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Last Updated: Wednesday, 20 July, 2005, 19:59 GMT 20:59 UK
Margaret Haywood interview
Margaret Haywood
Margaret is a state-registered nurse who spent three months working for Panorama undercover secretly recording her experience working on an acute medical ward in a failing hospital.

What follows is an edited transcript of an interview with her about her experiences and her reasons for chosing to do so.

Why did you decide to go undercover for Panorama?

First and foremost, we were acting on complaints, complaints we had heard from people whose elderly relatives have been patients at the Brighton and Sussex University Hospitals NHS Trust. A lot of thought and planning went into this and I worked on the ward without a camera before we decided that I should begin to film.

The public needs to be aware of exactly what's going on in these places, in these wards. We didn't have another way of telling them.

I feel strongly about nursing standards and I think nursing standards have just declined over the past few years. Hopefully some good will come out of this film. My ultimate aim is that the standards will improve and things will get better.

What was it like filming undercover?

Initially when I went in with a camera concealed in my uniform I felt a bit apprehensive. I had never done anything like filming undercover before, so it was worrying that I might get caught.

But first and foremost I'm a nurse. The nursing always came first when I was on the ward, the filming was a secondary thing.

Tell us about your time working at the Royal Sussex. What broadly did you discover there?

The staffing levels were low in my opinion. Sometimes on a shift I was left on my own looking after 12 patients. Some of the patients were highly dependent and some of them weren't able to communicate and tell me what they needed.

I've been qualified for 20 years. I've worked in highly stressful areas like accident and emergency and intensive care. But this is by far the worst thing I've ever done in all my life. I was completely exhausted at the end of shifts.

I really did do my best while I was there. I worked really hard to make sure that patients were getting good care, the care that they deserved and were entitled to, but sometimes we were so short staffed I could only give them the most basic of care.

What's the one memory you'll take away from this experience?

The memory which will haunt me for the rest of my life, is of a lady who was terminally ill with cancer, crying out in pain because she hadn't been given her pain relief on time. That was just so heartbreaking, it really upset me. When I did a couple of shifts in a row, I was able to make sure she got her pain relief on time and the change in her was sometimes quite remarkable. There was no good reason why it hadn't been given to her. Staff were busy and no one had checked, which is awful.

What other examples of bad nursing practice did you see while you were there?

Patients who found it hard to feed themselves were not always receiving the help they needed, or it took a long time. Some of the patients were really quite thirsty.

Some patients' fluid charts were not being filled in. On a few occasions I started fluid charts and feed charts but I think that it was only me and a couple of others who actually filled them in. Weighing the patients is important as well, to make sure that they're not losing weight and that wasn't always happening.

There were patients who were not getting their medication. Patients were not being helped out of bed. Instead some were being nursed in bed in these awful gowns with splits up the back which is degrading. Patients ought to have the freedom to wear their own nightwear or their own clothes.

You weren't there all the time, so it may be that things were being done better when you weren't there. Is it possible that the impression you've got is a rather unfavourable one?

That's always possible but I think I have a good overview of what's been going on there. It was clear from looking at the patients' reports, which should smooth the handover from nurse to nurse, that communication was poor. Nursing is all about communicating - with your patients and with your colleagues.

None of the patients had any care plans so there was no easy way to check that the care they had been receiving was effective.

If you were starting out in nursing now and this was your first ward experience, what kind of impression would you have of nursing as a career?

I think I would have left. I couldn't have coped with it at all. There's no way I could go through that or watch patients going through that. It's not what nursing is about. The morale was really quite low, everybody seemed to be complaining. It wasn't a happy place to be at all.

What's the single most important thing you'd like to see changed on the ward?

Patients should be given care, allowed their dignity and treated with respect. Nurses should make sure that patients are not left in pain or left in their own dirt. That would be a good start.

Could you have believed anything like this had you not seen it for yourself?

No, nothing could have prepared me for what I've seen. Nothing. Someone has to speak up for these people. It really has opened my eyes.

What risks have you taken to get this film on screen?

The risk that I am taking is that my professional registration might be taken away from me because I have broken confidentiality clauses, which are part of a nurse's code of conduct.

I've been a qualified nurse for 21 years and during that time a lot of people have told me things in confidence and those things have never gone any further. But for this programme it couldn't be like that.

So I had to go back to some of the patients I had nursed once the filming was over and tell them that I had been filming.

I was very worried that the patients or their relatives would feel I had been a double agent and that I had betrayed them or betrayed their confidence but mostly, I had a really positive response. People said that if it would help in the long term to improve care then we should go for it and show what we had filmed.

And the bottom line is that you're prepared to lose your professional registration as a nurse?

Yes. I worked hard to get my registration. I've worked hard all my life and I've earned a lot of respect along the way. I agreed to do the programme because I wanted to improve things in the long-term.

I think it is justified by what I've seen and what will be shown. People will understand. I think most good nurses and good doctors will appreciate what I have done.


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