Table of Contents:

 Introduction
 Context of my Practice Experience
 Identifying a Safeguarding Incident

 Critical analysis of the safeguarding decision, related to key literature and evidence.

 Voice of the adult patient and his experiences

 Impact of the incident on my practice – specific to my field

 Suggesting a limitation on the decision and suggesting recommendations for future

development.

 Conclusion

Safeguarding Incident Title:

Young person refusing all treatments

When we belong to the medical field or work as a student nurse, it becomes imperative for us to
understand different kinds of safeguarding incidents and should have appropriate grip to handle
these incidents. Basically, safeguarding incidents refer to the specified situations where there is a
need to take appropriate steps for the welfare, treatment and safety of individuals particularly in
case of vulnerable individuals such as young adults, children and disabled individuals. Any kind
of harm such as abuse, exploitation or neglect can be a safeguarding incident. To work as a
student nurse needs to have proper understanding about the handling of these incidents. The first
and foremost step is to learn to recognize the signs of harm in a safeguarding incident. Then, to
ensure timely safety should be the priority. If you have any suspect about the safety of
individual, then take immediate steps, such as, call for help or seek help from your healthcare
colleagues. Informing the authorities about the risk and then documenting the incident are also
some essential steps to be taken (C Halpin, 2022). Handle all the challenges appropriately by
following the policies and procedures of organization. Considering ethical considerations, we
should ensure to keep the incident confidential so that any person’s privacy isn’t leaked without
his or her consent. Keep improving your learning by adopting new practices. This whole study is
about the professional practices required while handling safeguarding incidents mostly in case of
vulnerable adults. Analysing recent studies, development of policies, incorporating legal
guidance and inspectorate reports can help to adopt effective measures for safeguarding adults.
These systems need to be conduct timely and these should be rigorous and transparent so that
public confidence can be ensured. To ensure public confidence is essential so that they must seek
for public services when they are at risk. There are many successful examples of safeguarding
incidents but there are many barriers such as cultural and sectarian barriers while conducting this
system among organizations. Due to these barriers and lack of communication, this system lacks
proper implementing strategies. There needs to be proper strategy for working in which
clarification of responsibilities and integration of processes is incorporated. This is also a risk
that while conducting protection measures, multiple routes can result in harm because of lack of
coordination. (Williams, 2011).

Safeguarding practice has now become a part of the mandatory training programme for all
healthcare providers. While handling the vulnerable individuals of society, healthcare providers
should be well familiar with the appropriate safeguarding practices because in such safeguarding
incidents, individuals are at their most in need of support. There are local and national policies
regarding Safeguarding incidents handling and thus proper legislation is designed to handle all
kinds of safeguarding incidents. For safeguarding vulnerable individuals of society, The Care
Act 2014 provides six different key strategies. These include; prevention, proportionality,
empowerment, protection, partnership and accountability. These measures ensure that
safeguarding practices are patient-centred and are appropriate. Besides the Care Act 2014, other
legislations regarding safeguarding incidents include: Human Rights Act 1998, The Children and
Social Work Act 2007, Safeguarding Vulnerable Groups Act 2006, Sexual Offences Act 2003
and even more. Thus, a variety of policies exist to describe the legislative importance of
protecting vulnerable individuals. (M Chernyshev, 2019)

Context of my practice experience:

