Nursing Students Want to Talk About Silence

We, as nursing students, are disturbed and concerned by the recent events surrounding Carolyn Strom’s disciplinary hearing. After having witnessed what nurse Strom considers inadequate care for her dying grandfather, she posted a critique of the care home in which he spent his final days. Even though she is evidently distraught by the passing of her loved one, she nevertheless manages to bring some constructive criticism despite the difficult ordeal. Instead of addressing the concerns cited in the post directly, the staff of the care home filed a complaint with the Saskatchewan Registered Nurses Association. This complaint was received, and after a trial where nurse Strom was ‘laid into’ as per witnesses, she was found guilty of professional misconduct [1][2]. Potential disciplinary measures include fines and, most severely of all, losing her license; in other words she might face losing her ability to practice nursing, and thus, unless she gets re-licensed, her career.

This event reminds nursing students everywhere that speaking out against perceived inadequacies in our health care system is a difficult and often dangerous task for nurses. This extends to private citizenship as well: nurse Strom was speaking out as a grieving grand-daughter, not as a nurse. Regardless, she is now facing punitive measures. Will we, as future leaders and patient advocates, have to fear speaking up in our private and/or professional lives as well?

As nursing students this situation is concerning as it is consistent with recent events where nurses have been silenced for voicing concerns about situations of compromised care. Recently in Quebec, nurses in a maternity ward were forced to testify anonymously about the dangers their patients faced following a recent round of cutbacks. They felt the situation was critical and that the ‘official channels’ were insufficient[3]. A nurse in Ontario was fired last year after speaking out about violence in the workplace[4].

These situations fly in the face of everything we are taught in nursing school, and of the discourses of ‘leadership’ and ‘patient centered care’ we hear from nursing leaders and policy makers. They suggest that ‘official channels’ are inadequate or even harmful for nurses who attempt to use them. Nurses need a safe space where they can not only voice their concerns, but insure timely action is taken to protect themselves and their patients. The tragedy of the Winnipeg Pediatric Surgery deaths in 1994 is one such example. Nurses tried for 10 months to voice their concerns, only to be dismissed as ‘too emotional’ and ‘not competent to judge’. Meanwhile twelve children died, of which 9 were wrongful deaths according to a subsequent inquest[5][6].

Instead of silencing the nursing voice, which we hear so rarely, why don’t our organizations address the issues of safe spaces for nurses to speak up? Why can’t our concerns for our patients, our families and our working conditions be heard? What message are you sending to the thousands of nursing students across Canada about the value of their professional judgement? We would greatly appreciate an open discussion on this issue. Silence does us no good.

Natalie Stake-Doucet, RN, PhD student, Faculty of Nursing, Université de Montréal, Quebec

Caroline Dufour, RN, MSc (student), School of Nursing, Faculty of Health Sciences, University of Ottawa, Ontario

Emilie Hudson RN, BNI, MSc(A) – Nursing student, Ingram School of Nursing, McGill University, Quebec

Jamie Carrier, MSc Nursing (student), Faculty of Health Professions, Dalhousie University, Nova-Scotia

[1] http://news.nationalpost.com/news/canada/shes-attacking-me-as-a-colleague-registered-nurse-facing-discipline-over-critical-facebook-post

[2] http://linkis.com/thestarphoenix.com/n/3yjNK

[3] http://ici.radio-canada.ca/nouvelle/811872/infirmieres-sainte-justine-chu-accouchement-mere-bebe-hopital

[4] http://www.cbc.ca/news/canada/sudbury/north-bay-nurse-fired-violence-1.3429850

[5] http://www.pediatriccardiacinquest.mb.ca/

[6] http://www.lactualite.com/societe/ne-negligeons-pas-les-alertes-des-infirmieres/

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