confidentiality? There are many different levels, i agree but you either adhere to the rules or you dont, you need to act within your conscience and i think that this is what thisa nurse has done. I took great offence at your earluier comments and referals to Nazies. Is this how you uphold the name of your profession? You implyed that you're a doctor, is it not a tradition to tell family members patient diagnosis, particularly in terminal cases, is this breach considered as being for the greater good?

http://www.southwaleslibdems.org.uk/news/000638/8500_patients_waiting_over_4_hours_for_ae_treatment_in_unacceptable__peter_black.html

[SeanMacGabhann]

antijen, was it not you who wrote

" In other threads regarding decisions made by individuals who are working with the public/people eg police, army, on expressing my thoughts on this forum, about people who can only follow orders, I've been reminded of Nueremburg,"

That gives Annaj (and anyone else) enough to accuse you of comparing people to nazis surely?

And you are being emotive - you are linking to incidents which are facts! (your exclamation point) but the whole point about being emotive is to overuse facts to make a wider, emotional argument. And using phrases like "who do you think you are?" just because she happens to counter your points with a few of her own is only proving Annaj's point not yours

Anyway, back to the topic. The main reason I'm not signing the petition is because it's pointless. It doesn't matter whether I agree or not - I can go to the petition website and find dozens of arguments I agree wholehearetdly with but I'm not signing any of them. Waste of time. Better of filling inlottery numbers, hope you win the money, then pay the nurses legal bills

[bignumber5]

I've been reminded of Nueremburg

who do you think you are? Accusing me of comparing every one to a nazi that doesnt agree with me

Err... unless you were referencing some obscure case of confidentiality breaching in Nuremburg, what were you doing? Please clarify your stance re: Bavarian ethics in practice before you get all hauty. Perhaps even re-read your own posts as a starting point, although since they make very little sense to me I can appreciate that may not help you much.

As for the rest of the tripe that you're spouting, South Wales being a small country, The NHS being the national health business, and your cracking example of what you think is standard practice in terminal illness but what is, in fact, a major breach of professional ethics... well, I find myself desperately hoping that you are playing a long game of 'avin' a larf. But remembering your similarly ludicrous stand-point on homeopathy, sadly this seems unlikely.

So, back on topic, as 'twere, not signing because don't agree with petition. Not arguing anymore because might get called summat nasty by someone who then denies it on the same page/do not have good enough working knowledge of ethics in the news in Southern Germany (delete as appropriate).

[Keef]

A hospital - Utopia. Love it!

[Sherwick]

It occured to me that it cannot be acceptable for healthcare employees to go through the formal channels of complaint.

This is because the abuse that happens is a failure of leadership and of management, so following an official route to complain to that same leadership or management is likely to lead to delays, obfuscation and even coverup.

Just like not auditing your own work, or the Chinese walls in investment banking between analysis and advice, there needs to be an 'external' channel imho.

For what it's worth, I think antijen brought up Nuremburg not because there was a similar case of confidentiality breaching there, but because of the 'we were only obeying orders' claims made there. I.e. in this case, the nurse was struck off for 'not following due process, which is there for a reason'.

[annaj]

Antijen, I took this this

In other threads regarding decisions made by individuals who are working with the public/people eg police, army, on expressing my thoughts on this forum, about people who can only follow orders, I've been reminded of Nueremburg

to be a reference to nazis, as did most people I would guess, and I was both uspet and offended by it for several reasons.

Now, to try and unravel and answer your points. I think it's very reasonable and healthy to try and avoid EDs wherever possible, after all, as the name suggests they are for Emergencies and most of us hope not to encounter too many emergencies in our life time.

I didn't say that my department is a utopia or that the NHS is perfect, I said that I am proud of the standard of care provided in the department I work in. I know a lot about the inequalities of care in different areas as my specialist training requires me to move around departments in the South East. So, for example, a few years ago I moved from a major teaching hosptial to a an outlying district general with an ED scheduled for closure. The difference in the standard of treatment we were able to offer, due to lack of resources and staff was noticable (although the standard of basic and nursing care was good in both departments) and I did everything that I could on and individual and departmental level to improve that for my patients. Because, of course, I agree that it's unacceptable for the standard of care to be different depending on where in the country you live. But regional inequality in health care, the reasons for it and the solution to it is a completely different debate.

