Reflective accounts

Reporting poor care

A CPD article improved Anita Skinner’s understanding of nurses’ responsibilities in raising concerns and reporting poor care.

A CPD article improved Anita Skinner’s understanding of nurses’ responsibilities in raising concerns and reporting poor care


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What was the nature of the CPD activity, practice-related feedback and/or event and/or experience in your practice?

The article focused on the importance of raising concerns and reporting poor care.

It outlined the responsibilities of nurses who witness poor care in their practice, and the procedures they should follow to report it. 

What did you learn from the CPD activity, feedback and/or event and/or experience in your practice?

The article distinguished between errors and poor care, stating that errors are the unintended outcome of genuine mistakes, while poor care involves acts of neglect, abuse or incompetence.

I learned that possible reasons for the occurrence of poor care include low staffing levels, low staff morale and increasing demands being placed on overstretched healthcare services.

The article emphasised that while it is understandable for nurses to be anxious about possible repercussions of reporting poor care, this is not an acceptable reason to fail to do so. It stated that nurses who encounter poor care and do not challenge it, risk breaching their professional standards and requirements.

How did you change or improve your practice?

As a nurse working in a care home, I have observed several examples of poor care. For example, I noticed that staff involved in administering medicines often did not inform the doctor that a patient had been refusing their medicine for several days, and patients’ prescription cards were frequently being back-signed if there were signatures missing.

After witnessing these practices, I reported my concerns to the manager and proprietor of the care home. They took my concerns seriously and action was taken to prevent such instances of poor care from reoccurring. 

I felt anxious when reporting my concerns about poor care because I thought there might be repercussions for me. However, reading the article reinforced the fact that, as a nurse, I have an obligation to report any instances of poor care I have witnessed and act in the best interests of patients.

How is this relevant to the Code? Select one or more themes: Prioritise people, Practise effectively, Preserve safety, Promote professionalism and trust

The article was relevant to The Code theme of preserving safety, which states that nurses must raise concerns immediately whenever they encounter situations that put patients at risk. 

This theme also states that nurses must escalate any concerns they have about safety or the level of care people are receiving, in line with NMC guidance and local working practices. The article outlined the procedures that nurses should follow in response to poor care.

The article was also relevant to the theme of prioritising people, because it emphasised that nurses’ primary responsibility is to patients, and that they must do all they can to provide optimal care. 

Anita Skinner is a nurse and manager at Discovery Care, Kent


This reflective account in this issue is based on NS873 Ion R, Jones A, Craven R (2016) Raising concerns and reporting poor care in practice. Nursing Standard. 31, 15, 55-62. 

Write your own reflective account

You can gain a certificate of learning by reading a Nursing Standard CPD article and writing a reflective account. To write a reflective account for Nursing Standard, use the NMC reflective accounts form. Complete the four questions about a CPD article you have read, writing about 700 words in total.

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