A Whistleblower’s Woes

A Whistleblower’s Woes.

A summary written for my Solicitor on the day I resigned in July 2009.

(with some later updates)

kate-greenaway-tell-tale-tit-your-tongue-shall-be-slit-and-all-the-dogs-in-the-town-shall-have-a-little-bit

Tell-tale tit, your tongue shall be slit”

..from a nursery rhyme.

  • March 1980: I joined 307 Field Ambulance RAMC, Territorial Army, subsequently training to Combat Medical Technician Class 1 and gaining the rank of Corporal.

  • April 1987: I began Nurse Training to RGN.

  • August 1990: I was registered as a General Nurse.

  • September 1990: I began working as a Staff Nurse for Lancaster Health Authority, (latterly known as University Hospitals of Morecambe Bay Trust).

  • I have worked continuously as Full-Time Staff Nurse for the Trust, since 1990, with the exception of a six month period in 1996, during which I was called up, by the Territorial Army Medical Services, for service as a Medic in the Civil War in The Former Yugoslavia. I was attached to the Parachute Regiment as Med. Corporal in charge of a British Army Base Medical Centre in the world’s most heavily-mined town.

  • 1997: I moved to Ward 23 at Royal Lancaster Infirmary, a 24-bed both genders ward: the Acute Stroke Unit. We also see Rheumatology, Medical Rehabilitation, and Acquired Brain Injury, as well as a wide variety of other medical conditions in patients aged between 13 & 103 years old.

It was never my ambition to become a “Whistleblower”. I wouldn’t have known what it meant. Rather, that role grew around me as my experience of caring increased my awareness. Starting on little whistles led on inexorably to bigger whistles, as a growing determination to have things done well led me into conflict with some other staff. In fact it was bosses that first termed me “whistleblower” when they sent me a copy of their Whistleblowing Policy. I’d never heard of it before &, as it turned out, neither had they!

In early 2003, a colleague confided in me that an Auxiliary Nurse had told her that she needed some strong painkillers for her son, who had injured his hand in a fight. He had chosen not to seek medical help, for fear of the Police learning of his involvement. Over-the-counter analgesia being insufficient, she intended to steal stronger “Kapake”, a Prescription-Only medicine, from the ward drugs cupboard. When I next worked with this nurse, I counted the boxes of this drug in stock. Later that night, I found that one box had gone missing. I searched the woman’s bag and found the tablets there. I reported this to Night-Sister straightaway. It was over 12 months before the Trust finally dismissed the woman. Before this conclusion, it became obvious that, somewhere along the course of management’s procedures, confidentiality had been breached. My informant colleague was shunned and “sent to Coventry” by other staff, at work and elsewhere, receiving anonymous threats of violence & death by telephone. A Police call-recording tracing device was put on her phone-line. Objects were thrown into her garden at night. She was forced to take time-off sick. She still today feels disadvantaged at work, because of the part she played. I would later receive an “Admonishment” from the Nursing Director for not sharing my suspicions before the theft!

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During this lengthy nightmare, as I arrived home after dark, my neighbour warned me that a car had earlier driven into the yard at the side of my house. It spent 20 minutes parked there, engine running, without the occupants attempting to ring my doorbell, before driving off just a minute or two before I arrived. Living, as I do, in a remote farmhouse, she expected that I would have passed the vehicle, on the long driveway in. I realised that this was the car I had just seen, behaving suspiciously. I had stopped at a junction, when a car, coming away from the farm at speed, braked violently as it passed me, mounting the kerb and skidding to a halt on the grass verge, some 50 yards beyond the junction. As I drove on away from the junction, I watched in the mirror as the car made a violent U-turn in the road, accelerating to follow me aggressively, very close, for about 400 yards, before falling behind. My name had also been divulged and I was being targeted for intimidation. I logged the incident with Police next day, who assured me that the son was now in custody. A few days later, a newspaper told that the woman’s son had been imprisoned for Grievous Bodily Harm in an assault on a female. But the woman has two sons, as well as a husband! I felt exposed, frightened and resentful, but knew nothing of Whistleblowing provisions at that time. Neither did management, it seems!

