Comment

Reporting concerns about a senior colleague is a necessary act of courage

Whistleblowing is never easy – particularly if the person is in a position of power
Reporting to senior colleagues

Whistleblowing is never easy particularly if the person is senior to you or in a different profession

It takes courage to raise concerns about the actions of a colleague. This is particularly so when the person is in a more powerful position through seniority, professional status or personality. Other factors can be the income the person brings to the organisation, the number of patients they treat, the control they exert, and their reputation.

Hierarchy can act as a deterrent to reporting concerns. However, as we have seen in the recent inquiry into the performance of consultant surgeon Ian Paterson , not raising concerns can harm patients. It can also be damaging to staff.

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Whistleblowing is never easy – particularly if the person is senior to you or in a different profession 


Staff should be able to feel that their concerns will be taken seriously. Picture: iStock

It takes courage to raise concerns about the actions of a colleague. This is particularly so when the person is in a more powerful position through seniority, professional status – or personality. Other factors can be the income the person brings to the organisation, the number of patients they treat, the control they exert, and their reputation.

Hierarchy can act as a deterrent to reporting concerns. However, as we have seen in the recent inquiry into the performance of consultant surgeon Ian Paterson, not raising concerns can harm patients. It can also be damaging to staff.

Staff may experience anxiety and distress, wonder if they will be believed, fear the consequences of acting or of failing to act, and may feel alone in their concern.

When thinking about raising a concern it can be helpful to seek support from someone else. People work in teams and things seen by one person may also have been witnessed by someone else. People can also collude to keep things hidden. 

Senior staff have a duty to act on reported concerns

It is vital that the staff member who is worried approaches a more senior person that they trust to do the right thing and that this person listens and acts. Reading the Paterson inquiry report, it is clear that this part of the process did not happen until a new chief executive acted on information he received and suspended the consultant surgeon, contacted the General Medical Council, initiated an investigation and commissioned a review.

Whistleblowers may fear the consequences of raising a matter, but where this is done in good faith they should be protected from retribution

Any nurse may witness something that worries them, whether it is the performance of a fellow nurse or a colleague in another discipline. The term ‘witness’ here is important: raising a concern should be made in good faith but at this early stage there may not be proof. The person should truly believe there is a problem.

Freedom to Speak Up (whistleblowing) policies guide staff to talk to someone within the organisation as there are limited circumstances where it would be appropriate to make an external report in the first instance.  

There are risks associated with not speaking up, so however difficult it is, reporting a concern has to be better, and in some ways easier, than worrying about something that you know is wrong and is causing patients, clients or colleagues to suffer.

When I was a director of nursing, I was approached by staff with concerns. At that stage you are not sure what the truth is, but as a senior nurse it is imperative to find out by seeking evidence to support or refute the allegations. Actions by managers need to be appropriate and swift. If a nurse manager ignores staff concerns, the important dialogue between managers and staff may shut down. Allegations may be made about, and by, senior or junior staff, and at this stage all parties need support. Whistleblowers may fear the consequences of raising a matter, but where this is done in good faith they should be protected from retribution.

Sharing concerns is a professional responsibility

It is helpful if there is evidence early on, such as contemporaneous notes about behaviour or audit results. Curiosity and information-sharing are key. Reporting concerns is a professional responsibility and none of us should ignore what we see, or hope someone else will report it, or just find ways to work around the problem. We owe this to patients and colleagues. 

It takes courage, but thinking carefully about who is the best person to tell, and speaking to them and presenting them with any evidence, is the first step. Colleagues in senior postions should be known for taking positive actions when addressing concerns - this should provide staff with the confidence to come forward, no matter who is involved.  


Caroline Shuldham is a non-executive director of RCNi and a former director of nursing

 

 


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