Like many, I am concerned about nursing. In my view nurses have become too defensive which inhibits our capacity to care.
We are less generous in our nursing because we are on the defence, ready to avert complaints before we are willing to really care.
The nurse/patient relationship is in crisis. It is not enough to blame individuals, the problems are widespread. There is something amiss at the heart of the culture. I have been concerned, like many, by the indifference to suffering I have witnessed in nursing staff. I think this is symptomatic of a wider cultural problem within the health service and the independent sector.
Nurses have taken the blame for this lack of care for too long without stressing enough the destructive effects of litigation, enforced target-setting, complaints and cutbacks, and huge public expectations. We have allowed the nursing role to be denigrated. Essential care is largely left to untrained staff who are underpaid, overworked and constantly criticised and become hardened and drained if they are not given the right support. The fact that nursing staff get tired, stressed and emotionally drained is overlooked. We continue to put enormous pressure on ourselves and each other to strive for unrealistic goals of tough “can do” perfection, which denigrate the very humanity so necessary to good nursing practice.
I once asked my university tutor if he thought nursing was undervalued as a profession because it was predominantly female; he said not undervalued so much as taken for granted, like mothers and wives.
It is time to take a good hard look at where we have gone wrong. The mantra “if it isn’t written down it didn’t happen” is chanted in every university lecture and training session. We need to examine what we are actually saying here. Is it saying first cover your back, look after yourself, defend yourself. Is this good soil in which a therapeutic positive relationship will flourish?
Part of the culture of litigation and blame also comes from an unwillingness to accept the reality of death and old age. We can relieve symptoms, we can make people comfortable and we can maintain their dignity but we cannot always make them better. Sometimes this is understandably difficult for patients and relatives to accept but it isn’t usually anybody’s fault - death and old age are bigger than any of us.
The public and legal professions need to accept the consequences of litigation and adding fuel to the blame culture, understanding that it erodes trust and good will and ultimately breeds resentment, because unless we have a healthcare system run by robots there will always be mistakes.
I am fortunate enough to work in a home where people do matter, where there are living, active relationships between service users and nursing staff, where the drive for efficiency and meeting targets has not outweighed the time for real care. However in healthcare the pressures are mounting. The drive to super-efficiency is ever-increasing, as are the complaints from angry relatives and the criticism from other professionals and the threat of litigation. I wonder who will be left wanting to care? Nursing should be counted as one of the most privileged and important careers you could choose. The fact that it isn’t reveals a lot about our values.
Lucy Calcott is a staff nurse at The Chaseley Trust, Eastbourne