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Nursing

Teaching and research - it's your decision

Provision of compulsory medication

Emergency contraception

When it is important to have care provided by a particular gender

Reporting concerns about discourteous treatment

Teaching and research - it's your decision

Right 2 ~ harassment ~ Right 9 ~ teaching & research

A consumer in his early eighties told an advocate that five years previously he had agreed to take part in a research trial which involved his having blood taken on a regular basis. Two years previous the consumer decided to withdraw from the study and despite advising the nurse of this she has continued to pursue him.

The consumer felt the nurse was obtaining information on his whereabouts from his doctor so he changed doctors three times in an effort to prevent her locating him. Following an incident where the nurse had turned up and been "really pushy' when he had visitors he located one of the advocacy brochures and decided to call a local advocate. 

The consumer's issues include:

• Feeling harassed by the nurse
• His choice to participate or not has been overridden by the actions of the nurse
• The doctor should not be giving information to the nurse about the consumer's whereabouts

Desired Outcome

• To be allowed to withdraw from the study without the nurse continuing to bother him
• His doctor would not provide any further information to the nurse

The consumer advised he had already tried self advocacy including: advising  the nurse he no longer wanted to participate, completing forms for withdrawing from the study and requesting his current doctor not supply any information to the nurse on his location. 

The consumer wanted the advocate to assist him to take whatever action was necessary to exit from the study. He did not want any further communication with the nurse as he felt he was getting too weak to cope with this issue. 

After discussion with the consumer a letter was sent to the nurse advising the consumer no longer wanted to be a part of the study. A copy of the Code was included with the letter. 

In response, the nurse advised she had removed the consumer from the study. The consumer was extremely relieved and grateful for the assistance he received from the advocate. 

Provision of compulsory medication

Public health ~ Tuberculosis ~ Compulsory treatment order ~ Respect

A young woman phoned advocacy with concerns about a compulsory treatment order which required her to take medication in front of a public health nurse at her place of work. Some months earlier she had been diagnosed with TB and as a result was referred to the Public Health Section for Communicable Diseases.

The consumer was concerned that she was required to leave whatever she was doing to meet the nurse outside the grounds to receive the medication. She also felt her privacy was being compromised as her employer did not know that she had tested positive for TB.

The consumer sought advocacy assistance to request she be able to self medicate, or if that was not possible then requested the public health nurse change the time she delivered the medication so the consumer would receive it after work, at her home.

At the request of the consumer, the advocate sent an email to the Public Health section and asked that they reconsider their treatment order and allow the consumer to self medicate. In response, the advocate received a call from the registrar who advised that she was going overseas for a week and that she would get in contact on her return.

As agreed, the registrar phoned on her return and advised that she would set up an appointment with the consumer to do more tests, in the hope that she would not need to take any further medication.  The consumer was elated with the response and attended the appointment. Following the appointment the consumer advised the advocate she would only require medication for another month and that as requested, the medicine would be delivered to her at her home.

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Emergency contraception

A woman became pregnant despite having taken emergency contraception provided by her medical practice. On discovering the pregnancy, the woman visited another medical practice to discuss termination. The doctor was understanding and asked that his nurse talk to the woman to make a referral. The consumer found the attitude of the nurse cold and unsupportive, and felt she was being judged in what was a traumatic situation for her.

She also discovered the first medical practice had not provided all available options for her in her situation, and felt that the pregnancy might not have eventuated if she had been given all the options. 

After talking through the options with an advocate she decided that a meeting with the practice manager to discuss the attitude of the nurse would be beneficial, and felt empowered to do this having heard about her rights and having the advocate support her at the meeting.

The practice manager and the clinical director thanked the woman for highlighting the issue so they could review their policies.  They agreed that they would talk to the nurse regarding how the consumer was left feeling, and would provide feedback from the nurse. They also agreed to produce an information leaflet for women seeking a termination, and would raise the issue at the next doctors' meeting.

The woman also contacted the first medical practice and pharmacy regarding their policies regarding information offered to women requesting emergency contraception, and changes were made.  A letter of apology was received from the nurse. 

The consumer felt that by raising this issue other women in this situation would be provided full information on their options.

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When it is important to have care provided by a particular gender

A man complained to the advocacy service about the way he was treated when he was admitted into hospital for a sensitive procedure. In particular his complaint was that he was not treated with respect by female nursing staff; and that his request for a male nurse was ignored and minimised. As a result of this experience; he asked to work with a male advocate and to only meet with male staff from the hospital.

With the support of a male advocate, the consumer met with senior management staff from the hospital to discuss the concerns about his experience, in particular the behaviour and attitude of female nursing staff. He was able to articulate his concerns clearly; and requested changes to procedures to ensure that a patient's need for respect and privacy were met; and that requests for gender-appropriate staff could be met wherever possible.

He was satisfied with the sincere apologies given by the hospital staff; and their plan to review procedures.

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Reporting concerns about discourteous treatment

A consumer contacted an advocate expressing concern about a male nurse who had cared for him during a recent hospital admission. He required medication to stop tremors, and the timing of this is important. When he relayed this to the nurse it was clear from his abrupt and response that the nurse was not going to accommodate this timing requirement. The same nurse left him unsupervised in the shower despite the consumer being shaky on his feet, ignored his concerns about swollen and sore heels, and was discourteous and off-hand with his comments when the consumer requested a wheelchair to get to the carpark when he was being discharged.

The consumer felt the hospital needed to be made aware of this nurse's attitude as he was concerned that other elderly and sick people would be treated similarly. After hearing about the Advocacy Service, the man and his wife drafted a letter to the DHB and asked the advocate to look it over prior to it being sent.

The consumer was pleased to receive a response from the DHB advising that the nurse was a 'bureau' nurse and no longer worked at the hospital. The consumer's concerns had also been passed on to his employer.

The consumer was pleased to have the opportunity to discuss his concerns and the process of his complaint with the advocate.

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