Saturday, April 17, 2010

Professor Dora Kohen, GMC, uniforms

Professor Dora Kohen was appointed to work at the General Medical Council, UK as Health Screener (screening complaints against medical doctors in order to refer doctors for psychiatric examinations). She also worked for Parole Board (2007-2008) paid for by Department of Justice.
Interestingly, at the time when religion was forced by Blair Administration on many public institutions, she wrote an article: "Nurses' uniforms" in Psychiatric Bulletin Vol 26 No4 April 2002 page 156. Essentially, she claims that nurses balloted to go back to wearing their nursing uniforms in all the psychiatric intensive care unit, acute male and female wards, and rehabilitation wards. and that this was followed by "a great reduction in aggression, violence and the number of untoward incidents on the ward".
Professor Kohen's article is only the length of an average abstract, does not have any critical appraisal of other literature about the wearing of uniforms in psychiatric setting, or of her own research, contrary to all the principles of good science. There are no references given, no scales or tests mentioned, no statistical analysis and no explanation why no bias was excluded. Presumably, it is the same nurses who voted for uniforms that subsequently would not be filling untoward incident forms. It was left to them to report any incidents.
It is very easy for me to note that one of the editors of Psychiatric Bulletin was at the time Dr Mike Shooter (a religious man), who was also a President of The Royal College of Psychiatrists to whom I wrote about my concerns about the wearing of religious uniforms when working with mentally ill. He was completely incapable of addressing the issue. He did not seem to care about science or evidence by allowing such an article to be published.
The facts are that in UK mental health care professionals have not worn uniforms when working with mentally ill for over thirty years. The papers on wearing of religious uniforms are not readily available on line, or in the average good medical library. These have to ordered and paid for (hundreds of pounds). It appears, Professor Kohen did not dip into her own pocket as I did to find out why uniforms are not worn. I did not regret spending hundreds of pounds in search of truth. I can give references to what I write about simply, because I am willing to do so.
Having found out that the wearing of uniforms in psychiatric setting leads to a barrier in communications, increased violence, more self-harm, more absconding and worse treatment adherence I did research on religious uniforms and what mentally ill people think about it by administering a questionnaire (and not uniforms). Most people found religious uniforms off-putting.
Professor Dora Kohen could have administered questionnaires with photographs of the actors dressed as nurses and controlled for sex as well as uniforms. There should have been two different questionnaires: A and B. In A questionnaire she could have had a female nurse dressed in uniform, male in casual clothes with a Linkert scale below and in B questionnaire other way round. Linkert scale could have on one end Most attractive and at the other end Most-Off putting. Patients would than put a vertical line across the horizontal Linkert scale line to indicate how they feel about it. This would remove nursing, and administrative bias in deciding to go ahead with uniforms.
My research on religious uniforms in psychiatric setting (the first in the world) was followed by furore and mobbing leading to sham peer review before the General Medical Council.
Interestingly, GMC Health Screener thought I had mental health problems ( I never had mental illness in my whole life). When I obtained documents from GMC about the investigation of my case under Data Protection Act 1998, it was 10 years later. Medical Screener's name was blackened. Why such secrecy is required? I sign my patients notes and so do other doctors. Covering up the wrong doing is old and stinky and it is not lawful.
The stigma of mental illness was attached to me so that what I say can be disregarded and this is the case up to present day. GMC should ask for its money back from all of those experts who gave it poor service.
Religion is politics dressed in drag, as somebody said and the low standard of Professor Kohen's paper is noticeable as well as that of the editor who approved it.
Professor Kohen, in her paper, refers to patients as service users but staff as "in patient staff". Clearly, Professor Kohen cannot stomach being consistent and saying in service users staff.
There is no mention of the fact that nurses can be badly paid, houses can be expensive to buy to live in and not spending money on professional clothes which cost a bit, can result in a desire to wear a uniform because it is a cheap alternative. I do not think the same nurses would be spending hundreds of pounds to get publications on the wearing of nursing uniforms.
I guess, under Labour Government we are supposed to think that nurses, workers did the right thing and doctors the wrong, as I also note they did not opt to wear white coats. They do not need to, and could not be forced to.
Once again, The Royal College of Psychiatrists acted in its own interests: preserving the power of the religious psychiatrists and not putting patients first.
Now, that thousands of Catholic priests are known to have abused children, The Royal College will continue protesting that they really, always do their best in the interest of patients.
The famous experiment of Little Albert, see below shows how fears can be formed: through bad experience. Surely, abused men would fear clergy who were under obligation to cover up abuse as well.
However, the evidence is there, when the choice is presented to The Royal College of Psychiatrists to choose between science and abuse of power, it's choice was abuse of power.
If nurses needed to be identified by patients or relatives they could have had their big badges clearly displayed. There is no need for uniforms for identification purposes. Why they would not go to a nursing office on the ward if they needed a nurse? Why is not there a member of staff on duty to assist relatives during visiting time? Etc, etc.

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