Vantage point: Don’t always be a bystander

Why intervening in difficult situations can make a difference to patients and staff.

Why intervening in difficult situations can make a difference to patients and staff

Picture: iStock

Sometimes we tell stories about situations we were unhappy with but where we could not have stepped in to bring about different outcomes. Many of these stories have a common theme: the people telling them were bystanders.

I have decided to pay more attention to these bystander stories and have started to ask the questions: ‘Why don’t we intervene?’ and ‘Why is it okay to say that something is not right after the event rather than when it happened?’

I noticed the other day, for example, a healthcare assistant (HCA) shouting at a patient to try to bring him back into the hospital. The patient was barefooted with an open gown and clearly intent on leaving. Other people were looking on but not stopping to intervene.

The HCA was evidently worried about the patient being outside in his bare feet and wearing only a hospital gown. I asked the patient if I could help and he said: ‘She’s shouting at me and all I want is to smoke my cigarette.’ We reached a compromise; the man would finish his cigarette and return to the hospital, and we would find him some footwear.

Positive outcomes

I suggested to the HCA that she should wait with him so they could return to the hospital together. Both thanked me and I was pleased that, on this occasion, I had decided not to be a bystander.   

What have I learned from this? If you notice something you think should not be happening, ask questions so you can help create a more positive outcome. Try it and see what happens, and you may want to urge others to do the same.

About the author


Geraldine Cunningham is associate director of culture change, Barts Health NHS Trust, London, and a member of the Nursing Management editorial advisory board

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