Now, to move on to your example of the family of a dying patient being told their diagnosis. If the patient had expressed a wish for their family to be told, obviously they would be. If the patient had expressed a wish that their family not be told, then they should and would not be told as this would be a breach of confidentiality. If the patient had expressed no opinion either way and was not in a position to do so and the doctor had no reason to believe that the patient wouldn't want their family to know, it would be reasonable to tell the family the diagnosis and prognosis, because it would seem to be in the patients best interest as it is reasonable to assume that most people would want their family to know. But there is not "tradition" amongst doctors of routinely breaching confidentiality of terminally ill patients, far from it, in the context of end of life decisions confidentiality is arguable even more improtant. When a person is facing death one of the few things they can retain control over is their own information and we have a duty to maintain that for them.

As for patients' names being called in a waiting room, well, that's interesting. You are right that strictly speaking it does constitue a breach of confidentiality, as do the patient name boards in wards that are being phased out now, but it is different to the old man being shown in the background of a TV show without his consent. In a clinic the only people who hear the name being called are medical staff and other patients and relatives. It's not ideal, but in terms of exposure, it's a long way from showing pictures of someone on national television. In areas where confidentiality is particualrly important, like the GUM or HIV clinic, patients are called by number not name, and you could argue that this should be done in all healthcare settings.

Now, back to the point. I'm going to say this for the last time now, so please, read carefully. I am not saying that this nurse was wrong to drawn attention to the failure of care that she witnessed. I believe passionately in the rights of all patients to recieve an acceptable standard of basic nursing care. I am saying that confidentiality is an extremely important principle and cannot be tossed aside on the grounds that the ends will justify the means. And I am saying that in this particular case, partly because I don't know all the facts and partly because it's complicated and I just can't decide, I don't know if the breach of ethics was justified or not.

The doctor patient relationship relies entirely on trust and respect. Being a doctor and having people, literally, trust you with their lives is and honour and a piviledge and we owe it to our patients to treat them with respect, dignity and privacy. Without confidentiality and trust the relationship just doesn't work.

[Greegz]

It appauls me to read how oppinionated people can be about a topic when, self admittedly (annaj), they dont know all the facts and have chosen to remain ignorant about it even though the the relevant links and information have been posted in the forum so that they can learn about it and make an INFORMED opinion. It seems to me that if you dont know about the case, you shouldnt comment. As far as I can see, this thread was originally posted to request support for an individual nurse and give everyone the information they need to make an informed opinion. By not doing this and commenting anyway is tantamount to inciting an argument. Of course confidentiality should be upheld whenever possible but in reality, everyone knows it isnt always possible. It should be noted that this petition has the full backing of the Royal College of Nursing, the largest Nursing Union in the UK, it is recognised nationally that a change is needed so signing a petition can hold a lot of weight.

Sherwick seems to be sensible stating "I think antijen brought up Nuremburg not because there was a similar case of confidentiality breaching there, but because of the 'we were only obeying orders' claims made there. I.e. in this case, the nurse was struck off for 'not following due process, which is there for a reason'. The following comments made by bignumber5 seem to be so far removed from reality, that its quite worrying, and downright offensive. If you are calling the current problems in the NHS 'Tripe', have you been walking around with your eyes closed? At least antijen has researched the topic before posting and has provided evidence to back up what she is sayin and not just making wild accusations.

Good on you antijen, I have signed the petition and will pass it on to my friends. Dont listen to the ignorance of uninfomed people. Having a qualfication dosent automatically instill morals and good ethics in people. You have to live with you own conscience at the end of the day.

[Ted Max]

http://www.thriftyfun.com/images/articles11/sockpuppet300x386.jpg

[SeanMacGabhann]

Greegz - posting links doesn't automatically supply all the facts either surely?

What is wrong with admitting you don't know ALL the facts and trying to weigh up the balance of available evidence?

Why be appalled?