And this is the life of a nurse?! Some ignorant people think it “Cissy” to be a nurse. Which kind of nurse would you be?

A Cissy?          
dummy

or a Whistleblower?                     
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Hospitals are only an intermediate stage of civilization.” Florence Nightingale.

In May 2005, working as Night Duty Staff Nurse on Ward 23 at Royal Lancaster Infirmary, I began to notice that an alarming number of “drips” ( Intravenous or Subcutaneous Fluid infusions ), which were prescribed to be given to very poorly and dependant patients, were being left in the closed position, i.e. not being administered because the giving-set clamp was switched off. In the normal course of events, one might expect, in a year, to find one or two such that had been left turned off by mistake. Now I was finding up to three in a single shift.

iv roller clamp

Realising that something was amiss, I set about finding the cause. I realised that these incidents were affecting only those patients cared for by Staff Nurse A and were apparent only on those occasions when my shift followed those on which she had been in charge of twelve of the ward’s patients.

On one night, S/N A was giving me details of a particular patient, during “handover” as I took over the ward. I became suspicious when she told me, in a manner more detailed than was usual from her, that “you might find that his infusion has run through. It was running behind (time), so I speeded it up.” I went straightaway to that patient and found that his infusion had been switched off at the roller lock at the very moment that the bag had emptied and before the giving-set chamber had run down. This implied that a member of staff had been aware that a fresh unit was required. I took the view that S/N A had turned off the infusion and had not attempted to continue it, concealing her omission by that incoherent report.

In early June 2005, I found an opportunity to talk to S/N A about these incidents. Believing we were not overheard, I asked her if she was having any difficulty with giving fluids, as I had found a number of “drips” turned off. I expected a denial or at least any of a number of possible excuses. However, I was shocked to hear her say, “Well, he is terminally ill. What are you doing when you give these patients fluids? You are just killing them slowly, aren’t you?”

At that moment, another nurse, Staff Nurse B, having heard the exchange, emerged from the Treatment Room, close by, and walked past saying to me, “Well she’s right, isn’t she?”

So there are two of them then!

It matters not that S/N A should protest her own opinion of this man’s “terminal” state. The fact remains that a Doctor had taken the decision to prescribe fluids and her clear duty was to carry out those instructions.

On 4th June 2005, I told a Junior Sister, Sr. C, about my discovery. She told me “Russell, I can’t do anything about that unless you put it in writing!” I felt obliged to make a hand-written report during the following night and handed it to Sr. C next morning, 5th June 2005.

I did not see Sr. C again for several months, because she took promotion to another area, but I do know that she passed on my report to the Ward Manager, Sr. D. When I started work one night, Sr. D told me “I read your letter. I’m sure it was happening, but A has resigned.” I assured her that it was indeed happening. She said nothing more. Nevertheless, I expected that Management, or even the Police, would want to, at least, discuss the report with me, if not take further details; but I would not be contacted again concerning this matter, until the report itself became the subject of my second Grievance dated 31.11.2008.

On 23rd September 2006, I was on night duty on Ward 23 RLI. As I began work on the ward, a patient, Mr DS, a young man who was suffering confusion and difficulty with communication as a result of a serious head injury, repeatedly tried to gain access to the locked Controlled Drugs, “CD”, cupboard. He had a history of drug abuse. I could not understand what he was trying to tell me and I was unable to persuade him to desist. Time after time, I was forced to return to the Treatment Room to ask him to leave. He became very animated and his speech more confused on each occasion. I was unable to afford him the time it might have taken to explore his feelings.

At about 21.45hrs, I saw him enter a six-bedded female area. I followed and found him begging aggressively for cigarettes from a frightened female patient. I asked him to leave and followed him out. He turned suddenly and threw himself at me, head-butting me in the face and bringing his knee upwards into my groin with great force. It is difficult to account for the next minute or two, but after a considerable effort, I pushed him to the floor in a store room, sitting on his chest to restrain him. I was unable to call other staff for help as I was shocked and out of breath. I suffered a split upper lip, a laceration to my right forearm and bruised painful testicles, as well as general aches and pains from the volley of blows that I had received. DS was uninjured.

