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News Article
Scandal of rogue nurses free to work on NHS hospital wards
Patient Safety Learning posted a news article in News
Scores of potentially dangerous nurses and midwives could be working in the NHS and putting patients at risk as their cases sit in a growing backlog of misconduct, Hundreds of accusations against staff are being progressed without a full investigation, a Nursing and Midwifery Council (NMC) whistleblower has alleged, risking false sanctions or rogue nurses being wrongly cleared if the cases collapse. Overall there are more than 1,000 outstanding cases against healthcare staff for a hearing, including 451 that have not even been allocated a lawyer to vet. In 83 of the more serious allegations, the accused staff have been put under restrictions but could still be working with patients. The NMC whistleblower has claimed the figures expose a hidden backlog of “under-investigated” allegations, with 451 cases against nurses and midwives still needing to be reviewed by lawyers. These could include nurses who are innocent but are awaiting a hearing, with one “stuck in the void” for eight years, the source added. The whistleblower whose allegations prompted The Independent’s investigations has raised repeated concerns to the Professional Standards Authority (PSA), which regulates the NMC, over the hidden backlog, which was only uncovered through a freedom of information request. However the PSA has not used its powers to trigger a review. The whistleblower warned the public is being left at risk of harm, while nurses and midwives could face miscarriages of justice. “The NMC’s desperation to hide these figures has caused it to make dangerous decisions including creating a surge team of colleagues from across the organisation to review these cases with only minimal training,” the whistleblower said.“It is proposing to mass outsource these reviews to a firm of lawyers who have never undertaken this kind of work before.” Read full story Source: The Independent, 3 March 2024 -
Content ArticleThis descriptive and cross-sectional study in the Journal of Patient Safety aimed to examine the impact of nurses’ fear of Covid-19 on their nursing care behaviour during the pandemic. 450 nurses providing one-on-one care to Covid-19 patients between January and March 2021 took part in the study. The results showed that nurses providing care to patients during the pandemic feared Covid-19, that their care behaviours were generally at a good level, and that the care behaviours of nurses with a high degree of fear were negatively and significantly impacted.
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Content Article
A silent safety scandal: A nurse’s first-hand account of a corridor nursing shift
Anonymous posted an article in Florence in the Machine
Corridor nursing is increasingly being used in the NHS as demand for emergency care grows and A&E departments struggle with patient numbers. In this anonymous account, a nurse shares their experience of corridor nursing, highlighting that corridor settings lack essential infrastructure and pose many safety risks for patients. They also outline the practical difficulties providing corridor care causes for staff, as well as the potential for moral injury. Using the System Engineering Initiative for Patient Safety (SEIPS) framework, they describe the work system, the processes and how that influences the outcomes.- Posted
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Content Article
This is part of our series of Patient Safety Spotlight interviews, where we talk to people working for patient safety about their role and what motivates them. Kevin talks to us about the role research plays in improving staff and patient safety. He explains how his own research has uncovered the extent of violence experienced by student nurses and the underreporting of sharps injuries among healthcare students. He also highlights how research can help universities improve awareness of issues facing students across all healthcare courses and provide more effective support. -
Content ArticleStudies have reported evidence on sharps injuries among nursing, medical and dental students but little is known about the amount, type and causes of sharps injuries affecting other healthcare students. This narrative review aimed to identify the extent, type and causes of sharps injuries sustained by healthcare students, especially those not in nursing, medicine or dentistry. The review highlights that some groups of healthcare students, including those studying pharmacy, physiotherapy and radiography, sustain sharps injuries from similar devices as reported in research on such injuries in nursing, medical and nursing students. Sharps injuries happen in a range of healthcare environments, and many were not reported by students. The main cause of a sharps injury identified was a lack of knowledge.
