Risk mismanagement

On the one hand we get a message that the nurses want my sons fit reaction protocols redrafted (6 pages of protocol) as they think they may be interpreting them differently from one another. On the other hand, when we check what the protocols say, we discover that the last one we got changed officially three months ago, hasn't been updated in any of his files.

I'm not so annoyed about the failure to update the files as you might imagine. What really irritates me is that we have to have these prescriptive, fine detail protocols in the form we do. They are the ultimate in 'nursing by numbers' and in my view, take away the discretion nurses have to act in the patients best interests. These are after all, fully trained and registered nurses with accepted qualifications as well as a battery of specialised training competencies. I don't have a problem with written guidelines, but when what nurses can do is spelt out in such fine detail, I can't help feeling that it's less for patients benefit than to protect the commissioners etc. from being sued. It doesn't even protect the nurses particularly, but it does give the authorities someone to blame if an error occurs. It all seems to be part of the beaurocracy of 'protection' and 'risk aversion' that prevents anyone from using their own judgement and taking any responsibility for their actions. Authority no longer seems willing to trust the people it employs. And the reality is that life carries on in spite of it.

CRB checks are mandatory but take three months to come through and don't actually prevent anyone wanting to abuse vulnerable people from doings so. Risk assessments get used to exclude disabled people from doing anything remotely exciting or interesting. Nurses have to comply with detailed protocols even though simple admin errors mean the protocols are actually out of date and incorrect. These things don't actually help to provide better care - but they do make it easier to find a scapegoat when things inevitably go wrong. Things do go wrong in life - shit happens. The aim should be to avoid the obvious blunders, recover the mistakes and trust people sometimes.

Protected - from living

I've just posted on the Guardian about the baby P etc. issue. I'm really concerned that all social work these days seems to be about protecting peoples/authorities backs. I know protection is important but feel it's now got to be the only thing social work is about.

There used to be a time when social workers provided a service to people like my son. Now we can only talk to one if there's a crisis, preferably a vulnerability/protection one. It's no longer about doing the right thing to make life better - now it's about not being caught doing the wrong thing. It feels to me that social work has retreated from trying to make life better into only being concerned with not getting blamed for making things worse.

It isn't providing a service anymore, it's preventing people from living .... by risk assessing all the joy out of life, .... by assuming everyone is guilty of the worst possible crimes until they can prove they might be innocent, .... by not looking for the best solution but only for the least risky (to them), .... by withdrawing any services they do provide and contracting them out so there's someone else to blame.

All life is a risk, assessing it, should be about working out what is likely to go wrong and making sure that is allowed for - not just 'don't do it, it might go wrong'.