At 06.30hrs on the following morning, 24th September 2006, Mr DS came out from his bedroom and immediately ran at me throwing punches. I wrestled him to the ground and held him there until other staff arrived. During this attack, I received painful exacerbation of a previous neck injury, which resulted in time off work and required physiotherapy treatment. The patient was again uninjured. I found out later that DS had been told that he had his own tobacco, locked in the CD cupboard for safekeeping. No-one had thought to inform me of this arrangement and DS was unable to explain to me.

I suffered a considerable amount of stress following the assaults, the episode being the more regrettable, because it could have been so easily avoided. It is my opinion that upset arose more from the anguish of being forced to treat my poor patient with such violence, as the situation dictated, while trying to remain in the role of nurse, than from the violence done to me. I had some difficulty reconciling my mixed feelings. I concluded that circumstances had forced me to behave in a wholly uncharacteristic manner.

The way in which these incidents were handled by management would come in for comprehensive criticism later, from the Independent Investigator of my first Grievance of 31.01.2008.

I believe these events were continuing to have effect upon my motivation, when I met with my Ward Manager Sr. D for Appraisal on 8th November 2006. She recorded that “This was probably the worst appraisal I have ever participated in. Russ has now reached his lowest ebb and now seriously questions his continuation within the nursing profession…………..Russell is a very hard-working staff nurse who has always been valued as part of Ward 23 team. He has a considerable amount of input to the day to day working of the ward. I will support him in any way I can.”

I received no support of any kind. Her kindly observations would not prevent her from attempting to discredit me later, during the investigation of the first Grievance.

But still worse was yet to come!

On 11th January 2007, I arrived at Ward 23 for the night-shift to learn that we would again be short-staffed. The Staff Nurse who had been in charge during the afternoon, S/N B, stated that she was willing to continue working until 04.00hrs to “help you guys out”. I could instantly see that her choice of leaving-time owed more to her personal preferences than any thought of ward requirements, but nonetheless appreciated her immediate assistance. The more usual offer of help from a member of Day Staff would have been to stay on until, say, midnight, leaving after patients had been settled and medicated. Night Sister was informed of the arrangement when she visited the ward during the evening and suggested that it would be unnecessary for S/N B to continue after 02.00hrs, as she herself would be in a position to give assistance after that time. This clearly did not please S/N B, but she agreed. At 02.00hrs, Night Sister came to the ward and told S/N B that she was free to leave. S/N B remained on the ward chatting about inconsequential matters until asking me to watch her cross the car park to her car at 02.35hrs. I could see that she was not happy at being told to leave in advance of her planned time. Had she been allowed to continue until 04.00hrs, she would have been able to claim a whole shift off during that week without incurring any time owed. Regardless of the above, and that she was contracted to work 30 hours per week; she actually worked only 27 hours during that week, yet still saw fit to claim 6 and a half hour’s night enhancement, for a night on which she was on night duty for only 5 hours. No adjustment for the shortfall was entered in the Time Owing Book to this effect. I have copies of the Duty Roster for that week, as well as S/N B’s Time-sheet submitted by her at month end. I contacted Internal Audit Department to report this after I saw that the pay claim had been authorised by Sister D.

On 5th February 2007, I met a Trust Fraud Investigator in the Internal Audit Dept. to provide her with my evidence. I gave her copies of the documents and made a statement to her about the above events. Aiming to provide some context in addition, I related a history of S/N B’s past misconduct. The incidents I had mentioned had all been reported and “dealt with” earlier. The Fraud Investigator took the impression that I was making a first report of those events, a number of which had occurred some years earlier. While she then busied herself with investigating the allegation of fraud, she referred the clinical incidents first to the Head of Medicine Directorate, who passed the matter to the Director of Nursing, from whom it passed in turn to the Modern Matron. Promised an independent and confidential investigation, I was already becoming alarmed at the growing number of participants, when, on 19th February, I received an email requesting evidence, from Matron, which had been copied to my Ward Manager Sister D, breaching confidentiality!

