Good staff must be helped to shine – not burn out

If we conducted a poll I suspect most people would say they “liked” nurses - or at least the idea of them - more than, say, guitarists or pizza delivery people but, given a choice, they would prefer to meet the guitarist going about his or her business than a nurse. Mostly, we probably think nurses are good people but, on the whole, would prefer not to find out.

Two friends of mine were talking to me about nurses recently. One had spent a lot of time with a dying relative. A former nurse himself he reflected (some time later) that the nursing was “as variable as he would have expected”. However, he spoke of a nurse “towards the end” reminding him of how nursing offers a unique opportunity to be remarkable, and what sort of mark an outstanding nurse can leave.

‘If we conducted a poll I suspect most people would say they “liked” nurses - or at least the idea of them - more than, say, guitarists or pizza delivery people’

He said that he didn’t notice at the time how easy she made it for him to stagger through decision making or how patient, gentle and warm she had been. He described her presence as “transcendent”.

More recently, another friend was referred by her GP as a matter of urgency to a specialist service only to be assessed andpretty much dismissed by a senior nurse with the communication skills and emotional intelligence of the angry fur ball who used to play drums on The Muppet Show. Sentences including “I don’t know why you were referred here” marked the nurse out as better suited to hosting The Weakest Link rather than a clinical service.

Now we all know that everyone can have a bad day and a few of them together do not make bad nurses, although they may mark us out as capable of bad nursing.

What’s more, we also know that there are some people nursing who really shouldn’t be doing the job. We don’t like to talk about it because we think it reflects badly on us - either because they are nursing and give the profession a bad name or, more often, because we wonder if we should do more about it when we see it.

We know that some poor nursing happens and that some of the people who do it recurrently seem to get away with it. And it may be the case that sometimes nursing culture sustains that wrongness, doesn’t it?

But I wonder if the same nursing culture manages to sustain the outstanding nursing exhibited by the staff nurse to my grieving friend. Have we managed to create systems of support, supervision or professional values that will enable that nurse to carry on being excellent? Or might that brilliance be lost to mediocrity? Or exhaustion?

There are good, bad and brilliant nurses. More good than bad I believe. But, when nurses shine, is the profession set up to protect and support them? Or do we - more often than we should - simply let them burn themselves out?

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