Early morning thoughts

I have never been a brilliant sleeper. Before the days of the iPad, I would wake at approximately 05:00 and read, or simply lie quietly and reflect on the events that were taking priority in my life. Since becoming the proud owner of this amazing piece of technology, I do all sorts of different (and my husband would say, inappropriate) things in the early morning, like shop for clothes and shoes on line, watch past episodes of Masterchef or look with longing at the temperatures in countries warmer and drier than our own. Today for a change, I logged onto the BBC news website and read what were rated their top stories. The fact that I am still here at all reading the news is amazing as according to the Mayan calendar the world should have ended on Friday at 11:30!

That aside, I was struck by two stories, both health related. One of the stories highlighted the plight of patients that had been treated badly by the NHS between 2002 and 2009. The story commenced with Secretary of State, Jeremy Hunt, stating how appalled and disgusted he was to hear about the lack of care afforded to patients in a hospital in Worcestershire. The story went on to detail how a patient had starved to death in hospital and how other patients were denied food and drink. It did say however, that this was some time ago and that the hospital management were working hard to change the culture to one of caring and compassion. No matter how many stories I read like this I cannot help feeling ashamed, ashamed because I am a nurse and let’s face it, it’s my profession that is being maligned. I wonder how things have deteriorated to the point described in the article; drinks and buzzers are left out of reach and patients left to lie in their own waste! As I was pondering this article and feeling angry and frustrated about it, I flipped to another article. This piece was equally disconcerting, this time it was Prince Charles speaking to the Daily Mail and making a heartfelt plea for the medical profession to be more caring and compassionate. Prince Charles called for what he described as ‘healing empathy, and for the age old qualities of compassion and caring to make a return’.

These articles brought to mind the Prime Minister David Cameron making a similar plea to my profession a few months ago. In fact, funds have been made available through the NHS Leadership Academy to support nurse and midwife training and the Chief Nurse has launched her 6 C’s initiative. The question that has to be asked though is what is really going on here? Speaking to many nurses, as I do regularly, they are equally as appalled when they hear about these cases. No one admits to knowing another nurse or healthcare professional that is unkind or unhelpful, so who are the nurses that are bringing our profession into disrepute? How is it that there are so many cases highlighting patient neglect and sometimes even patient deaths as a consequence of poor care and why have these cases come consistently to the fore over the last 10 years or so? This is where it gets tricky and no one wants to say that nurses aren’t as caring or professional as they once were. The fact is we have a different kind of society today to what it was even 20 years ago. We have different values and beliefs from when the NHS was first set up in 1948. Back then, just after the war, nurses were seen as kind benevolent angels. Middle class ladies, with sensible shoes and good manners, women (and invariably it was women) who were self-effacing and humble, thoughtful and softly spoken, and always white. The stereotypical nurse would be someone that would be willing to give 110% care and attention to the sick, the vulnerable and dying at detriment to themselves. This picture of the nurse has stuck in the nations psyche and is absolutely not the reality of what a modern nurse might look like.

Over many years, even though society has changed, the national view of what a nurse should be has not. Whether this view is right or wrong is up for debate but the fact is, nursing and nurses have changed. This is not to say they have changed for the worse. Talk to any nurse and they will tell you about the mountains of paperwork they have to complete, they will tell you about the continuous and relentless drive for efficiency and at the same time increased expectation of effectiveness. They will tell you about the changes in our nation’s demography, that people are living longer, with numerous and complex conditions, that they are sicker and extremely frail. Multiple demands are constantly being made on our nurses, all day every day. It is grindingly hard and often thankless work. There are more people over 80 years old in hospital than ever before and care in the community is not always an option, whereas for some, getting into and being in hospital is.

Make no mistake nursing is not an easy profession, it is for many a rewarding and wonderful profession but it certainly isn’t easy. The expectations we have on our nursing and hospital staff as a society are high, however we need to understand the very real pressures they are under and trying to cope with.

Having ministers and royalty join in the debate and highlight the plight for patients is all well and good, it keeps the issue of quality care for all, high on the agenda, however the question as to why we keep hearing about incidents of poor care remain wholly unanswered. I believe that in order for people to care for others they must feel cared for themselves. Being constantly taken to task for providing poor care doesn’t feel good, as a nurse it certainly made me feel bad.  I think in order to crack this particular nut we must have open and honest debates about nurses and nursing. Nursing must ask itself some seriously difficult questions, questions about the kind of profession it is and the kind of profession it aspires to be. The answers might be hard to hear but at least it would be a start in addressing some of the issues that are damaging our profession but more than that adversely affecting patient care.