The Trust Fraud Investigator had quickly concluded that “although it was possible that a minimal amount of time had been claimed and possibly not worked, the allegations could not be proved and the investigation costs would totally outweigh the possible gains.”! She did all this without reference to the Time Owing Book and wasted no time on my suggestions to examine other weeks’ records for shortfalls that were not adjusted in the Time Owing Book. There were several such easily identifiable examples of similar fraud. In a workplace that frequently warns of “Instant Dismissal!” for pilfering milk or an apple, I found this attitude to misappropriation of over £35 discreditable. Sr. D maintained that “B did not falsify her timesheet. In fact when I investigated I found she had in fact claimed for half an hour less than she worked.” This view puts her at odds with the “Counter-Fraud Specialist” of Internal Audit, who agreed that S/N B had apparently worked only 27 of 30 hours during the week in question. In her testimony to the investigator, Sr D talks of a “flexible arrangement” with S/N B’s working hours. She “understands” that “it may have been difficult for (me) to appreciate the whole picture”. I would put it that, as she had no way of knowing when S/N B was relieved of duties that night, it carries no weight that she carried out her own investigation. In effect, all she is telling us is that she merely checked B’s pay-claims against what B said she had worked. Unsurprisingly, they (almost) matched!

It may seem a strange principle to enunciate as the very first requirement in a hospital is that it should do the sick no harm” Florence Nightingale.

Then four days after making my report to Internal Audit, I witnessed yet another instance of clinical misconduct by S/N B.

Lab guinea pigs

Laboratory Guinea Pigs

On the evening of 9th February 2007, I listened to Staff Nurse B as she “handed over” her patients to me. Dealing with one patient, “GW”, she proudly told me that she had recently qualified to pass naso-gastric feeding tubes on patients with swallowing difficulties (common in Stroke patients) and had been hoping to find a patient who required one. She glowed with pride as she told me to “let Sister D know” that she had successfully demonstrated her new skill on GW. She admitted “I shouldn’t have, he’s already had four inserted and pulled them all out”. The clinical protocol, as it was understood on Ward 23, required that patients should be tried with NG tubes on no more than three occasions, because, if they show a tendency to remove tubing, there will exist a risk that a tube only partially removed might allow fluid to pass into the lung(s) resulting in life-threatening Aspiration Pneumonia. At this point, I made no comment, but lowered my spectacles to stare over them in a mixture of disbelief and disapproval. Revealing that she was aware of my misgivings, she hurriedly defended her action by saying that the relatives had been pressing for it and that in any case she had “got a Dietician to authorise it”. When I reached GW, I immediately recognised that he was slumped down in the bed, very flushed, and hyperventilating. As we lifted him up the bed, he vomited and I had the feed pump switched off. His temperature was in excess of 39 degrees. I immediately administered oxygen at a high rate and called the doctor, who diagnosed Aspiration Pneumonia, prescribing high doses of two intravenous antibiotics. I observed that the Dietician had emphasized that the feed should have been given during the “Daytime Only” by marking the chart accordingly. It ought not to have been started as it was, during the late evening, set to run for fifteen hours, during which period the patient would not be as aware as he might. I reported this to Sister D, when she came on duty in the morning. She looked shocked and concerned, commenting “I don’t know how she can justify passing another NG on him.” She would later tell the Independent Investigator when questioned, “I haven’t seen anything in writing about this. I recall the incident but not the allegation re B. I wish I had written something down about this at the time.” Clearly, she saw no reason to pass on her immediate concerns to management herself at the time.

Despite my recounting the events and producing documentary evidence to Modern Matron at a meeting on 24th May 2007, investigation of this incident had still not been commenced when my Grievance was reported on in April 2008. The incident was described by the Independent Investigator as “gross misconduct, as by failing to follow the clinical protocol a patient’s life was put at risk.” The Trust did not reveal to me that patient GW had died some ten days later. I only discovered that fact when the HR Director assured Police, in 2015,  that there was “nothing to suggest that his death was in any way affected by the alleged procedure carried out by (Nurse B)“. His Death Certificate lists 1. “CVA” (Stroke) & 2. “Aspiration Pneumonia” as causes. A review of the death, carried out (without informing relatives) by the Trust a full 7 years Post Mortem, revealed that, original notes having been destroyed, the microfilmed page of notes referring to the NG Incident had somehow become illegible on microfilming. The Trust Chief Nurse carried out this review & suggested, optimistically, that the patient “may” have had Aspiration Pneumonia on admission. If that were the case, it went undiagnosed throughout!

