‘Attack matron with a scalpel? Unthinkable’

“I have a boil on my hand, nurse,” Matron informed me, “And I would like you to lance it.”

Just a few minutes before, as it was quiet in A&E, I had been daydreaming, ruminating on the pleasent events of the previous evening. Not fully in tune. But, as matron approached, I was instantly on guard.

Was my uniform clean? Was my cap straight? I was only in my second year of nursing; this was the most powerful person I knew and she wanted me to lance her boil.

Nothing seemed less likely. I gestured to the empty space around me where so many staff had been just a few seconds ago.

“There are doctors and sisters here!” I protested.

I felt very exposed as she bore down on me, the last visible member of staff on a Tuesday morning. I was rooted to the spot, like a rabbit in the headlights. With the magical disappearance of all trained personnel, there I stood alone with matron.

And now she wanted me to deal with her problem.

I had never lanced a boil before. I had seen it done and understood the principle, but to attack matron with a scalpel? Unthinkable.

Again, I stalled hopelessly. “There are people around,” I remonstrated, gesturing at the complete void of human activity. Matron just waited, looking at me expectantly.

“I’m sure you would be better with someone more senior?”.

“You don’t understand, do you, nurse?” She asked kindly. “I am training you. I need to know that you are competent before I send you out into the world.”

As I cast one last, despairing look at the vacant surroundings realisation dawned, I would have to bite this bullet. Quickly, I cleaned and set up the trolley with swabs, antiseptic, scalpel, and dressings. I cleaned her skin, and then, as I had heard my seniors say, said, almost unbelievably: “This will just hurt for a second…”. With that I pierced the offending boil. Then I expressed the pus, cleaned the wound and dressed it. She thanked me profoundly, congratulated me, and said it had been virtually painless.

Amazed at my achievement, I watched as she strode silently away. She carried with her all the confidence of rank. I wondered at her bravery. To put herself in the care of someone so junior, simply to evaluate the training, was extremely courageous. No doubt she left with an impression of her student nurses. I hope it was of competence and caring. And it empowered me, gave me confidence. If I could deal with a matron, I could handle anything.

Now when I see hospital mangers, increasing in number and remoteness, I wonder whether they understand what can be achieved by such a simple exercise.  Is competence or caring among their vast array of targets? Do they see that by tackling these two issues, that results would follow?

Maybe it is time to lance the “target boil” and let the managers see that competent practice and practical caring, combined with dignity and respect, will bring the result they seek. The target boil hasn’t been lanced. Instead more targets have been introduced. And, now we have so many targets that they conflict and everyone merely runs around doing the best they can in the chaos.

The patient is now very ill. The target boil has caused septicaemia. The root of the problem has been neglected and it is doubtful that the Health Service can fully recover.

Linda Jane McLean is studying for a post graduate MSc in Clinical Leadership and works as a coordinator for the Charity, Arac.

© Linda Jane McLean

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