That this meeting of Congress discusses the impact on nursing, health care and our members when disputes about care decisions attain a high media profile.
There have been a number of high-profile cases recently – and in particular in the last couple of years – involving highly charged, emotive situations. At times such as these, nursing staff find themselves being torn in the roles of supporting families through difficult times and being the target of rage and abuse themselves.
Prioritising people so that they are treated with kindness, respect and compassion is enshrined in the NMC Code. As a workforce we endeavour to achieve this, however there are times when the people we care for, or their relatives, interpret our actions differently, and occasionally these differences can escalate. There is an increasing emphasis on creating partnerships and empowering the people we care for, and while this is to be welcomed, it also has the potential to increase disputes about an individual’s care.
Some such disputes, when not resolved by local teams or arbitration, lead to legal action. This can attract the attention of both the media and the that of other interested parties such as campaign groups.
Recently, there have been some particularly high-profile cases relating to children. These attracted national and international attention, and saw the members involved – and the organisations they worked for – subjected to abuse. There have been other cases where families have disagreed over the provision of dementia care, challenged the level of mental health care provided and the adoption of protocols used during end-of-life care.
The high-profile nature of these cases has led to RCN members being abused on social media, verbally abused as they went to work and, in some cases, threatened with physical harm. Despite the overt public hostility, there was little protection and no opportunity to respond. These situations place nursing staff in a very vulnerable position.
Our nursing workforce is already facing many pressures: poor pay, lack of staff, increases in workload, missed breaks, unpaid extra hours – the list is long and has a severe impact on the health and safety of nurses.
There is an obvious public interest high-profile cases, but the impact such cases have on staff is never told. Working in an environment where the appropriateness of care is questioned can lead to moral distress. The impacts and consequences of these situations can spiral and the risks are real: more highly trained and skilled nurses will leave the profession, and many will simply burn out.
At the moment nursing staff remain silent due to fear of professional misconduct, prosecution or of attracting further abuse. A one-sided debate will never be a true reflection of these issues, and allowing nurses and members to have a voice when important issues are considered by the media is a necessity. While the RCN rightly cannot comment on such cases where it is representing and supporting individual members, as a profession we need to have the freedom and support from our employers and professional and regulatory bodies to engage in public debate. We need to know that we will not be hounded by the bureaucracy for advocating for patients and their families or by the media for voicing an alternative view.