Previous incidents concerning B’s clinical practice had been made known to Sr. D in the past. On one occasion, while helping an elderly lady to bed, a pair of scissors had protruded through a hole in S/N B’s uniform pocket and stabbed the patient in the leg. The leg became very badly infected and swollen requiring treatment with IV antibiotics; the patient being very ill, confused and agitated for several weeks. This was common knowledge at the time and must have been documented in the patient’s paperwork. In addition, of course, the Ward Sister will have insisted on a “Clinical Incident Report” being completed, to detail the occurrence. Yet Sr. D does not know of “any specific incidents that led (her) to be concerned about B’s competence”. I regarded this “accident” as criminally careless, especially when, some weeks afterwards, I saw B with unprotected scissors still poking menacingly from the hole in her pocket.

doctors & nurses

“Let’s play Doctors & Nurses.”

On one memorable night shift, I found myself short-staffed again and was sent a very young and inexperienced Auxiliary Bank Nurse to help us. At one point she reported to me that a dressing on the sacral area of a patient had become detached. I asked her to lay the patient on his side for the meantime and I would tend to him when I had finished giving out medications. Later, I asked the young nurse to help me and she watched as I cleaned a dressings trolley and loaded it with the sterile stores and antiseptic we would require.

She asked me why I was doing all this, so I began explaining the need to avoid cross-infection. Halting me in the middle of my lecture, she explained that she had only asked because, on the previous night, she had worked Ward 23 with another Staff Nurse, when the same dressing had fallen off. On that occasion, she had watched the Staff Nurse use her scissors to poke the packing from the old dressing back into the patient’s wound; then replace the scissors into her pocket, without even cleaning them!

bloody scissors

I should point out now that this practice is not acceptable under any circumstances, before taking into account that the patient in question was known to suffer from Hepatitis C. This is a transmissible, incurable and deadly blood-borne virus. People infected with Hepatitis C virus often show no symptoms initially, but long term effects can include liver damage and cancer. The virus is transmitted by infected body fluids, and needle sharers are at particular risk. Scissor sharers can probably be included as well. It should come as no surprise to the reader to learn that the previous night’s Staff Nurse was B.

Of course, I reported the young lady’s story, (she had indicated her willingness to bear witness), to Sister D on the following morning. She told me “Well, B has identified dressings as one of her weaknesses in Appraisal.” I hold that such recklessness constitutes much more than “weakness” in an experienced Senior Staff Nurse. I never saw that young Bank Nurse again and now believe that she was excluded from Ward 23 by its jealous Ward Manager for her whistleblowing. Within days, I was hearing, from my colleagues, that S/N B had been questioning them about my smoking habits, trying to discover whether I was in breach of Trust anti-smoking policy. I realised that, in all probability, Sr D had spoken to her about her wound-care, and, in so doing, had breached confidentiality, provoking B’s attempts at retaliation.

When questioned about this incident by the Independent Grievance Investigator in March 2008, Sister D told him, I do not remember being told about this.” This unretentive Sister therefore felt able to maintain, in writing to the Grievance Investigator, that she did not know of “any specific incidents that led (her) to be concerned about B’s competence”.

From late February 2007, after learning of Matron’s breach of confidentiality, I realised that I was ill. I had difficulty sleeping and went over and over the events endlessly in my thoughts. I could concentrate on little else, could hardly remember what I had done the day before and lost interest in my usual pursuits, including socialising. I was unable properly to tend to the daily necessities of living. I told my GP who signed me off sick suffering from Stress / Anxiety. I remember protesting “I am not stressed, I’m just worried, that’s all!”

