Support for whistleblowing nurse struck off by NMC

[Sherwick]

Um, annaj, didn't you say earlier today (at 2:37 pm and earlier in the day) that you weren't in possession of all the facts?

May I ask how long do you think it would have taken to pursue all the channels you suggest.

Also, how many more people would have been abused duing that time?

As was pointed out earlier, consent was obtained from all but one individual. Frankly, if it was my gran being abused, I wouldn't have cared if consent was obtained from ANY of them including my gran.

I believe that exposing on Panorama brought a quicker end to this abuse than reporting to the NMC, the Health ombudsman or the police.

Is it necessary to show individuals? I think 'yes' to highlight the abuse that was occuring.

Once again, ensuring patient care trumps confidentiality each and every time for me, but maybe not for you.

Whatever ensured the quickest end to the abuse was the best way to proceed, and I think this was via showing on Panorama.

[Huguenot]

Did it bring 'it' to an end? (whatever 'it' is).

I understood the problem was far less severe and far more pervasive than could be solved with one TV programme?

[annaj]

Sherwick, yes I did say I wasn't in possesion of all the facts, becuase I'm not and neither are you, unless you were at the enquiry, and neither is anyone else on this thread. I am just the only person who seems to recognise that fact. We are all speculating and opinionating.

The rest of your points are your opinion and nothing more and you are entitled to them, but I disgree, and your argument hasn't swayed me any more than mine has you.

But please, stop questioning my professionalism and satndards of care, you have no right to. I have no idea what you do for a living, but whatever it is it would be rude of me to come on here and imply that you were rubbish at it, when I actually knew nothing about you or the job you do. The fact that I respect confidentiality doesn't mean I don't care about my patients and their care and to suggest that it does is most offensive.

[Sherwick]

I never implied that you were or are rubbish at your profession. However, I have every right to question your professionalism (and note, I am not questioning your standards of care and quite a few members of my immediate family are doctors - some pretty senior). The question is, would your standards on confidentiality compromise your care for your patients? To me it seems that they would.

For example, it would seem that you would follow the correct route to lodge complaints EVEN IF this would mean that more abuse would be likely to occur. I say that the morally correct route to take would be the one that led to LESS abuse occuring. Preventing abuse of patients is more important than patient confidentiality in my opinion, and I am entitled to hold opinions (as you say), some of which may question your professionalism.

[annaj]

No, my standards of confidentiality would not, and do not, compromise my standards of care.

If I knew or believed that a patient was being abused I would take action to prevent it, including, if they did not have capacity to consent, breaching their confidentiality if it were the only option.

What I don't agree with in this case is that it was the only option, or that the Panorama programme was the fastest or most effective way to effect change. Ms Haywood started secretly filming in November 2004 and the programme was screened in July 2005. That's eight months. Not that fast at all really. And the screening itself was only the start of change, it then took questions rasied in parliment after the programme before anything happened.

I have duly noted that some of your immediate family are doctors, including senior doctors, thank you. As it happens so are mine, it's a profession that for some reason often runs in families, but I don't see what bearing it has. I am talking about my own experience here, because ethical and confidetilaity decisions are something I face every day. That's why I know the system and the rules.

[Keef]

However, I have every right to question your professionalism

How do you work that out? What gives you the right to question the professionalism of someone you've never met? I don't get that at all.

[Santerme]

It is an extremely interesting debate and one I think which revolves around the distinction between professional obligation and duties and moral obligations and duties.

I had what I consider to be a professional career for 23 years as an Army officer and during that time came across instances of the same dichotomy

I would assume that by entering into the nursing profession one takes on certain defined standards of professional behaviour together with obligations to the employer, a Code of Conduct.

I would argue that taking on a nursing role is not merely a job entered into for financial reward and therefore it can be seen as a moral endeavour.

By and large it is a profession populated by people who want to help others and do good.

I would have thought that one of the obligations incumbent on the nursing profession would be to act in a manner to justify the trust of the public.

I would also have though there is an obligation not to act in a way which causes harm to the patients.

Herein lies the dilemma.

Where does the path diverge from moral obligation to the patient and to the employer.

My take would be at the point where the good of the patient is being compromised by the employer.

My argument would be that nurses obligations to their employers should not be permitted to overshadow the more fundamental duty of care they have towards their patients.

