Nursing student takes on modern slavery and trafficking
Louise Cahill was highly commended in the prestigious RCNi Nurse Awards 2017 for her work training students and qualified professionals and raising awareness of the growing but often unseen problem of modern slavery and human trafficking
Nursing student Louise Cahill was instrumental in developing a tool that helps health professionals identify and respond to victims of modern slavery and human trafficking.
The third-year adult nursing student at the University of Hertfordshire has also written a training session for nursing students that she has presented at universities across the country.
‘My goal is to ensure all nurses know the signs of modern slavery and how to respond,’ says Louise.
Meeting a slave
She first became concerned about the plight of people forced into slavery or trafficked while she was volunteering at a refugee centre. One of the refugees told her she was the happiest she could remember being.
‘She told me she had previously been a slave, and no matter how bad I thought her situation was now, it was always better than her past,’ Louise recalls. ‘I was shocked. How could someone be a slave in the 21st century?’
Louise started volunteering for charity StopTheTraffik, and after beginning her degree she attended a lecture by the anti-slavery commissioner, a role created by the 2015 Modern Slavery Act. ‘I began to realise that the criminal aspect of human trafficking was of greater focus than victims’ health.
‘In clinical practice I always ask nursing staff what they know, if they have seen trafficking, and what they would do if they came across it. Very few knew even the basics for identifying potentially trafficked persons.’
‘I realised that as a nursing student I did not need to wait for change, I could be the change’
She realised that nursing students, with their placements across a trust, could share knowledge about identifying and supporting potential victims, and this could be a cheap and effective way of raising awareness throughout the trust.
‘I realised that as a nursing student I did not need to wait for change, I could be the change,’ she says.
She won first place in the London Network of Nurses and Midwives in Homelessness Conference academic poster competition with her poster Human Trafficking and Health: A Role for Student Nurses.
‘It was during my research for this presentation that I developed the Communicate, Document, Escalate guide (see box). I then wrote an interactive training session for nursing students and contacted universities offering to deliver it.’
So far Louise has spoken to almost 2,000 students at various universities. She has extended the invitation to medical students. ‘We are one big team and we need to reach everyone.
‘As students, it is about getting the right help and knowing that it is okay to listen to your gut feeling and that you shouldn’t ignore your suspicions. It’s okay to speak to the safeguarding nurse and bring people in while your patient is there to engage.’
She started training qualified midwives and nurses, and after a session at a London trust one midwife contacted Rahab – a charity founded in 2009 to care for women affected by prostitution and human trafficking for sexual exploitation – as she had identified an expectant mother who fitted the profile. The woman had been trafficked, and was supported by the trust and charity.
‘We felt that having something quick and easy to hand would provide all NHS staff with a way to reference their instincts that something didn’t feel right’
Louise co-authored the tool to help professionals identify victims of slavery after meeting Imperial College Healthcare NHS Trust’s named midwife for safeguarding Anna Robinson following a presentation to midwives.
‘We felt that having something quick and easy to hand would provide all NHS staff with a way to reference their instincts that something didn’t feel right. We swapped information and started meeting up weekly.’
The tool, called the Modern Slavery Wheel, is based on the domestic violence power and control wheel.
Louise and Anna are part of an informal, voluntary team of NHS, charity and local authority partners who developed training to be used alongside the tool. The training includes an interactive workshop, guidance on how to speak to potential victims and a referral pathway.
‘NHS England funded our production of the wheel but we then developed training for front-line staff and are delivering it across Imperial and Chelsea and Westminster Hospital NHS Foundation Trust, targeting four areas – A&E, outpatients, sexual health and maternity,’ says Louise.
‘We are now running this training as a research project with the aim of seeing what knowledge is out there across these two trusts and whether training and tools can help improve identification and outcomes for patients.’
Louise was highly commended in the Andrew Parker Student Nurse category of the RCN Nurse Awards 2017, the profession’s top accolade. The judges praised her work as ‘terrific, brave and timely’.
‘Louise has addressed an important subject with this work. She has made so much progress and is clearly committed and hugely enthusiastic’
RCN Fellow Jane Denton was on the judging panel. She said: ‘Louise has addressed a very important subject with this work. She has made so much progress on her tool already and is clearly very committed and hugely enthusiastic.’
Deputy director of nursing at Public Health England Joanne Bosanquet said the tool had the potential to be rolled out across the health system and noted that Louise had already achieved a high profile for her work.
Louise continues to spread her message through social media. ‘I contacted nursing leadership when I saw modern slavery making its way into nursing discussions. In April, NHS England director of nursing Hilary Garratt and I hosted a #wenurses Twitterchat on what to look for and what they can do to help.’
Louise has achieved much while managing her studies and completing placements, but says her commitment to making healthcare more accessible for those who need it has been her motivation.
‘When you’re so passionate about something you don’t get tired of it. The charity has supported women identified by NHS services. This shows how important this work is. They are there because one of us spotted them, knew something was not right and got the women the help they needed.’
She hopes that her achievements will inspire nurses, particularly students, to have the confidence to act when they see an opportunity to improve care.
‘Don’t wait,’ she says. ‘I used to think, “when I’m qualified I can…” But advocating for this cause has made me realise very few students are fresh off the conveyor belt of life. So many have a wealth of experience or knowledge they can use to benefit our patients. And if it matters, push for the change – you’ll be surprised how many people will want to get on board and support you.
‘When I started my nursing degree no one I talked to had really heard of human trafficking or modern slavery. Now we have launched a tool to help identify and support this often unseen group. I feel so proud to have been a part of bringing about this change.’
If you suspect someone is a victim
Communicate, Document, Escalate is a guide for nursing students on what to do if they suspect someone is the victim of modern slavery of trafficking:
- Communicate – Nursing students who believe a patient may be at risk or has been trafficked should raise their concerns first with their mentor or, if unavailable, with the nurse in charge or safeguarding lead.
- Document – In compliance with the Code, make clear and accurate records of any concerns. A complete history of the patient’s journey not only helps to ensure patient safety but can also become significant to any subsequent legal processes.
- Escalate – The Salvation Army runs a 24-hour helpline offering professional advice and support. While the NHS is exempt from the duty to notify the Home Office of potential victims, healthcare professionals are encouraged to make a voluntary notification.
The Andrew Parker Student Nurse Award, in association with RCN Fellows, is sponsored by Guidelines for Nurses