During April and May 2007, I attended Counselling sessions at the Occupational Health Dept. with no resulting improvement in my sleep pattern. Later I was urged by Occ Health Dept. to undergo a course of Cognitive Behaviour Therapy. I agreed principally to pass the time while waiting endlessly for completion of the Grievance Investigation. The notes of these
“Confidential” sessions were subsequently submitted in evidence by the Trust to Employment Tribunal, …evidence of what was never revealed.

On 24th May 2007, I attended a meeting with Modern Matron , a HR Officer and a union rep. I explained the details of the above incidents and produced photos of some documents in support. Matron suggested that these issues might be the result of a “personal” difference. I denied this, pointing out that my reports concerned entirely professional matters. I learned that Sr.D had left her post on Ward 23. As she would tell the Independent Grievance Investigator in March 2008, “I resigned my ward manager post because of this. I don’t know why Russell did not tell me about his suspicions”. A thoughtful reader of this history may be able to answer her question for her. The evasive Sr.D continues to work for the Trust as a Clinical Lead Sister, on another ward.

I returned to work on Ward 23, during June / July 2007, on “phased return” building up weekly hours to full-time on day duty. Quickly finding myself in charge of the care of 12 patients, I found the ward chronically under-staffed and unbearably busy. I could not cope with the telephone ringing all day, confused handover reports, endless interruptions, ordered meals not turning up, working with bank and relief staff not familiar with the ward, etc. etc. I also found it difficult to trust other staff. I could not discuss my problems with them. My sleep problems returned and I found I could not continue. I saw the Occupational Heath Doctor who diagnosed Stress / Depression. Again I protested, “I’m not depressed. I’m just fed up!” He recommended that I try anti-depressants, “We have lots of staff on them!” I declined the offer.

happy pills

I was eventually persuaded by my GP to try a course of anti-depressant medication, which did no more than cause me to feel detached, aimless, forgetful and drowsy, without improving my ability to sleep. My GP discontinued the treatment and told me that he believed my condition to be “Reactive Depression” i.e. caused by external factors beyond my control. The Occupational Health Physician saw me on 23rd July 2007 and agreed that I was suffering from Stress/Anxiety. I have remained on certified sickness leave since July 2007. I have received Temporary Injury Allowance from the Trust since May 2008, and currently receive Incapacity Benefit, as well as Industrial Injury Disablement Benefit, assessed to be “psychologically disabled”, as a result of the Stress arising from the above circumstances.

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In January 2008, at a “Sickness Absence Review Meeting” with a “HR Business Partner” and Matron, I was threatened with dismissal, unless I returned to work on Ward 23. When I expressed the wish to return to work, I was interested to consider alternative employment in a less stressful area, which had been the intention of the meeting as had been proposed by the Occupational Health Doctor. I was informed that no alternative had been found and that I would have to work in the same ward that had twice caused me to be ill in the past. Matron admitted that the ward remained understaffed and that some newly-appointed staff were “not yet up to full competency”. I expressed my anxiety, but felt compelled to agree to return to work on 14th January 2008. Unfortunately, I found myself unable to comply with the terms of the planned return to work, due to sleep problems.

I think one’s feelings waste themselves in words; they ought all to be distilled into actions which bring results.” Florence Nightingale

On January 31st 2008, I submitted my first Grievance complaining that the Trust had abused my rights under the Whistleblowing Policy.

The Investigation Report, running to some 120 pages, was published in April 2008 and was discussed at a Formal Grievance Hearing on 13th May 2008. The report comprehensively criticised the Trust’s handling of the matters and laid blame for my illness on this, clearly stating that I was suffering from “work-related stress injury”. Revealing that the Trust had yet, after nearly 12 months, to begin investigating my allegations, it confirmed that confidentiality had been breached and no feedback provided. It recommended that arrangements be made for me to end my employment with dignity.