What we seem to have created in our system is a conflict of obligations, in a system which only exists because of it?s patients.

When is it morally acceptable hurting someone by omitting to help them or improving their care?

It seems to me in this instance this person has acted in a way which was for the good of others but which resulted in harm to herself.

I would hope that she had exhausted all internal means of changing the situation and had decided that whistleblowing was the only remedy left.

And if we acknowledge the earlier submission that nurses work for the good of the patient as their prime motivation for entering the profession, it is a laudable moral position and action to take.

Especially, if the sanction taken includes harm to your career.

I think that if this nurse had simply gone for the soft option, of using all internal channels to bring the plight of the patients to light and merely left it at that, then it would seem a logical conclusion a low level of care would persist.

Personally, I do not find her methods of making this neglect evident to the public onerous.

And I think she would have a fairly good case to pursue a claim against her employers, if she had used up all internal mechanisms of complaint, because a medical ethics lawyer could make the case she was being asked to provide a less than adequate level of care, which I would have thought breached whatever code governs the nursing profession in this country.

[annaj]

My argument would be that nurses obligations to their employers should not be permitted to overshadow the more fundamental duty of care they have towards their patients.

But confidentiality is an obligaiton to the patient, not the employer.

Ok, one more link this time to the NMC panel's judgementwhich is extremely interesting (as an aside it would be equally interesting to know how many people on this thread have actually read it)and sets out very clearly why it was a breach of ethics and why the sanction was so strong.

Edited to say that I realise you can get to the judgement linked here either via the link to the NMC website posted on page 1 by antijen or from the piece in the Guardian posted by TedMax, but I thought it might be useful to have it as a separate link so it's easy to find for anyone who's interested. Not that many people are by now.

[Santerme]

The panel has concluded that, for it to be ?essential? for the registrant to breach confidential information, she must first have exhausted all other avenues of addressing the inadequacies on the ward; alternatively there must be an immediate need. So far as the latter is concerned, there was no immediate need since the Panorama programme would not be screened for some time, that is until after the editorial process had been completed.

As to the matter of whether all other avenues had been exhausted, the panel cannot so find. The registrant did not exhaust the process of making representations as to conditions on the ward to management or senior management.

This pretty much cooks her goose as it were.

[Sherwick]

Keef Wrote:

-------------------------------------------------------

> However, I have every right to question your

> professionalism

>

> How do you work that out? What gives you the right

> to question the professionalism of someone you've

> never met? I don't get that at all.

Keef, don't we question the professionalism of people we've never met all the time? Bankers, politicians, accountants auditors (Enron) - the list is endless. I have a right in this instance because my gran is in a care home. Annaj implies that s/he would rather follow due process rather than look out for the healthcare of my gran. (I've asked - albeit in a roundabout way - on many occasions whether going to the media is OK if it stops abuse quicker - the answer appears to be 'no').

[Sherwick]

Santerme, I disagree with the panel's findings. In my opinion, all that the nurse needed was to THINK that going to Panorama would lead to the abuse stopping QUICKER not IMMEDIATELY. It certianly wouldn't have stopped IMMEDIATELY if she had followed due process so why does this immediate need only apply to not following due process? Double and illogical standards.

As for this: "she must first have exhausted all other avenues of addressing the inadequacies on the ward".

ALL other avenues? "ALL"? What rubbish! That could have taken a VERY long time!

Finally this: "The registrant did not exhaust the process of making representations".

THANK HEAVENS FOR THAT!

[JetSetWilly]

i posted at the start of this thread, and have followed it with a certain degree of detachment, watching because yet again someone dares post an alternate view to that of the OP, it descends into personal attack. my original view remains the same she breached the code of conductofthe nmc, regardless whether or not it was the right thing to do,and while her actions may have been honourable, and most likely thought to be so by some members of the panel which struck her off the register, the reason she was struck off the register is because the code was breached and the nmc have to be seen to uphold their standards, and rules, because not to do so sets the prescendent for others. its harsh but the rules are the rules.

[Santerme]

Sherwick Wrote:

-------------------------------------------------------

> Santerme, I disagree with the panel's findings. In

> my opinion, all that the nurse needed was to THINK

> that going to Panorama would lead to the abuse

> stopping QUICKER not IMMEDIATELY. It certianly

> wouldn't have stopped IMMEDIATELY if she had

> followed due process so why does this immediate

> need only apply to not following due process?