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News Article
NHS nurses being investigated for ‘industrial-scale’ qualifications fraud
Patient Safety Learning posted a news article in News
Hundreds of frontline NHS staff are treating patients despite being under investigation for their part in an alleged “industrial-scale” qualifications fraud. More than 700 nurses are caught up in a potential scandal, which a former head of the Royal College of Nursing said could put NHS patients at risk. The scam allegedly involves proxies impersonating nurses and taking a key test in Nigeria, which must be passed for them to become registered and allowed to work in the UK. “It’s very, very worrying if … there’s an organisation that’s involving themselves in fraudulent activity, enabling nurses to bypass these tests, or if they are using surrogates to do exams for them because the implication is that we end up in the UK with nurses who aren’t competent,” said Peter Carter, the ex-chief executive of the RCN and ex-chair of three NHS trusts. He praised the Nursing and Midwifery Council (NMC) for taking action against those involved “to protect the quality of care and patient safety and the reputation of nurses”. Nurses coming to work in the UK must be properly qualified, given nurses’ role in administering drugs and intravenous infusions and responding to emergencies such as a cardiac arrest, Carter added. Forty-eight of the nurses are already working as nurses in the NHS because the NMC is unable to rescind their admission to its register, which anyone wanting to work as a nurse or midwife in Britain has to be on. It has told them to retake the test to prove their skills are good enough to meet NHS standards but cannot suspend them. The 48 are due to face individual hearings, starting in March, at which they will be asked to explain how they apparently took and passed the computer-based test (CBT) of numeracy and clinical knowledge taken at the Yunnik test centre in the city of Ibadan. The times recorded raised suspicions because they were among the fastest the nursing regulator had ever seen. Read full story Source: The Guardian, 14 February 2024 -
Content ArticleThere are many unheard and under-acknowledged voices and perspectives in the health and social care workforce, and they usually belong to those in the most junior, poorest-paid and precarious roles. All these voices deserve more attention than they get, but those of newly qualified and registered nurses and midwives are especially important given the current retention crisis in both professions. Since spring 2023, the King's Fund have been working with 22 newly qualified - newly registered if they trained internationally – nurses and midwives on a project called Follow Your Compassion. A documentary record of the everyday working lives of these nurses and midwives across a variety of settings across the UK health and care system, the project is a companion piece to The Courage of Compassion (2020), a report by The King’s Fund and RCN Foundation which described the core workplace needs of nurses and midwives, and what must be done to meet them.
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News ArticleA nurse whistleblower has described her eight years of hell as she fights the NHS over its failure to properly investigate claims she was sexually harassed by a colleague. Michelle Russell, who has 30 years of experience, first raised allegations of sexual harassment by a male nurse to managers at the mental health unit where she worked in London in 2015. Years of battling her case saw the trust’s initial investigation condemned as “catastrophically flawed” while the nursing watchdog, the Nursing Midwifery Council, has apologised for taking so long to review her complaint and has referred itself to its own regulator over the matter. With the case still unresolved, Ms Russell will see her career in the NHS end this week after she was not offered any further contract work. Speaking to The Independent she said: “If I’m going to lose my job, I want other nurses to know that this is what happens when you raise a concern. I want the public to know this is what happens to us in the NHS when we are trying to protect the public. “I have an unblemished career. They’re crying out for nurses. I’ve dedicated my life to the NHS. I haven’t done anything wrong.” Read full story Source: The Independent, 6 February 2024
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Content ArticleThis article in the Nursing Times explores reflective practice in community nursing, focusing on a stressful incident in which a patient who had not been contactable during a home visit was later found to have died. The article emphasises the necessity of structured reflection, utilising Rolfe’s reflective model, to explore nurses’ feelings. It delves into the model’s stages, its impact on critical thinking and guiding reflection through questions, and highlights the importance of reflective practice, emphasising its role in learning, professional development and improving patient outcomes. The article concludes by showcasing the successful implementation of a new model and its positive impact on patient safety in home visits, providing a structured approach for nurses and health professionals.
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Content ArticleIn this animation, the Nursing and Midwifery Council (NMC) look at speaking up and what this means for you as a registered professional.