Upon reading the whole of the attached evidence and testimonies, I realised that I had very grave differences with some of the statements made to the investigation. I hoped to discuss these anomalies when I met the Divisional Senior Nurse in June 2008. I was disappointed to hear him admit that he had read only the first four pages of the report, i.e. the Summary, Findings, Conclusions and Recommendations, but not all the attached appendices. He therefore had no knowledge of the issues I wished to raise and saw the meeting purely as a Return to Work interview, despite what he ought to have read in the Recommendations section. He would later conspire with the “HR Business Partner”, in evidence to Tribunal, denying telling me that he had read only 4 pages of the report. (This denial was of great interest to my Barrister who noted that he had declared in writing that he had only read the Summary.) He spoke about possibilities of finding placement for me in another area, but admitted that all wards were stressful. He seemed puzzled when I expressed doubts about working in a nursing team again. I indicated my lack of faith in the management of these “teams”.

3 monkeys

I found myself cast back into a depression that, after all the ground gained in the Grievance process, I could yet locate no-one in the Trust with the time/inclination to acquaint themselves thoroughly with my situation.

I submitted a further Grievance dated 30.11.2008, which complained that there was an earlier instance of the Trust not dealing properly with serious reports. This second Grievance specifically referred to the June 2005 report I had made concerning the withholding of fluid infusions. It was designed to reveal weakness and evasion in the testimony of Sister D to the original Grievance Investigation and her attempts to discredit me, arising as they did from the breach of confidentiality. I suspected that I had not received feedback, because the report had not been passed on properly.

The second Grievance Investigation Report was completed on 9th January 2009. During the painfully long period between its completion and its Hearing, the Trust Occupational Health Physician received a referral for me from the Divisional Senior Nurse, who had expressed concern about my mental health. This resulted in my attending sessions of treatment with a Cognitive Behaviour Therapist. Upon review by Occupational Health Dept., the Doctor replied to Senior Nurse stating that my mental condition was in “status quo“, (i.e. without prospect of improvement), while delay in dealing with the underlying issues continued. There was no apparent resulting contact or discernible hastening of the process. The Trust’s concern for my mental health did not, it seems, stretch as far as an obligation to comply with its own stated timescales. The Trust’s Grievance Procedure calls for timely response: …expeditiously address disputes raised by staff,…managers should ensure that grievances are answered and resolved as speedily as possible , …timescales given should be seen as a maximum. Despite repeated appeals, from myself, for adherence to the Procedure’s principles, I was to be allowed to go on suffering until such time as the glacial Trust might “in due course” reach a determination.

The Grievance Hearing of April 28th 2009, held after inexcusable and unexplained delay by the Trust of over 15 weeks, upheld my complaint; the report in question having been found in a Matron’s archive files, unactioned and unacknowledged for almost 4 years. The report made reference to an intent to hasten the death of selective patients and can hardly be imagined to be more serious. It would have been most helpful to me to have been given the opportunity to discuss the content at the time. This, not least, because I knew that there was at least one other nurse who shared the view, that some patients ought to have their deaths hastened improperly. The Trust apologised to me for any distress caused in a formal written acknowledgement of Grievance Findings.

During the Hearing however, I found that I had to explain my motives to the Chairman, Mr P. Downey, who asked me, “Where is all this leading?” I might have hoped that attempting to shed light, into the darker areas of Trust failure, would be appreciated for its own sake. We ought never to ask where events may lead, when we decide to do the right thing. I told him that I thought that I had almost taken the decision not to continue nursing, no easy move to make concerning my only means of support. He wrote later insisting that I had simply declared that I did not intend to continue nursing! The Chairman had already revealed that his nursing degree had taught him little when he suggested that S/N A’s victims may have been patients who were on the “Liverpool Care Pathway”. This is a detestable backdoor-euthanasia practice by which “terminal” patients are deliberately, but “legitimately”, dehydrated to death. Had he any experience of such matters, he would have seen that his hopeful suggestion could not be the case. Doctors do not prescribe fluids for “Liverpool Pathway” patients, so nurses cannot decide to arbitrarily withhold them at will later.

