Riots: nursing staff can refuse to treat racist or violent patients
Posted 07 August 2024 - 11:38
Updated RCN guidance states staff may withdraw care where they feel threatened, but only after consulting their manager and following local protocols
Nursing staff have been reminded they can refuse to treat racist or violent patients in certain situations, amid concerning scenes of riots and violence in parts of the UK this week.
The RCN has updated its guidance on withdrawing care following reports of nursing staff from overseas being attacked or feeling threatened in recent days. Two Filipino nurses who were pelted with stones during a riot in Sunderland at the weekend.
Consider your rationale for withdrawing care
The guidance states: ‘If you find yourself in a situation where you consider you may have to withdraw care you should consider your rationale for taking such action very carefully.’
The RCN adds situations where there is fear of physical violence, or discriminatory behaviour, including racism ‘may justify a refusal to treat, the withdrawal of care or the finding of an alternative’.
Some nurses from overseas have said they plan to leave the UK because of the situation. Belfast Health and Social Care Trust told the BBC it knows about ten nurses from overseas who say they will be leaving Northern Ireland.
And a nurse from India told the BBC: ‘I’m not going out, I’m working, and we are all frightened. We can’t go out shopping. It's scary to go out with children. It’s really terrifying. When my contract is finished, I will go back to my country.’
South Asian nurses ‘afraid and appalled’ by scenes of violence
Rohit Sagoo, founder of British Sikh Nurses, which addresses the health and well-being of the South Asian community in the UK, said nurses from all parts of that community were ‘afraid and appalled’ by the violence.
‘Some international nurses are scared and surprised as they have not expected this behaviour in the UK,' he added. 'We must ensure that our diverse and international nurses are protected and safeguarded from acts of racism.’
Mr Sagoo praised nursing leaders for highlighting support strategies, including the option to refuse care.
NHS staff ‘can and should’ turn away patients who display racism
There has been an outpouring of condemnation for the violence that followed the murder of three children in Southport last week, as well as support from nursing and healthcare leaders for staff from minority ethnic backgrounds.
England’s health secretary Wes Streeting said patients who are racist to to NHS staff ‘can and should’ be turned away from care.
Nursing employers should act urgently to ensure safety of staff
RCN general secretary Nicola Ranger said: ‘I’ve been horrified in the last week to see the appalling scenes across the country. We have updated the RCN’s guidance on when and how our members can refuse to treat a patient. This is the most difficult decision and every situation and patient interaction is unique.
Professor Ranger said employers have a duty of care to keep staff safe at work and said organisations should take urgent action to reassure nursing staff, review risk assessments and implement safety measures.
Messages of support for NHS staff on social media
Chief nurse for adult social care in England Deborah Sturdy was among a number of healthcare leaders to post their support for staff on social media:
On X, North Bristol NHS Trust chief nursing officer Steve Hams wrote a ‘message of solidarity’ to the ‘2,140 global majority nurses, midwives and care staff’ in his organisation.
‘We have over 200 nationalities represented in our NHS,’ he wrote. ‘We are a vibrant and beautiful mix of heritage, cultures, religions and languages, the very essence of what makes us one team.’
Refusing to care for a patient: actions to take
- Consult your manager and make any concerns known verbally and in writing as soon as possible
- Follow agreed protocols and workplace policy
- Consider the need for risk assessment
- Make an accurate record of the decision to refuse to treat so you can justify your actions later
- Consider the NMC Code and your duty of care
- Keep a copy of all documentation and record of dates of meetings and discussions
- Consult the patient and, if appropriate, their family
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