Saturday, 2 May 2015

my feedback to NHS Fife Associate Nurse Director who did not listen to me: "Developing and maintaining therapeutic relationships"

This morning I wrote a letter in an Email to Nicky Connor, Associate Nurse Director (AND) of NHS Fife, in response to her letter which did not uphold my complaint about a nurse who accosted me in Stratheden Hospital and then reported me to the police (see post misuse of power).  

Scottish Sunday Express 5 October 2014
I describe it as intimidation, bullying and harassment towards a patient advocate, psychiatric survivor activist and human rights campaigner.

Here are some extracts from my letter which reflect the concerns I had with the response from the AND:

Strapline: your letter 27 April 2015 as "designated complaints lead" - my feedback and concerns about the writing style - "Developing and maintaining therapeutic relationships"

[short extracts]
 "Firstly I want to say that, in my opinion, the letter is not well written and reflects everyone mentioned in a bad light.  Particularly FG and KT.  The fact that you did not uphold my complaint based on only what FG said demonstrates a biased and flawed decision. ..."

"I think that your reporting of what was said, the words you use, the implications, the tone, the phrases, are unhelpful and in places provocative.  I would recommend that you undergo training in how to handle complaints appropriately and how to de-escalate a situation when writing about it.  However it may be that your intention in writing this letter was to provoke a reaction?  That's what it reads like.  I am a writer and a wordsmith so this is my area of expertise, nowadays.

For example.  You use the word "entirely" to give emphasis and make a point.  As if that gives your words more validity and authority.  Eg "It is entirely unacceptable to take recordings or photographs ..."  You seem to be lecturing me in your letter.  As if I was a member of staff or a "silly little girl" ...  "

"There is no way that I can put your letter in a blog post because of the way it's written and the fact that you have mentioned the names of KT and FG all the way through, like a stick of rock.  But what I will do is put parts of this letter and yours in a blog post, to explain the reasons for not being as transparent as usual.  I have no desire to shame your staff by name.  It's not productive.  I try to behave professionally even when the professionals don't. ..."

[longer extract]
"FG should not have approached me in the way that she did, on 22 March in the Ceres Centre shop.  It was unexpected and she came right up to me, in my face.  It was intimidating.  This is what the IPCU nurses used to do in February 2012.  On 4 February when I was sitting at the dining room table in the ward five of them came up to me.  Four stood over me while the fifth sat down.  It was bullying and intimidation.  I stood my ground, sat firmly and eventually they moved off.  This was repeated at various times.  The nurses did not appear to have an awareness of body language.  I have described it as "space invaders".  It happens because of forced treatment in psychiatric settings. 

Psychiatric nurses are in the habit of forcing drugs into patients.  It's a fact of life.  However this should not result in them behaving forcefully with anyone they meet.  That is an issue which training might help with.  Plus ongoing supervision and support.  Not all the nurses at Stratheden behaved like this.  Some of them did the opposite and retreated from engaging with patients or family members.  Sat in the staff room writing notes.  

It's all about human relationships and working alongside people.  Therapeutically.  For interest, I have co-written a chapter with a mental health nurse lecturer for a forthcoming book, 3rd edition of 'Psychiatric and Mental Health Nursing: The craft of caring':

Strapline of "Developing and maintaining therapeutic relationships".

Our piece was a conversation and here is one of my paragraphs:

"C: I believe a therapeutic relationship or helping alliance in psychiatric settings is very similar to the friendships made over the years, with people of like minds.  Therefore in the mental health setting it should be no different from the “real world” and grounded in equality, reciprocity and level playing fields.  It should be about getting alongside a person rather than doing things to or for a person.  It will also be about sharing experiences as if nurse and patient were on the same side of the fence.  The challenge in the psychiatric setting is that personal stories are usually only shared by patient or carer and then written down in the notes.  This is not to advocate mental health nurses revealing their whole life story, issues and problems, but to demonstrate vulnerability and being human, allowing the person/patient to be the expert of their own experience.

As a community development worker since 1980 I have engaged in an empowering way with people where the aim has been to enable, to inform and to create spaces where people can learn, grow and become independent, emancipated members of their community.  It has meant that from the beginning the end was in sight.  You might describe this as having an exit strategy from the entrance door.  I see this as being therapeutic and in the best interests of the “other”.  I would like mental health nurses to empower patients and, in so doing, be empowered themselves.  The challenge as ever will be in the dynamics of nurse/patient/psychiatrist triangle.

I am copying others into this Email, for their information."


Extracts from the letter received from Ms Connor, Associate Nurse Director, NHS Fife:

"FG advised that she attempted to explain to you that she was simply asking if you were recording her, and she asked you to refrain from doing so as video recording equipment should not be used within patient areas (I had a Blackberry phone with me).  FG advised that your subsequent response was "you have come along here to tell me off haven't you, you silly little girl" and that you appeared to be tapping your phone and allegedly saying "I will be recording this as well, this is great". ..."

"FG advised that she then left the Ceres Centre and sought advice from Senior Nursing Colleague.  It was determined that due to the possibility that you may have been video recording patients and FG felt "assaulted" by your hostility towards her, she contacted the police that day.  On discussion with the police they advised FG that she had grounds to raise a complaint and they suggested to her that they would speak with you regarding the incident. ...."

"Having given consideration to the concerns you have raised and the response provided by KT (Clinical Services Manager) I note that the interactions between yourself and FG in the Ceres shop were unwitnessed and therefore I am unable to verify individual accounts of the event in question. ......  KT assures me that she considers that FG acted in the best interest of her patients and she fully supports her actions ...... I am unable to uphold your complaint."


I will write more about this in future blog posts.


front page of booklet from NHS Fife Patient Relations Dept

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