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Content Article
Top picks: Nurses championing patient safety
Patient_Safety_Learning posted an article in Nurses
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Nurses are at the forefront of health and social care delivery. Often they are also leading, championing and driving change for patient safety. In this edition of our ‘Top picks’ series we celebrate some of the amazing work nurses are doing to prevent avoidable harm and improve patient and staff experience. The examples below include blogs, interviews and practical improvement projects. They have been shared with us by members of the hub, a global community of people passionate about patient safety. You can sign up to the hub here, it’s free and easy to do. -
News Article
Letby inquiry: Former nurse director among ‘core participants’
Patient Safety Learning posted a news article in News
The former nursing director at the hospital where Lucy Letby murdered seven babies will be among the 'core participants' of the Thirlwall Inquiry. The inquiry, chaired by Lady Justice Thirlwall, will investigate how Letby was able to commit the murders and attempt six others while she worked as a neonatal nurse at Countess of Chester Hospital NHS Foundation Trust in 2015 and 2016. This week, Alison Kelly, who was director of nursing and quality at the trust during the time of Letby's crimes, was announced as 1 of 10 core participants in the inquiry. Also named were former Countess of Chester chief executive Tony Chambers, former medical director Ian Harvey and former human resources director Sue Hodkinson. Ms Kelly and Mr Harvey were among the senior staff at the trust who were accused of failing to act when clinicians first raised concerns about Letby. How managers responded to such concerns is one of the areas due to be investigated by the Thirlwall Inquiry. A number of organisations are also on the list as core participants, including the Nursing and Midwifery Council (NMC), NHS England, the Royal College of Paediatrics and Child Health, the Department of Health and Social Care and Countess of Chester itself. Read full story Source: Nursing Times, 3 January 2024 -
Content ArticleChildhood immunisation is a critically important public health initiative. However, since most vaccines are administered by injection, it is associated with considerable pain and distress. Despite evidence demonstrating the efficacy of various pain management strategies, the frequency with which these are used during routine infant vaccinations in UK practice is unknown. This study aimed to explore primary care practice nurses’ use of evidence-based pain management strategies during infant immunisation, as well as barriers to evidence-based practice.
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Content ArticleThe Royal College of Nursing (RCN) held its first ever safe staffing summit, bringing together global nursing workforce experts with senior nurses across the UK to agree a vision for the future and how to fight for it. When there are too few nursing staff, they can be stretched dangerously thin. With tens of thousands of vacant nurse posts across the UK right now, this happens too often. The summit heard compelling evidence about the impact of safe nurse-to-patient ratios, set in law in other countries, where there are limits on the number of patients one nurse can safely care for. Nicola Ranger, RCN's Chief Nurse, reflects on the outcome of the RCN’s first ever safe staffing summit.
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News Article
NHS nurses suffering shocking violence from patients, senior nurse warns
Patient Safety Learning posted a news article in News
Nurses are being put in increasing danger from shocking levels of violence and aggression by patients, a senior nursing leader has warned. Prof Nicola Ranger, the Royal College of Nursing’s (RCN) director of nursing, said the crisis in the NHS had fuelled bad behaviour by patients frustrated by worsening delays for treatment since the Covid pandemic. Ranger said the situation was contributing to an exodus of nurses from the NHS, amid a vicious cycle of staff shortages and rising violence. This meant that there were often not enough nurses on duty to keep colleagues safe, she added. Calling on the government to make tackling the abuse of nurses a priority, Ranger said there was a sense of despair in the profession about their deteriorating working conditions. “I think the public would be totally shocked if they knew how common it is for nursing staff to be on the receiving end of violence and aggression at work,” said Ranger. “Nurses are put in jeopardy, it’s become all too common for them to be threatened by patients on shift. “We genuinely have got a nursing crisis in the UK that doesn’t seem to be being acknowledged by our government at all. Being spat at, being hit, being punched, can for some nurses just literally be the final straw." Read full story Source: The Guardian, 1 January 2024 -
News Article
Blackpool nurse and colleague jailed over drugging patients
Patient Safety Learning posted a news article in News
An "evil" nurse who drugged patients on a stroke unit for an "easy shift" and a healthcare worker who conspired with her have been jailed. Catherine Hudson, 54, was found guilty of giving unprescribed sedatives to two patients at Blackpool Victoria Hospital in 2017 and 2018. She was also convicted of conspiring with Charlotte Wilmot, 48, to give a sedative to a third patient. Hudson was jailed for seven years and two months. Wilmot was sentenced to three years. Evidence during the trial highlighted the "dysfunctional" drugs regime on the stroke ward with free and easy access to controlled drugs and medication which led to "wholesale theft" by staff. Prosecutors described it as a "culture of abuse" after police examined WhatsApp phone messages between the co-defendants and other members of staff. The pair were investigated after a student nurse witnessed events while on a work placement on the stroke unit and told senior managers in November 2018, who called in police. The whistleblowing nurse, who the prosecution had asked not to be named, told officers she had concerns over the use of insomnia medication Zopiclone, which can be life-threatening if given inappropriately. She said Hudson had told her the patient had a Do Not Resuscitate Order in place "so she wouldn't be opened up if she died or... came to any harm". Read full story Source: BBC News, 14 December 2023 -
