No time for silence: speak up about abuse
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No time for silence: speak up about abuse

Lawrence Whyte Agency nurse, South Yorkshire

Allegations of mistreatment at the Edenfield Centre following a BBC investigation remind us of the responsibility all nurses have to raise and escalate concerns

The shocking allegations of mistreatment of vulnerable patients at a secure mental health unit in Manchester, which have been widely reported in the media, made me feel ashamed to be a nurse.

Nursing Standard. 37, 11, 13-13. doi: 10.7748/ns.37.11.13.s10

Published: 02 November 2022

Several members of staff at the Edenfield Centre in Prestwich, Manchester, have been suspended and a police investigation launched into allegations made by the BBC’s Panorama programme in relation to the treatment of people with mental health problems.

The film appeared to show some staff mocking and slapping patients at the medium-secure unit, using restraint techniques inappropriately, and bullying and abusing those in their care.

For me, there is an uncomfortable feeling of being part of a profession whose purpose is care and compassion, supporting dignity and safeguarding human rights, yet against which allegations of abuse repeatedly emerge.

When I started working as a nurse at a large psychiatric hospital in 1972, a damning report was made by two members of staff alleging abuse by other staff. This eventually led to a public inquiry in 1976 – The Inskip Inquiry into St Augustine’s Hospital.

ns_v37_n11_10_0002.jpg

An image from the Panorama undercover investigation into care at the Edenfield Centre

Picture credit: BBC

The hospital I worked at was not alone; other hospitals were the subject of official inquiries during the 1970s and 80s, highlighting similar abusive behaviour by so-called professional staff.

Many hoped that, with the closure of these large institutions, the possibilities for such abuse would subside, but sadly this has not been the case. In recent times, a number of smaller facilities have found themselves under investigation for abuse by staff. Reducing the size of institutions is not the solution to the problem of toxic cultures in services for people with mental health problems or learning disabilities.

I am sure there are good and caring staff at the Edenfield Centre, just as there were in the hospital where I trained. Caring for people with severe mental health problems is challenging. There can be pressure on staff to maintain control over people whose behaviour is aggressive and disruptive. There are protocols for dealing with this, yet it can be an intimidating atmosphere in which to work.

‘We must be willing to speak up if we witness cruel or demeaning behaviour by colleagues, or risk being complicit in what has happened. Creating ways in which staff can do this safely needs to be a priority’

Furthermore, people can be inappropriately placed. People with autism being cared for in mental health services is common, for example, yet autism is not a mental health problem and staff who work in these services may have little training in how to manage neurodiverse conditions.

Challenging poor practice and cruelty

As nurses, we must be willing to speak up if we witness cruel or demeaning behaviour by colleagues, or risk being complicit in what has happened. Creating ways in which staff can do this safely needs to be a priority for health and social care services. Nursing, as a whole, has a duty to make this happen.

When I work in clinical settings as an agency nurse and witness the skills of some of my colleagues, it restores my pride in my work. But cases of abuse in healthcare settings are too prevalent to support the theory that this is ‘just a few bad apples’. Neither do I believe that it only occurs in mental health and learning disability settings.

How nursing responds to such cases is just as important as the actions of professional bodies and the criminal justice system.

It is time for the silent majority of nurses, who work within their professional code, to express their outrage towards practices such as those alleged at Edenfield. They should be supported in this by other healthcare professionals – as failures of care are multidisciplinary, not just confined to one profession – ensuring it is also an opportunity for real change.

Compassionate leadership in nursing: how to make it a reality rcni.com/compassionate-leaders

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