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OPINION

'Why did the chicken cross the road? To escape the cannibal'

Have you heard about Flossie the cannibal chicken? If not, you have come to the right place.

Flossie was one of a group of four chickens in a chicken coop. One morning, when the keepers went to feed the chickens, only Flossie was left.

I’m guessing that they quickly reasoned that one of three things had happened.

  1. Three of the chickens had tunnelled to freedom.
  2. Evolution had kicked in overnight and three of the chickens had flown the coop.
  3. Flossie had killed and eaten the other chickens.

A search for clues found no tunnels or discarded chicken-sized mining tools nor any swooping chickens overhead. Flossie, however, lay against a shed wall burping over a pointless toothpick with a bloodstained beak and a drumstick on her lap.

Something went wrong for Flossie and she turned on her own. There is no way back from eating a chicken, unless of course you aren’t a chicken yourself - if you were a fox or a person, it wouldn’t make the news.

Just goes to show that chickens are like every other species - OK I’m guessing about a lot of species - some of them are not very nice. This seems particularly clear when reflecting on our own species.

We can, if we are feeling miserable or touched by self-loathing, notice that in the words of the inimitable and splendid musician Nick Cave: “People they ain’t no good.” The case for the prosecution calls hundreds of witnesses ranging from war, genocide and man-made famine to street violence, the stoning of ambulances and fraud.

I know that for every act of terror or unkindness, there is a rationale or excuse, from “we are carpet bombing people to free them from oppression” to “he was drunk/upset/not himself because he was drunk/unloved/lacking in self awareness” - but the truth is some people are not very nice.

Indeed, some people are difficult. They can be aggressive, confrontational, self-serving and manipulative. They can believe ridiculous things about other people’s rights, religions or haircuts and maraud through life being hateful. If we are lucky, they don’t touch us too much or too often.

But all people are potential patients. Even the nasty ones. While we know

that all patients need to be treated the same - with unconditional positive regard

and empathy, and non-judgementally - constructing that regard and that equanimity takes energy, skill and sometimes our full attention.

Nurses face managing difficult people in difficult situations every day. Some patients can be wearing, spiteful, vicious, unhelpful and even vile. And it is a given that they require the same considered management as “easier” patients. The emotional energy, skill, consistency and awareness required to attend to difficult patients is wholly and unquestioningly assumed.

I wonder if, as nursing continues to come under scrutiny from so many quarters, the consequences of emotional labour should not come under the scrutiny of nursing itself? Do we even acknowledge the need to re-nourish? To articulate the continuing professional development needs of nurses in this area?

The emotional labour of nursing remains all but overlooked, perhaps because it does not fit into the construction of the idea of nursing as a quasi-medical profession. If so, what a strange oversight. A progressive idea of nursing requires more than a focus on knowledge and skills. It requires a professional and educational focus on protecting and rearming nursing values and qualities as well. It requires a collective willingness to re-nourish nurses.

Readers' comments (36)

  • michael stone

    Anonymous | 24-Jul-2011 4:27 pm

    You missed the point – I did NOT stray into EoLC. I was pointing out, that last year some GMC EoLC guidance includes a section, which translates a mid 1990s court case, and the principle of Informed Consent, into a very clear piece of guidance about clinician-patient interactions. It goes, clinicians inform the patient of clinical options and outcomes, then the patient decides which, if any, of any offered treatments to accept: this is something which is TRUE IN GENERAL, not restricted, TERMS (it just happens, that the GMC updated EoLC guidance last year, and that section is in some updated EoLC guidance – it could equally well be somewhere else).

    But this requires that patients be accurately, adequately and pretty much continuously, kept aware of clinical factors, in order that the patients can make informed decisions.

    This separation between clinical expertise, and whether the treatment is acceptable to the patient, was the point I was making – as that is now, fairly clearly, the legal position, patients need to be able to ‘see the truth’. It gets very complicated, for various reasons, if the underlaying law is that patients make their own informed decisions about treatments, if clinicians do not do the informing !
    And clearly patients must also BELIEVE they are being told the truth - if patients can detect 'a front' they will become suspicious, surely ?!

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  • above we have heard this all, oh so many times, are you taking over all the comments again? what happened to your forum?

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  • michael stone

    Anonymous | 25-Jul-2011 2:59 pm

    Very little on the Forum front so far - a couple of people have recently engaged in one of the topics, and we have moved to e-mail to do it properly. But unfortunately, they are not the 'typical front-line nurses' I am trying to get answers from - they are both involved with publishing guidance, and getting responses from such people was not why I contacted NT in the first place.

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  • As you have been asking the question for quite a while from typical front line nurses now without getting your answer, then you may need to accept they do not have the answer and seek your answer elsewhere.

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  • AARGH! Another thread ruined with EoLC stuff!! This is really really annoying!

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  • LoL EoLC!

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