News ArticleAn overworked nurse who failed to give medication to a patient told a colleague “I don’t care anymore”, a hearing was told. Niall O’loingsigh was lead nurse in the Avon unit within the Charterhouse Care Home in Keynsham, Somerset, which looks after elderly residents and those with dementia. In 2020 a complaint was made by a colleague about him breaching safe medication management protocols and being dishonest in relation to medication administration. A misconduct hearing at the Nursing and Midwifery Council was told later, in May 2021, he was seen behaving in an “unsupportive manner” and told a colleague: “I don’t care anymore”. The panel also heard how on 18 May 2021, Mr O’loingsigh failed to record he had administered medication to three residents, BristolLive reported. A colleague wanted to report Mr O’loingsigh’s conduct, in which Mr O’loingsigh patted her on the back and said “well done mate, you did the right thing but I may lose my PIN though”. Mr O’loingsigh told his colleague of feelings of distress and anxiety about being reported and its impact on his career, but he wanted to reassure her. The colleague however felt “uncomfortable”. The panel found that he underwent “a course of conduct which put patients at risk of suffering harm at the time of the incidents” and noted “there were repeated failures over a period of time”. Read full story Source The Mirror, 10 December 2023
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Content ArticleThe COVID-19 pandemic highlighted systemic weaknesses in the healthcare system. This survey of 3,067 registered nurses working in New Jersey used the Donabedian framework to identify challenges related to providing safe care during the pandemic. Respondents identified several organisational factors, including inadequate resources and staffing, which adversely impacted their ability to adhere to patient safety and infection prevention and control protocols during the pandemic.
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Content ArticleFollowing on from the care failures highlighted in the 2021 report, 'No one's listening', the Sickle Cell Society have published a new report taking a deeper look at sickle cell nursing care. The findings show the need for vastly more resources, training and support in this critical area of care. The report highlights that not only is no-one listening, but that lives are still being put at risk.
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Content Article
Thirlwall Inquiry
Mark Hughes posted an article in Other reports and inquiries
The Thirlwall Inquiry has been set up to examine events at the Countess of Chester Hospital and their implications following the trial, and subsequent convictions, of former neonatal nurse Lucy Letby of murder and attempted murder of babies at the hospital. This website provides information about inquiry team, terms of reference and publications relating to this. -
News ArticleThe public inquiry into the Lucy Letby murders will seek changes to NHS services and culture next year despite the fact that formal hearings are likely to be delayed until the autumn. Inquiry chair Lady Justice Thirlwall will issue an update message later today. In it she will stress the inquiry will “look for necessary changes to be made to the system of neonatal care in this country in real time and at the earliest opportunity, avoiding delays in making meaningful change”. HSJ understands Lady Thirlwall will look to agree on some changes, based on the inquiry’s evidence gathering and discussions with the sector before it begins oral hearings – which are unlikely to start for at least a year due to ongoing legal action. Lady Thirlwall will say the legal constraints mean its early work will focus on the experience of families who were named in the cases already heard; and “on the effectiveness of NHS management, culture, governance structures and processes, as well as on the external scrutiny and professional regulation supposed to keep babies in hospital safe and well looked after”. She said, “I want this to be a searching and active inquiry in the sense that it will look for necessary changes to be made to the system of neonatal care in this country in real time and at the earliest opportunity, avoiding delays in making meaningful change”. Read full story (paywalled) Source: HSJ, 22 November 2023
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Content ArticleUS healthcare organisations continue to grapple with the impacts of the nursing shortage—scaling back of health services, increasing staff burnout and mental-health challenges, and rising labour costs. While several health systems have had some success in rebuilding their nursing workforces in recent months, estimates still suggest a potential shortage of 200,000 to 450,000 nurses in the United States, with acute-care settings likely to be most affected.1 Identifying opportunities to close this gap remains a priority in the healthcare industry. This article highlights research conducted by McKinsey in collaboration with the ANA Enterprise on how nurses are actually spending their time during their shifts and how they would ideally distribute their time if given the chance. The research findings underpin insights that can help organizations identify new approaches to address the nursing shortage and create more sustainable and meaningful careers for nurses.
