International Centre for Nursing Ethics Return to FTC General INDEX Return to ICNE Index
Making nursing concerns known
This is a copy of the the section 'Making Concerns known' in Guidelines for Professional Practice, UKCC, London 1996, Tel. 0171 637 7181. It is best to read it in the context of the entire Guidelines and the Code of Professional Conduct, which may be obtained from the UKCC.
38 Employers have a duty to provide the resources needed for patient and client care, but the numerous requests to the UKCC for advice on this subject indicate that the environment in which care is provided is not always adequate. You may find yourself unable to provide good care because of a lack of adequate resources. Also, you may be afraid to speak out for fear of losing your job. However, if you do not report your concerns, you may be in breach of the Code of Professional Conduct. You may also have concerns over inappropriate behaviour by a colleague and feel it necessary to make your concerns known. You will need to report your concerns to the appropriate person or authority, depending on the type of concerns. You may feel it necessary to discuss these decisions with other colleagues or a membership organisation.
39 The clauses of the code which relate specifically to these issues are numbers
11, 12 and 13:
"As a registered nurse, midwife and health visitor, you are personally accountable for your practice and, in the exercise of your professional accountability, must ...
11 report to an appropriate person or authority, having regard to the physical, psychological and social effects on patients and clients, any circumstances in the environment of care which could jeopardize standards of practice;
12 report to an appropriate person or authority any circumstances in which safe and appropriate care for patients and clients cannot be provided;
13 report to an appropriate person or authority where it appears that the health or safety of colleagues is at risk, as such circumstances may compromise standards of practice and care;"
40 These clauses give advice on the minimum action to be taken. This will help to make sure that those who manage resources and staff have all the information they need to provide an adequate and appropriate standard of care. You must not be deterred from reporting your concerns, even if you believe that resources are not available or that no action will be taken. You should make your report verbally and/or in writing and, where available, follow local procedures. The manager (who may also be registered with us) should assess the report and communicate it to senior managers where appropriate. This is important because if, subsequently, any complaint is made about the registered practitioners involved in providing care, this may require senior managers to justify their actions if inadequate resources are seen to affect the situation.
41 As outlined in clauses 11, 12 and 13 of the code, the registered practitioner's role is to make sure that safe and appropriate care is provided. This means:
• promoting staff support throughout health care settings;
• telling senior colleagues about unacceptable standards;
• supporting and advising colleagues at risk;
• reporting circumstances in the environment which could jeopardize standards of practice;
• making sure that local procedures are in place, challenged and/or changed;
• being aware of new codes, charters and registration body guidelines;
• keeping accurate records and
• when necessary, obtaining guidance on how to present information to management.