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Practice comment

“In the middle of a maelstrom, good nursing is everything”

I am no stranger to trauma and, having practised for over 20 years, I’m no stranger to nursing either. I thought I knew what good care meant and how to make a difference – now I really do.

For three months, my life turned upside down. My dad ended up in intensive care following a massive haemorrhage after routine surgery. For three months, I camped out on three units while dad endured four more life-threatening bleeds, a cardiac arrest, three major operations and countless investigations. These three months demonstrated to me the real power of nursing.

I have always known that it is the little things that make a difference but to really feel this is something else. Little things, said and done, have the power to make the situation bearable or to amplify distress.

Acts of kindness brought comfort: the healthcare assistant who appeared with coffee in the middle of the night, just after we had been told that dad was unlikely to survive; the junior staff nurse who sat in supportive silence, while we waited to hear if he was alive. There was everyday kindness: the thoughtful ward clerk who looked after my overnight bags; the concern for my battle-weary mum, and the tireless feeding of our ceaseless hunger for information.

Of course, it wasn’t all good. Emotional exhaustion depleted my resources, and thoughtless nursing caused me disproportionate distress: the sister who told me off for exiting the wrong way on an unfamiliar unit; the senior staff nurse who told me “not to worry” as he suctioned 300ml of frank blood from my comatose dad’s tube. There was the matron who could not understand my concern that dad’s feed had been delayed for 12 hours; and the nurse who, for two hours, failed to find a colleague to help her sit up my spluttering dad. I know as well as the next nurse that sometimes you have to wait. Now I know the agony waiting brings.

I liked to find dad washed and shaved, with his lines labelled, and I worried that the nurses were not in control on days when this was not the case. He looked so cosseted when I found him snuggled under a bubble blanket, and so lost when I found him unshaven with his sheets askew.

It was the high-tech, high-intervention stuff that saved my dad, but it was the attention to detail that truly made the difference. I found enormous comfort in the way the nurses supported his swollen sausage fingers on little rolled-up towels, and wrote his favourite programmes on the whiteboard near his bed. When they remembered not to speak into his deaf ear, I knew he mattered. I was touched when they remembered my name and told him I was there.

I am one of the lucky ones – my dad came home. Thoughtless care and shoddy nursing, while upsetting, were outweighed by compassion. Yet shoddy care exists and is tolerated. It needs to be named and rectified for not only the distress it causes but also the dilution of care and the damage it does to the profession.

Small acts of caring and concern kept my family going. We need to treasure this ability and foster its growth. It is easy to underestimate the impact of nursing actions. When you are in the middle of the maelstrom, good nursing is everything.

Ruth Bailey is a practice nurse, Charter Medical Centre, Hove

 

Readers' comments (6)

  • tinkerbell

    I agree with you wholeheartedly. When you see your loved one suffering every detail is magnified, the small act of kindness and the uncaring disregard for the person you love. Thank God there are diamonds amongst the chaff but as you say those who don't care enough to feel for another humans suffering should be shown the door, they are a disgrace to the nursing profession and our humanity and not fit to practice. They would be better employed somewhere else where they can do no damage to a living breathing soul and certainly not as a nurse or a doctor where trust is paramount because it is not ust what we do when someone is watching but what we do when someone is not watching that shows we have a conscience or a moral compass and those without a conscience are not fit to work with the vulnerable and sick.

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  • Ruth, I too, wholeheartedly agree with you.

    My Mum, sadly no longer with me now, 10 years ago had a 6 month stay in hospital, that should never have happened - too long a story. It was a long road to recovery, with a string of medical blunders along the way but the kindness of the few helped me and my family along. It came mainly from a very special cadet nurse, the N/A's and one or two trained staff only. This should tell us all something.

    So glad your Dad made it.

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  • I agree wholeheartedly with the sentiments expressed by both writers. I remember the thoughtless comments made by one health support worker when I found my mum in clothes that were not her own and dressed inside out, sitting soaked up to her neckline in urine; well she knows no better! This from a supposed carer. Mum died of gangrene & septicemia cause by a pressure ulcer.I wonder where trust and care came into this?

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  • i have been out of the nhs for two years . i really miss the caring side of my work . i recently tried to return but was advised as i had not had any " hands on care" in the last six months i was not suitable . my ex partner works for the nhs and continues to tell me not to return as i am an old school nurse, qualified nearly 30 yrs ago, so would be frustrated , disollusioned and disgusted with todays nhs These postings make me realise he is probably right . i am sure i am not the only one feeling this way . COME ON NHS , SHAPE UP AND START TO SEE HOW MANY NURSES ARE BEING DRAWN AWAY FROM THE SYSYTEM . I am sure bevan would be turning in his grave seeing how his dream has become such a nightmare !

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  • I am sure Bevan would be turning in his grave.

    I have been nursing for 38 1/2 years and coming towards the end of my career, perhaps. However, my dilemma, in my own mind, is on one hand I want to get out and on the other, I feel I am leaving a 'sinking ship'. I still feel I contribute to a caring and knowledgeable profession, but feel I am urinating against the wind for a lot of the time.

    I am seeing things coming into practice that I introduced some 20 years + ago, in small pockets, that were abandoned. As a staff nurse then, I felt that I wasn't supposed to have the innovation to improve care and practices. I still hold the belief that the profession is too hierarchial to embrace good ideas from lower grades. Is that why we are losing the basics of caring?

    It is the little things that upset us in many cases, such as with bereavement, so it makes sense that it is often the little things that make the difference when we, or our loved ones, are most vulnerable.

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  • Hi Ruth
    Firslty so glad to hear your Dad made a recovery and hope he is doing well.
    My Mum died almost 2 years ago in Intensive Care and I cant find the words describe the wonderful compassionate people who cared not just for her but for the tribe of family who stayed day and night. As an ex ICU nurse I too saw the best of care and attention to detail. We had photos of my Mum on the back of the door so that the nurses would "know" who she really was rather than the swollen little body she was by the time they were looking after her. We had the nurse who told us off whilst she was being admitted for going to the wrong toilet but the beautiful soul who didnt want to go off duty whilst my Mum was dying as she wanted to be there for us. My faith was restored in a profession that I had always felt proud to be part of.

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