During my course of study, an internship session was conducted by which we got the opportunity
to work as clinical nurses. So, I was appointed in a busy paediatric ward of the hospital as a
student clinical nurse. So, I got an opportunity to face the challenges and complexities of
healthcare service. The ward where I worked was catered with wide variety of patients suffering
with different kinds of illnesses like acute, chronic and even with post-operative care. While
providing the services of healthcare, the main focus was not only on providing medical treatment
but also on establishing a safe environment where patients and their families can feel safe.
During my internship period, I faced a challenge in the form of a patient who refused to take all
treatments. Basically, that patient was a 16-year-old adult who was suffering with a chronic
illness and was he was receiving medical treatment for many past years. During my duty period,
I just noticed that patient from refusing to take any kind of medical treatment. It was a challenge
for all team members to implement appropriate strategies and approaches for patient’s treatment.
Collaboration among whole team members regarding the potential issues was ensured (J
Baumbusch, 2017). The team consisted of clinical nurses, physicians, psychologists and other
social workers working together for the well-being and treatment of patient. Proper
communication strategies such as regular meetings and conferences etc. were conducted to
ensure effective decision-making. In this way, collaborative behaviour played critical role in
addressing complexities of the case. Safeguarding incident under analysis was crucial to conduct
to address the challenges. The hospital firm had proper policies and well-established strategies
and protocols in order to safeguard such incidents. These polices were used to reinforce through
regular practices, training and education programs. The main aim of these strategies and policies
was to ensure the protection and well-being of all paediatric patients mainly the vulnerable
individuals due to the chronic illness (S Dahlke, 2015). To ensure ethical considerations, these
policies also included the rules to protect the patient’s autonomy while keeping their needs and
care at first priority. So, during my duty experience, I observed all the ethical dilemmas when a
critical case of a young individual arose when he refused from taking all medical treatments. As
a clinical student nurse, I faced it as a challenge to keep the delicate balance between the
protections of patient’s autonomy and to ensure patient’s wellbeing, safety and health treatment
(PJ Liu, 2021). The lessons that I learned there while handling this case included that is that
effective communication and co-ordination with the patient and his/her family is essential and
foremost step, to build a therapeutic relationship with the patient and his/her family is essential in
order to address their concerns, to explore the reasons that why the patient is refusing from
taking medicine, try to prioritize to work on a shared decision policy upon which the best
interests of patient rely. In short, my clinical experience as a student nurse in the paediatric ward
of the hospital provided me rich knowledge to withstand all the complexities and exploring the
ways to understand safeguarding incidents regarding to young individuals. The collaborative
nature of the whole working team coupled with the robust strategies and policies of the hospital
ensured comprehensive approach towards the safeguarding incidents. This whole scenario is
critically analysing the safeguarding incidents regarding young people refusing the medical
treatments as it ensures patient’s autonomy, care, safety and health treatment. (EL Stevens, 2015)

Identifying a safeguarding incident:

Here in my experienced scenario, the safeguarding incident is revolving around a young man
who is refusing from all medical treatments of his chronic illness. This raises significant
concerns about the well-being and health of the patient because this may affect his overall health.
Safeguarding incidents can be in various forms such as abuse, neglect, self-harm and even
exploitation. The presented scenario involves the case of self-harm.

Critical Analysis of the safeguarding decision related to key literature and

evidence:

Analysing the safeguarding decision critically, it is essential to review pertinent material and data
in order to objectively evaluate the safeguarding choice on the young person's refusal of
therapies (Warren, 2018). It can be difficult to strike a balance between young people's
autonomy, healthcare requirements, and safety when making decisions on occurrences affecting
them. The relevance of a person-centred strategy that respects the young person's freedom to
make decisions about their own body while taking their interests into account is emphasised in
important literature. It emphasises the value of clear communication, developing trust, and
making decisions together with the young patient and their family (McCafferty, 2017). To ensure
that young people are safeguarded from harm and given access to resources, there are ethical
issues and legal frameworks that must be taken into account.

The young person's perspective and their experiences:

It is crucial to take into account their voice and experiences in order to fully comprehend the
safeguarding event involving the young person's refusal of therapies. The young person should
be seen as an active participant in their own care, and any decision-making procedures should
place a strong emphasis on understanding their point of view. Healthcare practitioners may learn
a great deal about their experiences and develop a better understanding of their motives by
paying close attention to and empathising with their worries, anxieties, and justifications for not
wanting to get treatments. The young person's voice adds crucial context to the safeguarding
occurrence, enabling a more thorough investigation of the circumstances (S Bragg, 2020).

The incident's effect on your practise specifically in your field:

My practise as a student nurse has been significantly impacted by the safeguarding event in
which a young person refused all treatments. It has brought to light the difficulties and
challenges of caring for young people who demand their autonomy. The significance of
mastering good communication techniques and creating a rapport with patients has been
highlighted by this instance (C Pretorius, 2019). It has led me to consider other care strategies
that honour the young person's desires while maintaining their safety and wellbeing. This
experience has also helped me to better grasp the moral dilemmas associated with protecting
children and the necessity of a person-centred strategy.

Suggest a limitation on the decision and suggest recommendations for future

development:

