Raising concerns ‘speaking up’ a student nurse perspective by Andrew Catherall Twitter @AndrewCatherall

It is really tough being a student nurse, I am sure that goes without saying most of you reading will either be student nurses or have at least been in the recent past but I think as we spend more time in the clinical or work environment the more we forget the anxiety of the first time we stepped into our first placements. For me having come into adult nursing with no prior care experience it felt like stepping into an entirely different world. I was fortunate enough to have an excellent first experience working on a great ward with very supportive mentors and colleagues, but some of my friends were far less fortunate. The topic for this blog is what happens when student nurses feel that their experience were bad enough to speak out.

The Nursing and Midwifery Council (2013) clearly states that raising concerns is a part of our code of conduct and that speaking out is a fundamental part of protecting our patient’s wellbeing. This being said I don’t believe speaking out to be an easy task. I believe to do it requires intense personal courage and self-confidence. As such supporting those who want to raise concerns is essential. But to understand how we can support people we need to understand what stops people from raising concerns.

I am currently involved in a research project that aims to examine the factors that prevent students from raising concerns, this idea came out of conversations I had with my student nurse peers who had poor experiences on placement and wanted to speak out about a variety of issues but choose not to. I don’t have any answers yet to what it is that holds students back from speaking out so it is difficult to say what we can really do to improve people’s experience and to support students but speaking as a student I think the number one recommendation would be to provide better education about safeguarding and incorporate raising concerns into our safeguarding training. Ensuring that students who do raise concerns have the option to move to another placement area or have their anonymity protected are also good ways of supporting students. These options though are only relevant once a student has already come forward; the real battle is about making the environment safe for anyone who may wish to raise a concern.

Fear of the repercussions of ‘speaking up’ is a major factor that prevents anyone from coming forward self-preservation is one of the most powerful human instincts and it is easy to see why someone may think twice before raising a concern(s). So far I have tried to avoid the phrase ‘whistleblowing’ I don’t like the phrase because I feel it stigmatises speaking out and raising concerns. Whistleblowing doesn’t do justice to how important raising concerns is to the delivery of safe care. Front line staff feeding back their concerns to their seniors and using feedback to improve care, whether this is through identifying inadequate staffing levels or pointing out that a colleague’s behaviour is below what is expected of the profession.

So to wrap up it is really easy to underestimate the value of raising concern or to see it as an unsavoury activity but it forms a key part of service improvement and safeguarding. I feel that supporting students in raising concerns is really important both for improving the students experience on placement and for the benefit of our patients. Thank you for reading see you over on Twitter this Wednesday 17th September for #EBNJC 2000-2100.

Andrew Catherall is 2nd year student nurse (Adult) at London South Bank University he can be found on Twitter on @AndrewCatherall

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Nursing and Midwifery Counicl (2013) Raising Concerns: Guidance for Nurses and Midwives. London. NMC

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