> Double and illogical standards.

>

> As for this: "she must first have exhausted all

> other avenues of addressing the inadequacies on

> the ward".

> ALL other avenues? "ALL"? What rubbish! That could

> have taken a VERY long time!

>

> Finally this: "The registrant did not exhaust the

> process of making representations".

> THANK HEAVENS FOR THAT!

Sorry, I fully support her methods, I think morally it was fine, but in the black and white of legalese she has no real defence for her actions.

The sanction, I do feel was unduly severe.

I am afraid my experience of administrators (I spent three labourious years in a staff job in the MOD) is that they find every reason not to make a decision and once forced to, make the one least likely to be contentious or a future danger to their own position.

[RosieH]

Sherwick Wrote:

-------------------------------------------------------

> Keef, don't we question the professionalism of

> people we've never met all the time? Bankers,

> politicians, accountants auditors (Enron) - the

> list is endless. I have a right in this instance

> because my gran is in a care home. Annaj implies

> that s/he would rather follow due process rather

> than look out for the healthcare of my gran. (I've

> asked - albeit in a roundabout way - on many

> occasions whether going to the media is OK if it

> stops abuse quicker - the answer appears to be

> 'no').

Sherwick, I think you're being out of order here - could you please cite where annaj has said she would put due process ahead of the needs of her patients? The point is that in this case the two aren't mutually exclusive - what prevented the nurse getting consent from the people she filmed?

It seems that perhaps this is an emotive issue for you and you seem to be misconstruing what someone has said. I wouldn't for a second suggest that it's deliberate on your part, but I do think that personal attacks are bang out of order.

[Sherwick]

consent was gained from all patients but one I believe.

I don't believe annaj has said that (she would follow due process over patient care), but s/he has, in my opinion, implied this. I believe this because s/he supports the panel's conclusions and punishment.

As I said, most of us question others' professionalism all the time - are they personal attacks? Perhaps they are. The fact is that this is annaj's profession, and I think that the profession has made a serious error (much like bankers/politicians/accountants sometimes do). Since annaj supports this decision, I am questioning her professionalism, and as such, it is a personal attack. There's nothing much I can do about this except keep quiet and say nothing.

[antijen]

Sherwick I think your thread above "It certianly wouldn't have stopped IMMEDIATELY if she had followed due process so why does this immediate need only apply to not following due process? Double and illogical standards." covers a lot of that has been going on in this debate, if you feel passionately about something on this forum,where it differs in this black and white way, whether your a doc, nurse ,patient we can all feel this to be personal,people should be allowed to express what they think, but it has been showed that only applies again with double standards on this forum. There is only so much can be said and it is a choice between whether you feel this issue was fair or not. But I believe it has become with a number of people on this thread much more difficult especially people working in this system, and I sympathise, but I believe it can also be as personal for each of us, expert or not. Trust is a word thats came up again and again, if I need to visit my family and friends in care I've come across staff, time and time again, who refuse to answer my questions of moral dilemas they are often faced with, it always ends going round in circles, caught up in the system springs to mind, but I will certainly continue because I think patients if they wish should be able to ask and talk to people who are treating them about some of the issues raised here, I know I would absolutely want to know if whoever was looking after my mum, what there position would be if faced with abuse. Then maybe there could be a trust.

[Asset]

The nurse in question has been nominated for the Nursing Standard's Patient's Choice Award..

[antijen]

http://nurseawards.rcnpublishing.co.uk/patientschoicepack.asp A link to vote.

[woofmarkthedog]

But was she actually blowing a real whistle whilst on the ward, that would really disturb the patients wouldn't it ?

W**F

[iaineasy]

I also wouldn't say anyone has defended the panel, people have just raised a couple of details that are relevent and worrying.

The question is, do the ends justify the means? In this case I'd say the answer is yes. However, it is a slippery slope, and if everyone decides that they are going to make a judgement call on the confidentiality rules, based on what they think is right, then it's all going to go to sh!t.

-----------------------------------------------

hear hear!

[dulwichmum]

I feel for this nurse, but I do not think that the ends justify the means.

[TE44]

http://news.bbc.co.uk/1/hi/england/8351508.stm