It's critical to be aware of a potential constraint while making the safeguarding decision for the
young person who refuses all therapies. The viewpoints, experiences, and prejudices of the
healthcare team may have an impact on this case's decision-making process. It is vital to
understand that a young person's autonomy may be jeopardised if personal values and beliefs
unintentionally influence decision-making. Healthcare practitioners should reflect on their own
biases and continue their education to guarantee a more inclusive and objective decision-making
process in order to alleviate this constraint (C Garritty, 2021).
It is advised that future efforts concentrate on encouraging open and honest communication
between medical personnel, paediatric patients, and their families. Regular conversations,
instructional initiatives, and shared decision-making models that give kids the power to actively
engage in their care can help achieve this. Additionally, setting up clear policies and procedures
for instances involving children who refuse medical treatment can give medical personnel a
foundation for navigating these challenging circumstances (JG Martins, 2020).
Furthermore, to guide decision-making in safeguarding situations, continuing research and
evidence-based practises should be given priority. Studying the experiences and viewpoints of
young people who refuse treatments can provide important information about their reasons and
aid in the development of therapies that are tailored to their particular needs. Furthermore,
interdisciplinary teamwork and knowledge-sharing among medical experts can improve
comprehension and provide a thorough approach to protecting children (MJ Page, 2021).
Future developments can improve outcomes for young people who experience similar
safeguarding incidents by addressing the limitation of personal biases, encouraging open
communication, establishing clear protocols, and incorporating evidence-based practises.
Conclusion:
By addressing the restriction of personal biases, fostering open communication, establishing
clear rules, and adopting evidence-based practises, future advances can enhance outcomes for
young people who suffer comparable safeguarding occurrences. Additionally, it has pointed up
certain stumbling blocks to decision-making, such individual biases, which should be overcome
by continuing learning and introspection. Going forward, it will be crucial to keep encouraging
open communication, creating precise standards, and implementing evidence-based practises in
the safeguarding sector. Healthcare providers may improve their knowledge, ensure a more
comprehensive approach to treatment, and enable children and teenagers to actively engage in
decisions regarding their own health by doing this. In the end, this critical event analysis has
been a worthwhile learning experience that will influence my nursing practise in the future and
reinforce the value of moral decision-making and person-centred care in preserving the
wellbeing of children.

References
1. Halpin, C., & Reid, B. (2022). Attitudes and beliefs of healthcare workers about influenza
vaccination. Nursing older people, 34(5).
2. Williams, S. (2011). Safeguarding adults at risk in the NHS through inter ‐agency
working. The Journal of Adult Protection, 13(2), 100-113.
3. Chernyshev, M., Zeadally, S., & Baig, Z. (2019). Healthcare data breaches: Implications
for digital forensic readiness. Journal of medical systems, 43, 1-12.
4. Baumbusch, J., Shaw, M., Leblanc, M. E., Kjorven, M., Kwon, J. Y., Blackburn, L., ... &
Wolff, A. C. (2017). Workplace continuing education for nurses caring for hospitalised
older people. International Journal of Older People Nursing, 12(4), e12161.
5. Dahlke, S., & Baumbusch, J. (2015). Nursing teams caring for hospitalised older
adults. Journal of Clinical Nursing, 24(21-22), 3177-3185.
6. Liu, P. J., Hernandez Chilatra, J. A., & Phelan, A. (2021). Examining nurses' role in Adult
Protective Services related to safeguarding older people. Journal of advanced
nursing, 77(5), 2481-2497.
7. Stevens, E. L., & Cook, K. (2015). Safeguarding vulnerable adults: learning from the
reflective assignments of pre-registration students in the adult field of nursing
practice. The Journal of Adult Protection, 17(1), 31-40.
8. Warren, L. (2018). Role of leadership behaviours in safeguarding supervision: a literature
review. Primary Health Care, 28(1).
9. McCafferty, P. (2017). Implementing article 12 of the United Nations convention on the
rights of the child in child protection decision-making: A critical analysis of the
challenges and opportunities for social work. Child Care in Practice, 23(4), 327-341.
10. Bragg, S., Renold, E., Ringrose, J., & Jackson, C. (2020). ‘More than boy, girl, male,
female’: exploring young people’s views on gender diversity within and beyond school
contexts. In Trans
11. Pretorius, C., Chambers, D., & Coyle, D. (2019). Young people’s online help-seeking and
mental health difficulties: Systematic narrative review. Journal of medical Internet
research, 21(11), e13873.
12. Garritty, C., Gartlehner, G., Nussbaumer-Streit, B., King, V. J., Hamel, C., Kamel, C., ...
& Stevens, A. (2021). Cochrane Rapid Reviews Methods Group offers evidence-
informed guidance to conduct rapid reviews. Journal of clinical epidemiology, 130, 13-
22.
13. Martins, J. G., Biggio, J. R., Abuhamad, A., & Society for Maternal-Fetal Medicine
(SMFM. (2020). Society for Maternal-Fetal Medicine Consult Series# 52: diagnosis and
 management of fetal growth restriction:(replaces clinical guideline number 3, April
2012). American journal of obstetrics and gynecology, 223(4), B2-B17.
14. Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C.
D., ... & Moher, D. (2021). Updating guidance for reporting systematic reviews:
development of the PRISMA 2020 statement. Journal of clinical epidemiology, 134, 103-
112.