Safeguarding Measures for an Elderly Patient Facing Abuse

If this concern was raised with you within a clinical area what immediate actions would you take

Answer: In this medical/clinical case study scenario where the adult patient, here elderly person was unwilling to go to his/her house because his/her daughter gets angry on them and sometimes abuse them mentally and physical. This scenario needs safeguarding as this deals with safety issue of the adult and necessary steps of safeguarding (Boland, et al, 2013) is needed to assure the wellbeing of the adult and to stop the abuse which may also leads to complete neglect of the patient’s clinical condition by the caregiver (Ramsay, et al, 2012). If this scenario was raised with me as a student of nursing, I would first consult with the head of the nursing team regarding what kind of safeguarding would be perfectly suitable for this elderly person. At the first place by following the nursing ethics I would take the consent from the patient, that if I would talk with the local safeguard personnel regarding the safeguarding of him/her, then I would take the help from the multi-disciplinary team. As a nursing student I cannot take all the necessary actions by myself. The safeguard personal (Lawson, 2017) talked to them and they encouraged the concerned person to make own decision and I would do it fast to prevent the patient from further major harm. Being a nursing student my first and foremost duty is to ensure the medical condition of the patient, so I checked if the patient got the daily medicine in regular basis from the carer in his family. To ensure it I made a list of medicine and advised the patient to check it and after taking the medicine just marked it on daily basis. If the patient did not feel safe with this practice then I would arrange a caregiver after talking with my authority to make the patient’s clinical condition’s treatment safe. I would suggest the patient to record the abuse he/she was facing to protect his/her condition. So the safeguard personal would take necessary legal steps to safeguard the patient. After that by judging and recognising the mode of abuse the local personal would contact the Adult Social Care and Health workers (ASC&H) to meet me and take the necessary actions (Evans, 2013).

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Where a concern is raised by a patient or relative in a clinical area what actions should be initiated by the clinical staff

Ans: As safeguarding is a practice which should be exercised by everyone with responsibility, therefore as a clinical staff there should be great emphasis on eradication of health and social disparities which are directly related to the livelihood of the patient.(Fisher, et al, 2016) As a clinical staff if such thing arises with patient or relative then the immediate actions will be taken are as follows: First thing needed to be done is to identify the signs of abuse, reason of harm and type of negligence. Then it is needed to be identified the risk, if it is an abuse or negligence case. Then one need to look for the appropriate advice from the professional and need to make sure the professionals understood the risk properly, so that there will be no negligence with the patient’s health. (Boland, et al, 2014) Here I would take the help from the local safeguarding personal (Lawson, 2017) to discuss the case of the specific patient. The national safeguarding procedure should be followed like first the local authority would talk to the patient and his/her family, then they would take necessary communicative practice with neighbouring services based on social care. In parallel there should be emphasise on the impact of these acts on the current circumstance. In this whole process other efficient persons can be involved other than family and caregivers, like local safeguard personal and ASC&H workers. National Health Service (NHS) has also promoted practice for safeguarding by promoting few rules, these are ‘Data Protection Act’ cannot make any hindrance during information sharing. Honesty is needed during the practice and consent sharing is needed if necessary. They have some key policies to safeguard children and also the adult people who are vulnerable by setting frameworks, like assurance of safeguard from health and other system in a concerted way where staff need to meet the requirements of the individuals. (NHS, Safeguarding Policy,2015; Straughair, 2011 )

In the short scenario above you have been asked to write a statement. How should you respond to this request

Answer: In the current scenario I need to plan the proper way of solution and if needed I need to consult with my authority and competent personal. In my mind I should be clear enough about my concern by reading practical guidance and documents from local authority. The strategies I shall follow in this scenario are following. I need to define the category of problem, if it is abuse (Physical/Mental) or negligence. Here the cases are quiet serious as the patients are pushed and verbally abused by their care givers, here daughter. I found there were previous evidential support from the cases where similar kind of things happened and in a few case intervention of adult safeguarding authority was very much useful, however in two cases the solutions were not simple and ultimately that led to severe atrocities. Therefore in current scenario without proper intervention the health of patients is at risk so emergency system to safeguard should be used. I shall arrange an emergency meeting with multi-disciplinary professionals dealing with safeguarding. The patients will also be informed so that they can fully take part in their own safeguarding. The meeting committee should consist of nurse, doctors, family members of the patient and the local safeguard personal. Depending upon the circumstance legal authorities like police can also be involved. After this meeting sessions further steps shall be decided and I shall try to implement all the conclusions extracted. All the minutes of the meetings shall be kept for further legislative issues. This process may help me to build my future career by using my expertise of safeguarding. From the conclusion I shall learn the way to circumvent future problems using my reflective analysis on transition to registrant.

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If this scenario arose during your practice placement, can you list the people or resources that are available to support you

Answer: The processing of safeguard practice is an argumentative process and proper guideline should be followed during involvement of people and resources. If this above mentioned scenario arising during my practice then following list of people and exact resources will support me:

The concern should be discussed with the team members of nursing team.

Then this issue should be brought to line manager.

Line manager should discuss with social care agencies and try to resolve the matter.

If not resolved then the safeguarding leads should be discussed.

During the meeting sessions the multi-disciplinary specialist should be involved.

Health officers at chief executive post.

Healthcare trustees.

Executives of health board.

Non-executive directors.

Investigating officials.

Members from different voluntary sectors.

The patient (if possible).

The daughter of the patient along with other family members.

The local safeguard personal.

ASC&H workers.

Along with these various resources should also be used by me like guidelines provided by NHS, safeguarding reviews and reports for showing instance and various e-guidelines. During the contact and meeting arrangement process a thorough knowledge of legal issues should be kept in mind and in this issue digital and e-services may help a lot. During the meeting sessions proper recording of the statement can be done with the help of audio, video supports. (Phair, et al, 2014)

References

Boland, B., Burnage, J. and Chowhan, H., 2013. Safeguarding adults at risk of harm. Bmj, 346, p.f2716.

Boland, B., Burnage, J. and Scott, A., 2014. Protecting against harm: safeguarding adults in general medicine. Clinical medicine, 14(4), p.345.

England, N.H.S. and Wales, S., 2015. Safeguarding policy.

Evans, T., 2013. Organisational rules and discretion in adult social work. British Journal of Social Work, 43(4), pp.739-758.

Fisher, J.M., Rudd, M.P., Walker, R.W. and Stewart, J., 2016. Training tomorrow's doctors to safeguard the patients of today: using medical student simulation training to explore barriers to recognition of elder abuse. Journal of the American Geriatrics Society, 64(1), pp.168-173.

Lawson, J., 2017. The making safeguarding personal approach to practice. Safeguarding Adults Under the Care Act: Understanding Good Practice, London, Jessica Kingsley Publications, pp.20-39.

Phair, L. and Manthorpe, J., 2011. Health care and adult safeguarding: an audit informing the relationship of the UK vetting and barring scheme with the NHS. The Journal of Adult Protection.

Ramsay, J., Rutterford, C., Gregory, A., Dunne, D., Eldridge, S., Sharp, D. and Feder, G., 2012. Domestic violence: knowledge, attitudes, and clinical practice of selected UK primary healthcare clinicians. Br J Gen Pract, 62(602), pp.e647-e655.

Straughair, C., 2011. Safeguarding vulnerable adults: the role of the registered nurse. Nursing Standard, 25(45).

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