Asking questions

Screening – I have just obediently attended by appointment for breast screening – it wasn’t a particularly pleasant experience but nor was it that traumatic – it was just a functional experience – technically competent but very little chat and connection. It felt very empty and I wondered whether the person asking me the questions was protecting herself from really connecting with the women who troop through her caravan. I tried really hard to get her to be more person-centred but she wasn’t having anything of it. She instructed me in relation to how to get my breast on the machine just as she would anyone else; no change in tone and just like reading from a script. As I stood there with my tit being squashed in the machine, being told not to breath and not wanting to delay the procedure, I wondered what it must be like for the frightened, overweight, short, disabled or distressed. I wanted to disrupt the flow but thought better of it – I have stirred up enough stuff this year in my employment without causing trouble for breast screening. It didn’t feel person-centred, it didn’t feel kind, it just felt perfunctory and efficient. It reminded me of when I went to the breast clinic 8 years ago with a “lump” and had a thoroughly miserable time being shipped from one room to another, watching the specialist nurse trail after the consultant. Is all of this a wise use of precious resources? Will I go back? Will that put me at risk? My Mum had breast cancer caught on screening when she was 69.. that didn’t kill her – it was the Crohn’s disease  and undiagnosed recurrence of sarcoma in her uterus. Are we increasing anxiety and turmoil for well people and doing this in a way that is unhelpful and actually causing more harm than good?

I met one of my “heros” last Friday, Margaret McCartney (http://margaretmccartney.com/welcome/), and realise that nurses need to join the conversations about over diagnosis and the implications that has for our professional roles and relationships. I am learning about the issues and hope to generate interest amongst how we can encourage more questioning in care and how curiosity might be seen as a “good” thing and not deviant and also that obedience may have a lot to answer for in relation to nursing practice. I strongly suspect that part of the “hidden curriculum” in nursing education is about obedience and subservience. The recent media frenzy about University education has not even touched on this topic and the simplistic and reductionist view of what nurses do is limiting the debate about what knowledge is essential for expertise and excellence in nursing practice.

I am getting frustrated with passive aggressive approaches to resistance in nursing practice- stop it! Let’s join forces with other professions and learn to trust each other’s intentions and start having grown up conversations about how to improve health care experience for ALL…

These and other topics are in need of exploration and elaboration – I intend to spend the winter months reading about these issues, training my “monkey brain” to focus and slow down – I believe that this is possible… that way I hope to not be so frustrated with myself and my lack of productivity.

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