Conversations on Twitter and the Radio 4 play have got me thinking.I’m so cross I don’t even know where to start. Nursing hasn’t got a glass ceiling so I’ve no idea what Jeremy Hunt is on about…but then again that’s nothing new.
I’ve spent the last 18 months making sense of my 3 years as a nursing apprentice between 1979-1982. I was encouraged to go into nursing with my 2 A’levels as I was told that the hospitals wanted “bright gals” in the profession and that the School of Nursing wanted questions asked… So it was said at the interview…..
The reality of being a student was very different – “not even a useful pair of hands” was the comment from a health care assistant on my first ward. I found the whole experience difficult and didn’t feel I fitted in anywhere. The wards wanted a pair of hands and I thought I was there to learn about nursing care – it was an uncomfortable mismatch and time and time again I found myself crying in the sluice. I also found myself repeatedly conflicted by the allure of nursing care and the horrible way I was being treated by Ward Sisters and staff nurses – being bullied and interrogated and finding the physical and emotional work exhausting and traumatic but I loved being a nurse and found myself absorbed by the nursing role. Fortunately I did encounter clever and caring staff nurses by my fourth ward but the struggles continued – I stayed in nursing for economic reasons and probably due to lack of self belief – my friend Mandy left and went to study a degree – she was bold and brave.
Not that I realised that I was really conflicted back then when I was 18/19 – it is only with the wisdom of hindsight and the reflexivity of the “what went wrong?” with my career change last year that I have excavated much of this. I found that very early on in my management role I was struggling with the type of nursing I was dealing with – sentimental and sanctimonious – resistant to reflection and no engagement with CPD. I found that I really struggled with “managing” these nurses and found myself upset and in tears rather than finding effective ways to help practice improve. It is now I can see that I was stuck in my 18 year old traumatised self and that the effect of the nursing care I was witnessing was to re-traumatise me in relation to the experience of being a student. I didn’t know that at the time and my distress was exploited and my boss found it irritating. A more compassionate environment might have sought reasons for my despair rather than seek ways of getting rid of me BUT I am grateful that I was so badly treated. That injustice and deliberate misunderstanding has given me the time and space to find out what was going on for me and heal my relationship with my chosen profession.
The difficulties we face in nursing are enormous, complex and politically loaded – today’s announcement about the new apprenticeships in nursing have rekindled my fury with the lack of value placed on the caring role, Yet again nursing is talked about in relation to personal qualities rather than in relation to the skills and knowledge required to help manage patient care in the 21st century. I loved being a “clever” specialist nurse and got satisfaction from helping patients navigate the complexity of the health care environment but I still kept on asking questions.
Studying a Master’s degree in 1994 was an unusual career move and in many ways it caused a lot of friction. I was indignant and ambitious back then and when the Medical Consultant and I locked horns I decided to leave and work at the University rather than seek solidarity with my nursing colleagues. I don’t regret many things in my nursing career but I do wish I had stayed in that post, developed my PhD in action research and allied myself with other nurses working in clinical research posts. One of the things we don’t do in nursing nearly enough is come together and use a collective voice to ask questions about the way we are perceived by politicians and the public. I often see a divided profession with a tendency to competition that leads to top trumping and point scoring rather than a collaborative and cooperative way to take the profession forward.
I don’t have any answers to the current state of affairs but I am reassured that I can feel fired up enough about the current debates to get these words down. We need to think about what we are doing for the next generation of nurses because I don’t see a great future. We are not cultivating the next generation of thinkers as none of this will be filling them with optimism about the value of their degrees. We need thinkers and doers in nursing – we don’t ever question that in other health care professions but I have to say that while nursing is reduced to either sentimental altruism or the messy “body work” then I can’t see much changed in 37 years – now that can seem really depressing. BUT I know different – I meet nurses every week who are intelligent, curious and compassionate – eager to improve care for their patients and working on an equal footing with academics across many disciplines – they are admired and respected by their colleagues and passionate about the work they do. This latest debate can be frustrating but I also know that there is a great deal to be positive about but we just don’t shout about it enough. We have to be more confident and assertive in blowing our trumpets in nursing – not massaging egos but promoting those who are developing improvements in practice. Please let’s do that more and find ways of being kind, curious and generous.