I did find it less than surprising to learn from the Grievance Investigator that, when questioned about the report of June 2005, the unforthcoming Sr D told him that she had “no recollection” of it. Amnesia gets the better of her yet. That was, we may hope, the most serious report a Ward Manager might ever see in her career. Her innocence is incompatible with practical considerations of the manuscript’s passage from Sr.C to Matron’s archives. I cannot now hang on to hope that the Trust will show any interest in exploring further Sr.D’s remarkably unreliable powers of recall. It must remain my assertion that future unseemly events on her ward are likely to be “forgotten”, in the interests of keeping up appearances.

So now that’s two upheld Grievances,
…for what they’re worth.

There is no part of my life, upon which I can look back without pain” Florence Nightingale

In summary, I believe that I have been ignored and abandoned by the Trust, betrayed by some of its members, defamed by my Manager and estranged from my colleagues, because I dared to bear the full responsibilites of my position. I felt it my duty to draw attention to the evidence that one colleague was acting malevolently to patients and yet another was dishonest and slovenly. It was my clear duty to inform management and, naively, I relied on their support. I did not expect any recognition for this. I wished only for the concerns to be rectified and to be allowed to continue my work. I could not have fully appreciated then what incompetence, complacency and self-interest would make of my efforts. As a result, one nurse was allowed to retire without being questioned about very serious neglect of duty, possibly attempted murder, and a second allowed to avoid facing charges of Gross Misconduct, by resigning to find NHS employment elsewhere. In admitting and apologising for failures, the Trust has shown only an eagerness to put any damage behind them. This was done without showing me any reason to desire trusting what remains of my career to one of their badly-managed and ill-disciplined “nursing teams”. I’m sure I’ve seen better-led flocks of seagulls! I am sure that the secretive Sister D will be able to quickly “forget” all the unpleasantness her concealments have caused. It is unlikely that I will find that so easy. When my NMC Registration came up for renewal, I had to submit my application forms to the Trust for their endorsement. They “lost” my forms, TWICE! I got the message & gave up my Nurse Registration. Stuff it!

Management have distanced themselves from the vexing daily dilemmas to be found at ward level. Their cool superiority can intimidate even Nursing Sisters into concealment of raw facts. A widely-held belief, that complaint will not be listened to or handled professionally, has silenced many staff. The Trust has never, in 20 years, sought my opinion on any meaningful practical subject. Staff surveys are prejudiced and limited in scope. All staff suggestions are dismissed in one of two ways: either they are too trivial however inexpensive, or they are too expensive. Disinterested in patient problems, Trust management continue to trumpet their achievements in Trust magazines, press and TV, as well as in applications to Government. The pursuit of “Foundation Trust” status has only made this situation worse. Nothing that may conceivably detract from the achievement of Flagship recognition can be allowed any attention. Such management diversions allow staff to work independently and unsupervised, adopting whatever disagreeable practice or expedience, confident that detection is unlikely and can be relied upon not to result in any form of accountability. The results undermine the whole profession. However unpleasantly old-fashioned it may appear, reports, investigations and disciplinary measures must again become a common and familiar feature of “Clinical Governance”, or we may be forced to buttress that sham with the old faith in “Angels”. As I have revealed here, no report damaging to management reputation will be investigated or acted upon, even if it does contain information relating to an intent to murder, or practice likely to endanger the lives of patients. Business interests, image and appearance have become everything. We need not care for patients, but we must appear to do so. This cannot be the way in which the public expects a hospital to be run. Indeed it owes more to the style of dishonest doorstep sales than the business of caring. Such a scandalous situation deserves my most strenuous attention.

On 20th July 2009, as yet unable to interest any management member in the whole truth, I was obliged to submit my resignation from the post of Staff Nurse. “Take this damn badge off o’me.”

P.S. By cleverly exploiting my financial dire straits, brought about by the illness incurred from the stress caused to me by whistleblowing, the Trust obliged me to agree to give them “time to look for alternative employment in a less-stressful area”. After a lengthy search, they admitted that there were no such opportunities available – “All the wards are busy & stressful.” By this time, any claim I might have made to Employment Tribunal was “time-barred”. I paid £9000 in legal fees to discover this deception and felt compelled in 2010 to sign a non-disclosure agreement to recover that sum. Patient Safety concerns had successfully been concealed. Russell Dunkeld

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