[annaj]

*sigh*

Greegz, ignoring the fact that that you registered four minutes after antijen was last online specifically to post on this thread, I'm going to give you the benefit of the doubt and assume that you're not in anyway related to antijen and answer you're accusations (probably against my better judgement since I've been persistently misunderstood, misrepresented and insulted on this thread)

I have read all the links posted, but I still don't consider myself to be in possession of all the facts, because I wasn't at the enquiry and so didn't hear all the evidence presented. The links only provide selectively reported highlights and have all been posted by those who disgree with the panels conclusion and so are inherently biased. Wider research on the case reveals, not surprisingly, a wider range of opinions, some which reflect my own, but none of this gives me the full facts of the case.

I was offended by the Neuremburg reference, because at no point have I said that I, or anyone, should "just follow orders". To say that I have is either to have entirely misunderstood me or it is a deliberate attempt to undermine my argument by alluding to nazis. I think I had every right to be offended by it and to counter it.

I resent being called uninformed when, in fact I am very well informed on the subject of medical ethics, whereas antijens posts are scattered with misinformation, from her original assertion that we all swear the hippocratic oath to the misunderstanding of the issues around end of life confidentiality. I don't consider myself better than anyone else just because I have a qualification, but this is something that I know a lot about and I think it's ok for me to engage in debate about it. I have answered, I think, every point rasied against me with reasonable, rational and well informed arguments and in return I have been insulted and accused of all kinds of things from not caring at all about my patients to reminding antijen of Neuremburg (although, of course, that wasn't calling me a nazi).

I think it's time to walk away from this one. Think what you want of me antijen and Greegz, I'm proud of what I do and the way that I do it and I live quite happily with my conscience.

[antijen]

Annaj That's exactly what youve said, "follow rules", the confidentiallity rule, regardless of you saying earlier "On a personal level I feel deeply saddened that this nurse felt she had no choice, but to take the action that she did and that the system failed so completely to care for it's most vulnerable patients, but was the decision right, I still don't know." Sit with your clear consience, leave others who refuse to follow the rules in your safe little bracket, seperating them from you.

BNF When all else fails look for anything to distract from the topic, how sad you should put a search on my name, does that remind me of anything? Oh yes lets make this nurse the problem and covers the real issues. You've been taught well, I'm sure you will prosper in this so called healing system.

Smg In regards to Nueremberg of couse I was being too confusing for you, who would have thought I thought it was clear enough from my post, (thanks sherwick) I was talking about morals. If only it could be sorted with a lottery win, this womans legal fees will be covered to a point, only after she's been through the appeal system whereas now the union are handling it.

[SeanMacGabhann]

patronising little soul aren't you antijen?

[Administrator]

I can confirm that Greegz and antijen are both posting from the same computer.

[SeanMacGabhann]

hilarious Admin - the keeper of the TRUTH needs to be two people. One person can't handle that much truth

Antijen

I could never be a doctor for the simple reason that if anything were to happen to you which required, say a trip to ER, I would have to fix you up regardless of how patronising, petty, misanthropic, spiteful and wrong you are.

Still, ethics eh???

[Greegz]

As the song goes "IIIIIIIIIIIIIIII got no strings to hold me down...." Nuff said there!

Having a similar opinion to someone does not have to have a genetic link, Doctor. I have been following the case closely and believe there has been a gross miscarriage of justice, and this is not my first link in support of this nurse, just the first on this site. I posted here because the debate appears diverse and interesting, and antijen has raised an interesting disccussion and many others have made some valid points. Obviously you do not care one way or the other

[*sigh*]so why waste your time posting, maybe you should stick to the patient care you state you're so passionate about. The tome of your posts that begin with a sigh have a patronising and slightly condecending air about them, but I'm sure that is not your intention. You say that you were not present so don't know all the facts, I respect that but that has not stopped me researching the case as much as I can and developing an informed judgment, like a lot of people. Nice debating with you, enjoy your walk.

: SeanMacGabhann. Posting of links is just a starter, you can ask for the bill and leave or delve deeper into the menu and find more interesting dishes! I am appauled that passion for a case and topic such as this is met with flipency when there is an admission of not knowing the subject matter, that demonstrates ignorance.

[SeanMacGabhann]

I haven't disagreed with you in anyway about the case oh mult-headed-beast

I merely said signing petitions was a waste of time. It is. But feel free etc

And then you started being OTT in your interactions with others posting so I took agin you,