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Content ArticleA substantial barrier to progress in patient safety is a dysfunctional culture rooted in widespread disrespect. Leape et al. identify a broad range of disrespectful conduct, suggesting six categories for classifying disrespectful behaviour in the health care setting: disruptive behaviour; humiliating, demeaning treatment of nurses, residents, and students; passive-aggressive behaviour; passive disrespect; dismissive treatment of patients; and systemic disrespect. At one end of the spectrum, a single disruptive physician can poison the atmosphere of an entire unit. More common are everyday humiliations of nurses and physicians in training, as well as passive resistance to collaboration and change. Even more common are lesser degrees of disrespectful conduct toward patients that are taken for granted and not recognised by health workers as disrespectful. Disrespect is a threat to patient safety because it inhibits collegiality and cooperation essential to teamwork, cuts off communication, undermines morale, and inhibits compliance with and implementation of new practices. Nurses and students are particularly at risk, but disrespectful treatment is also devastating for patients. Disrespect underlies the tensions and dissatisfactions that diminish joy and fulfilment in work for all health care workers and contributes to turnover of highly qualified staff. Disrespectful behaviour is rooted, in part, in characteristics of the individual, such as insecurity or aggressiveness, but it is also learned, tolerated, and reinforced in the hierarchical hospital culture. A major contributor to disrespectful behaviour is the stressful health care environment, particularly the presence of “production pressure,” such as the requirement to see a high volume of patients.
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News Article
Nursing watchdog to miss target to cut soaring complaints backlog
Patient Safety Learning posted a news article in News
The nursing watchdog will miss its target to tackle a 5,500-case backlog of complaints as referrals hit a record high. The Nursing and Midwifery Council NMC has admitted it won’t hit its pledge to cut the number of unresolved complaints against nurses and midwives to 4,000 by March 2024. The news comes as it faces questions over the way it handles complaints after The Independent revealed a number of serious allegations, including poor investigations that have led to fears of rouge nursing going unchecked. The newspaper exposes have prompted two independent reviews. Details of the first two reviews have been revealed for the first time and will look at: The NMC’s response to whistleblower concerns, including whether they were treated fairly and whether it acted fairly and reasonably. Any evidence of cultural issues which may have impacted the NMC’s response to whistleblowing. Whether concerns raised are substantiated and indicate a decision-making process by the NMC which is insufficient in protecting the public. Evidence of shortcomings in guidance and training. The senior whistleblower whose evidence prompted the review said: “The NMC has refused to change its approach to the investigations into my whistleblowing concerns to allow me to share and explain my evidence without fear of reprisal. I don’t think it is possible to draw safe conclusions about either how I have been treated or the impact of our culture on case work from reviewing only 13 of our current 5,500 open cases, and 6 closed cases and a selection of my emails.” Read full story Source: The Independent, 16 November 2023 -
Content ArticleThis article in the British Journal of Anaesthesia argues that the criminalisation of medical accidents leaves clinicians scared to report systemic causes and contributors to bad outcomes, removing a foundational pillar of patient safety. Looking at the case of RaDonda Vaught, a nurse who was found guilty of criminally negligent homicide for a fatal medication accident, the authors highlight the need to move away from seeing adverse incidents in healthcare as being easily avoided through greater attention, trying harder or adherence to rules. They call on healthcare organisations to learn from the case and argue that healthcare systems need to be collaboratively redesigned with a systems perspective.
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