I manage 8 teams of District Nurses in an outer London borough and this month I decided instead of the usual team meeting to devote this time to reflecting on the importance of Dignity in Care. Together, we watched the NMC series of short films entitled, 'If you don't do something, who will?
In this we are shown 3 scenarios; In the first we meet Joe, a resident in a home for the elderly, being helped in the morning by 2 staff who are chatting across him and not listening to him. We see him being brought downstairs without his glasses, given food he doesn't like and being patronised by a well-meaning kitchen assistant. In the second film a lady visits her midwife with her husband. The midwife has a good rapport with the husband who speaks for his wife as she does not speak English. The Patient is withdrawn and has severe bruising to her arm. The midwife does not act until the phlebotomist raises concerns. When the lady is subsequently seen with a translator she admits to her husband's physical abuse. The third scenario shows a girl with learning difficulties who is clearly terrified at being a hospital patient and unable to cooperate with the necessary investigations. Her mother's concerns and pleas to be allowed to stay with her are rejected by the Ward Sister who feels they are doing their best and the mother should 'calm down and let them do their job'.
We were all quiet for a few minutes after the films and there was an atmosphere of sadness in the room. When discussion started it was felt that none of the staff shown in the scenarios were being deliberately cruel or unfeeling and I, for one admitted to coming across similar situations in my own nursing career. It was also felt that it did not necessarily take more time or require more staff to empathise with people and treat them with dignity. One District Nurse discussed her experience in reporting a situation to the Safeguarding Adults Team, in which an elderly man appeared to be a victim of fraud. It was agreed that although we do not always know the outcome of these investigations that by reporting we are doing what we can because 'if you don't do something, who will'.
I also explained some of our local initiatives which were addressing the outcome of an investigation into the deaths of six patients with learning difficulties who had been admitted to hospital in England for routine procedures. The report had concluded that the patients were the victims of 'death by indifference'. This has led to training in Learning Difficulties for all staff, and a change-agenda under the title of 'Six lives'. The staff at the meeting were surprised to learn that one of these patients died in our local acute hospital.
I distributed the dignity challenge cards to the nurses and feel that the films and discussion afterwards, highlighted the importance of all ten of the challenge points.
If all people involved in nursing or caring for people were mindful of these 10 points, it would naturally lead to safeguarding adults and help to ensure equitable care.
Bernadine Wrobel, DN RGN.
Adult Service Team Leader
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