Seven steps to speaking up about poor practice

It’s never easy to raise concerns about a colleague. But if you witness care that poses a risk to patients, you have a duty to tackle it head on. 

As an RCN member, you're not alone. Learning and development facilitator Rachel Wood explains what to do.

banner read your local policy

Your employer will have a policy which explains the process for raising concerns internally or directs you to an outside specialist body such as Public Concern at Work.

In the first instance, read the policy so you can be sure you’re following the right process. It will tell you who to speak to and what to do if you need to
escalate your concerns.

blue banner seek support asap

From the beginning, ask yourself: “Do I need some help here?” 

You can speak to an RCN rep in confidence to discuss your concerns and seek their expert support and advice. 

This can be invaluable as your rep will ensure you have the correct understanding of your workplace policy and guide you through the right process. 

It’s a good idea to speak to your RCN rep before you approach anyone else.

If you don’t have a rep, don’t know who they are, or don’t feel able to approach them, you can call RCN Direct on 0345 772 6100 for support.

blue banner consider if you can talk to person direct

If your concern is something minor that can be easily resolved, then you could approach your colleague informally.

If you do this, you will need to make sure it’s followed through and results in change. It’s still a good idea to read your employer’s policy and seek support before doing this.

blue banner escalate to more senior colleagues

If the concern is more serious or an informal chat isn’t an option, then your employer’s policy will outline who to speak to and in what order. 

You can also raise a concern in writing and the policy will tell you how.

blue banner keep a log

Make sure that you keep a timeline and record your concerns and notes from any related conversations. However minor, it is important to keep a record as it could escalate at a later date. 

You could also complete a reflection so that you can learn from the situation. But remember, you must maintain patient confidentiality at all times.

blue banner remember your contract duty

Whatever your role, you probably have a contractual duty to speak up if you believe there is a risk to patient safety or public protection. 

Members registered with the Nursing and Midwifery Council (NMC) will also have a professional duty. 

When investigating errors or incidences of poor practice, the NMC may look at whether other staff could have known about these and not reported them. 

It might be tempting to say that you didn’t notice but if you choose to overlook something that results in patient harm, you could find yourself in difficulty with your employer and the NMC.

Challenging something is tough and takes courage. But remember, you’re absolutely doing the right thing and you’re doing what’s expected of you as a member of the nursing profession.

There's no need to feel alone. Seek support from the RCN. 

For more advice...

Read the RCN’s full guide on raising concerns.

You can call RCN Direct on 0345 772 6100. Lines are open 8.30am to 8.30pm, 365 days a year.

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