“Speak the truth, even if it makes your voice shake” Unknown
Yesterday I attended my penultimate lecture as a student nurse, the countdown to qualification has begun. Its flown. My journey so far brings tears to my eyes as a write for so many reasons, the current work load and stress probably driving, but ultimately my pride in what I do being at the forefront. My gosh I am a lucky girl.
So anyway, back to the lecture. Imagine the setting, half filled lecture theatre adorned with distressed and emotionally fraught faces; student nurses trying to find the motivation to complete dissertations, all of us at times forgetting why we started this. So todays lecture was in fact a debate ‘Whistleblowing ‘ . The tension and passion is high, I shoot a look to my esteemed and equally as passionate colleagues, wink at Leanne…we’ve got this! Our team is presenting the negative impacts and associations of when nurses raise concerns professionally; that may or may not lead to formal whistle blowing procedures.
Whistleblowing is a hard topic to debate. Although geared up to show we are well read and conversed with the negative implications surrounding this subject, in our hearts we are so very nearly nurses, in fact we have been all along. We know our responsibility along the journey of students to newly qualified. We know our code of conduct. In fact I live and breath mine. And yet we are to debate the difficulties of speaking up, of saying “that is NOT ok” , “that is NOT safe” and unfortunately at times “It’s not OK to treat me like that”. And yet from our short time within health care settings, we have ample lived experience that in fact Whistleblowing is everything but easy.
I myself have personal experience of raising concerns. Professionally the amount I can divulge is minimal. I am bound to protect my patients confidentiality, the Trust’s and universities reputation and my professional body. So I will keep the detail brief and focus instead on the implications that speaking out had on me as a person.
I have raised concerns in practice twice, once within nursing and once within other health care settings. The first time, outside of nursing, for patient negligence and my own bullying and harassment. I must be clear, I am a strong, confident and independent woman. I hold my head high and my shoulders back. I consider what I say, the impact that it may have and above all, MY PATIENTS. I have found that this approach makes me a well received student with the right people and incredibly unpopular with the wrong ones. So when thrown into an ‘if your face fits’ culture, quite frankly they annihilated me. I was ‘brought down a peg or two’, ‘reminded where I sat in the food chain’ and emotionally broken down to make me compliant.
This strong confident woman could no longer lift her head, make eye contact or at times speak without crying. However, upon seeing select patients subject to similar behaviour, the advocate in me and what I now know to be ‘The Nurse’ found her voice, stood up and screamed at the top of her lungs “THIS IS NOT OK…YOU CANT NOT AND WILL NOT TREAT ME OR MY PATIENTS LIKE THIS”. None of my complaints were new ones. The cultural issues had been long lived. Feeble promises were made with the intentions of resolutions. Ultimately I may as well have been shouting at a brick wall. I was left isolated and abandoned. Near to a nervous break down. But…the embers of that fire remained.
18 months later I witnessed patient abuse. Knowing what I did you would think that I would have thought twice, don’t get me wrong, for a Nano-second I did and boy did it bring back the emotions. The isolation, the fear, the self questioning. But…I reported them to a senior nurse that didn’t care and didn’t hide it. I received some support during the investigation, which quickly stopped at the point I asked “who do I come to if there are repercussions?”….silence. I have to say though a few individuals were in fact amazing and got me through it in one piece. The events and consequences were less hard hitting this time.
It was the second time that I learned the lesson. I am responsible for me, I am responsible for my patients, I am responsible for complying with my code. A code that when I first read it I genuinely welled up with pride, because…why would I NOT want to display those ethics and morals? When I read the code I knew I has found my flock, I’d just been a bit lost before. So having been through the processes of highlighting poor practice twice I leaned I can only be responsible for me. The trick is to do what we need to and move on. Unapologetic and unmoved in my own moral compass.
Following the second incident I arrived at my next placement to a sneered and mildly threatening greeting from a member of non-nursing staff of “you’re that student that made the complaint” to which I replied “yes that’s me, I’ve arrived…tell your friends”. After a few clipped comments the team moved on, they never accepted me but they accepted that their opinion of me clearly didn’t matter to me and they saw through my practice that my patients were my only focus.
Back to the lecture….
My peers expressed similar concerns, all leading back to culture. Our experiences concluded that throughout our training we have been repeatedly inspired by fantastic nursing care, amazing mentors and inspirational members of the MDT. Yet we have also been thrown into ingrained cultures of demotivation, that focus on everything but the well being of anyone frankly.
Our debate got heated, we scorned the panel who presented that we must be the change, we would be supported. That the health secretary Mr Hunt ( I will not use his first name, we are yet to be friends), is putting into place further measures, to support raising poor practice. Following the debate I later read his speech…he is growing on me. We were frankly exacerbated. Exacerbated because there is an elephant in the room. That elephant being that our culture needs the kindness, compassion and respect that the NMC commands of us. Not only to our patients but to each other as health care professionals. We need to politely and consistently give and request respect. We need clarity in our communication with each other on our expectations, encouraging two way constructive feedback. Making raising concerns directly with each other common place and the first thing we should do.
“So what are you going to do about it Naomi?” asks Bridget our module lead.
“I’m going to blog, I’m going to raise awareness, I’m going to consistently raise my concerns!”
The concept of social media and an open forum immediately spread a look of panic across the panels face. I am bombarded (quite rightly) with the list of considerations, confidentiality, professional conduct etc. And naturally I have already made these considerations. But I will not be perturbed. Because we are debating that there is a problem and as students we’ve already conclude that culture has not changed over three years of our training. So what IS the solution?
WE are the solution. Every Nurse, Every student, every living breathing soul that makes contact with our patients, across the MDT. Once again, it comes back to kindness. Kindness, compassion and respect. Of our patients and each other as professionals. It comes back to ‘working co-operatively’. It comes back to being the change that we wish to see within healthcare and treating our patients how we would want our loved ones to be treated. It really is that simple. So how about this, we stop talking about it, we stop debating it, we stop making excuses that work constraints and time don’t allow a positive and supportive cultures and we just focus on being good people. Holding each other up. How about we stop giving power to policy makers and we take it back, because we don’t need models or policy to make the difference that needs to be made. WE control out culture, yes US! We make our culture. So lets make a change.
Dedicated to ‘The Brave’, to those of us who stood up spoke the truth and will continue to do so until we run out of breath. We’ve got this and we are enough to make a difference.