Clinical placements

Every voice should be valued

Escalating concerns after witnessing substandard care made a mental health nursing student determined to uphold his own values and take any criticism on board. 

Escalating concerns after witnessing substandard care made a mental health nursing student determined to uphold his own values and take any criticism on board. 


Speaking out as a nursing student can be intimidating, but it is
important to feel supported enough to do so. Picture: Alamy

During a second-year placement on an inpatient mental health rehabilitation unit I observed two isolated incidents of what I felt to be poor nursing care.

In the first incident, an at-risk falls patient was showered on a chair from the ward’s lounge area, rather than a more suitable designated aide. The chair was returned to the lounge without being disinfected, sparking infection control concerns. In the second incident, a patient’s chronic masturbating in his room was joked about between staff in front of other patients, prompting concerns around dignity and confidentiality. 

I spoke to the charge nurse following both incidents but was told ‘that's how it is’. I was made to feel like an over-eager student who did not understand the ‘real world’ of nursing, and that when I had ‘been in the job a while’ I would not concern myself with such lapses.

I felt the charge nurse did not appreciate that fundamental patient care had fallen below the expected standards, so I reiterated the importance of infection control and patient dignity, citing the Nursing and Midwifery Council code. The code states that nurses should ‘raise and, if necessary, escalate’ any concerns about patient or public safety, or the level of care people receive in the workplace. With this in mind, I contacted my personal tutor at university and a ward matron. 

Investigation 

The university safeguarding team were alerted and a trust investigation was carried out. I had to provide a full written statement to the school of nursing’s adult safeguarding lead and was interviewed by a senior matron, who congratulated me on my courage. 

I was told the ward would be investigated by the trust and that practice would improve as a result, in the offending ward and in the unit as a whole. Although I have received no official update on this, students continue to be sent to the clinical area for placements and none has reported similar issues. 

During the process I did feel conflicted. As a student who was challenging qualified staff with years of experience, I questioned my own authority. But the care I observed had fallen below what should be expected, and I am grateful that my concerns were taken seriously by my tutor, the safeguarding team and the senior matron. I am only disheartened that they were not taken seriously by staff in the first place. 

My actions caused those involved to be put under professional scrutiny. This felt unpleasant, especially as I had been working alongside them, but I followed the NMC code before escalating concerns and feel my actions have helped to safeguard patients. 

This experience has strengthened my resolve to not let my personal and professional values slip, and I will continue to escalate any concerns appropriately. Equally, if I find my own nursing practice criticised or challenged, whether as a student or a qualified staff member, I will be mindful to not disregard others’ opinions. 

Every voice – including that of a nursing student – should be valued. 


Robert is a third-year mental health nursing student

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