A Portuguese nurse and why Brexit should make the NHS safer

ONE of the scariest experiences I ever had as a doctor was a few years ago while working a nightshift in A&e.

In the course of my career, I’ve been sworn at, slapped, punched, threatened, spat at, you name it … but this was totally different.

I was on duty in a busy inner city hospital casualty department. It was a tiny team — just me and a nurse. The usual nurse was off ill, so an agency had supplied a replacement.

As soon as I introduced myself, I realised that her spoken english was very poor. She was from Portugal and lived there most of the time, coming to the UK to do stints as an agency nurse.

After a brief, hesitant discussion, I became aware that she didn’t believe in mental illness — the area of medicine with which we were dealing that night.

She described people who suffered from mental illness as being merely ‘weak in the head’, and said that they should be told to pray. Aghast, I presumed her real view had been lost in translation.

but then I spotted her giving a patient medication to sedate him, although it hadn’t been prescribed. Worse still, it was in fact potentially dangerous considering how unwell the patient was. When I reprimanded her, she shrugged. (To be honest, I’m not sure she understood me.)

PROBLEMS continued when the family of another patient, a female, complained that the Portuguese nurse couldn’t understand them and they didn’t want their relative to continue under her care.

She then discharged a patient who was suicidal, and I had to call the police to find him and return him to the hospital.

Finally, the nurse went missing for several hours when she was supposed to be monitoring a disturbed patient with dementia. I found her asleep in the office. by this stage, I was so worried about her interacting further with patients that I told her to stay there while I made the rounds alone.

The following morning, I reported what had happened to our manager, who duly informed the agency and told them we wouldn’t have the nurse back.

Of course, this woman may have been a one-off bad apple and a liability, even if her english had been impeccable. but I can’t be certain that the language barrier wasn’t the problem.

either way, the truth is that the NHS hiring system is unable to do proper checks to ensure that health staff who come from fellow EU countries are capable of doing the job. There is no requirement for language tests, or even a test of basic medical competency.

I am the first to accept that the vast majority of nurses and doctors from EU countries who work in the NHS are highly competent and skilled. Their ability to speak english as a second language puts my own schoolboy efforts with French and Spanish to shame.

Nevertheless, it is not right that EU employment laws mean we cannot make checks on foreign staff before they are hired.

Under current rules, regulators must register all EU nurses as ‘ safe’ without carrying out any checks — even if they have not practised for decades.

The rules are that only nurses from NON-EU countries may be subjected to competency tests.

This week, the Nursing and midwifery Council called for loopholes that prevent nurses from european Union countries being tested to be closed. In a damning report to the Commons Health Committee, the Nursing and midwifery Council warned that the current situation is ‘unsafe’.

This ludicrous state of affairs demonstrates how EU rules risk the welfare of the sick.

my hope is that brexit will result in sensible changes and improvements to the standards in nursing care. Hopefully, such changes will include more stringent checks on abilities of staff from EU countries.

FIGURES show that in 2015/2016, nearly 10,000 nurses and midwives from EU countries registered to work in britain. In total, about 40,000 nurses working in the UK trained elsewhere in europe.

This is a vital issue because poor nursing care affects the most vulnerable: the elderly, the disabled and those with mental illness.

To highlight this basic truism is not xenophobic. The issue is about providing best patient-care.

And the unarguable fact is that there is a worrying difference between the standards we demand from british- trained nurses, compared with those who come from EU countries.

While it is quite right that foreign nurses should work in the NHS, it is vital that they should conform to the same high standards.

As well as new agreements on trade, environmental regulation, border controls etc, brexit also offers the ideal opportunity to reinforce proper patient- care standards in our Health Service.