'Should we all be a little more selfish?'

Readers' comments (24)

• mike | 5-Dec-2011 2:23 pm

  Adam I am in absolute agreement with you on this one, and it is a stance I wish more Nurses would take.
  
  It is about time Nurses realised that it is not unreasonable to want a healthy work life balance, or reasonable breaks so that we are not collapsing, or a fair off duty for the same reasons. It is not wrong to expect that sometimes we put ourselves, and our personal lives before our work. It is not right that we miss birthdays and christmas' and time with family or friends month after month, year after year. It is not right that our health and our relationships suffer.
  
  Many Nurses give their all when they are on shift, but we all have to realise that this martyrdom is getting us nowhere apart from an early grave and a downtrodden profession.
  
  Look at the attitudes of some before the recent strikes. 'We will just have to put up with the decimation of our pensions and our pay because after all, the patient must come first!' Why?
  
  Of course patient care and well being is important, but it is not down to us to sacrfice ourselves because of the failings of the powers that be. I truly think that managers/trusts/government get away with unsafe and dangerous staffing levels, poor working conditions, the general dismissive treatment of our profession, etc et etc, precisely BECAUSE of this 'martyrdom' attitude displayed by many.
  
  It needs to stop.
  
  I urge all of you to stop this martyrdom attitude now. Work to rule, and stop staying for hours after your shift has finished. Refuse off duties that are blatantly unreasonable and unhealthy. Demand days off together to get a semblance of a work/life balance. Leave on time, take your breaks. Take action in further strikes and realise that patient care is the responsibility of the management/government too.
  
  To do so is not being selfish, it is not being self centred, but even if it was, then so what? Look after yourselves first, because noone else will, and as Adam says, who will be left to look after your patients then?
  
  

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  Adam Roxby | 5-Dec-2011 5:13 pm

  Hello Mike
  
  Im glad you agree. It is something I see all too often and I thought I should say something about it. Im also glad I made it clear that the patients should be the main focus but there comes a time when nurses (and students) need to take care of themselves.
  
  Im looking forward to hearing what others think as well. Thanks once again.

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  Aaron Rudd | 5-Dec-2011 11:11 pm

  I've seen nurses suffer for their patients, missing toilet breaks, skipping food and drink or staying beyond their shift hours. There has to be a limit of course, but surely a certain level of suffering is acceptable on our part? Unacceptable levels of suffering being the point where there is a danger of you becoming a patient or danger to your patients/colleagues? For example, missing your lunch for a day won't kill you, but missing it for a week probably will damage your effectiveness and health. Self awareness is key, awareness of your capabilities and limitations (especially the latter!)
  
  Mike raises good points, but in the ideal world we'd have enough staff etc to get everything done and still get good breaks etc. We all know that isn't the case, the workload changes constantly and will be good on some days or bad on others, sometimes staff are ill and sometimes the world conspires to make our day a living hell. If we don't push ourselves to achieve our objectives for the day, in the name of encouraging the established authority to rectify our issues surely only our patients will suffer?
  
  I don't think that taking care of yourself on duty is selfish at all, but making reasonable sacrifices for your clients is honourable?
  
  I think teamwork plays a big part here, being able to recognise when a co-worker is approaching the danger zone?
  
  I'm only a 1st year student, and only just finding my way in the world of nursing; but it seems to me that until nurses get more power in how the money budgeted to the NHS is spent we'll remain far away from achieving that ideal world. Until that world arrives, we have to make do with what we have.

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• Jessica Ellis | 6-Dec-2011 2:01 am

  Here in the States, it would help if the ones who consider it such a badge of dedication to skip meals and stay late wouldn't look down their noses at those of us who prefer not to treat our personal needs with disdain. I, for one, can think better and be less impatient if my stomach isn't growling and I'm not resisting the urge to hold my crotch because my bladder is about to pop. Seriously...taking care of our needs at work means less burnout and better patient care...being a little more selfish about our needs just benefits everyone. Well said, Adam.
  
  Jessica Ellis
  Nursing.Coursepark.com

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  Adam Roxby | 6-Dec-2011 5:07 pm

  Hey everyone
  
  As usual, I love reading the responses I get from my articles.
  Aaron – I would agree that a certain amount of suffering should be expected that if it is a fine balance. I think the answer to most of the problems that I raise it in my articles is more staff but has that is unlikely to happen other solutions have to be sought.
  I think you make an interesting point about empowering nurses they have more control over budgeting but I wonder as to whether that would just add another managerial aspect to a job that is already weighed down by paperwork?
  Anyway, I was once again for your comment.
  
  Jessica – I don't think I have knowingly responded to a comment from the US so that's quite exciting. I'm also pleased to see that you agree with me, thank you.

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• Anonymous | 6-Dec-2011 5:08 pm

  Once again you bring up an excellent debate, only this time it is dear to my heart.
  
  In local government we face the same issue, the job always comes first and I strongly believe that this should change.
  
  As servers of the public we are abused and exploited into doing extra work because of our conscience. By missing breaks/annual leave or working extra hours we are covering up the fact that there is not enough staff to provide the service that is being asked of us. This behaviour really needs to stop as it is giving the government the wrong message and is not flagging up the real problems with the NHS/Local Government.
  
  If we continually take on extra work we are replacing much needed extra staff and setting ourselves up for stress related illnesses this in turn puts more pressure on those left to do the work.
  
  Sadly, our conscience is our worst enemy as the public/patients will need to suffer before anyone addresses this issue.

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  Adam Roxby | 6-Dec-2011 5:14 pm

  Hello anonymous
  
  I think you have highlighted of a vicious circle that we seem to have got ourselves into. We create the illusion that the system is working and it is an illusion that is only sustained by the hard work and sacrifices made by the staff. While the recent strikes may have been about the pension pay, is not hard to see more disillusionment in the public sector because of working conditions, pay and public expectations.
  Thanks for your comment.
  

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• mike | 8-Dec-2011 11:43 am

  Aaron, you are confusing a 'certain level of suffering', which some may deem as normal hard work or the very occassional sacrifice to help a colleague which I agree is a good thing, with the institutional and quite frankly poor conditions and practices imposed on us that are at the very least unhealthy and unsafe, and should almost certainly be illegal in the large part. Suffering with these sacrifices is not honourable, it is stupid and ultimately self defeating.
  
  Anonymous | 6-Dec-2011 5:08 pm well said.

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  Adam Roxby | 8-Dec-2011 12:40 pm

  Everything in moderation as I like to say. You should just know what your limits are and be sure not to put yourself at risk.

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• Anonymous | 8-Dec-2011 1:17 pm

  I put this comment into 'Recognise and reward the moral code of nursing' by mistake but found I could copy and paste it here.
  
  Anonymous | 8-Dec-2011 12:29 pm
  
  on the last ward I was in contact with the nurses always left on time even if it meant leaving a patient in the lurch. they said that if they didn't look after themselves they were unable to look after their patients.
  this is very different to the attitude we had where patients always came first no matter how late you had to stay, even though our bosses (following a directive from above - ie the coffee drinkers in the top floor offices) said no as there was no overtime payment, which we didn't expect anyway. they failed to understand that our aim was our patients and colleagues and not extra pay. despite this we could not envisage leaving a patient or a colleague in the lurch so we arranged among ourselves to sometimes take the extra time off if and when possible to make up for it, usually at weekends where there was a long shift overlap but this was not planned in advance we just did it if the ward was particularly quiet and we were not on take in.
  
  however, the new bosses who replaced the old because the autorities put them there considering them more efficient or better puppets and pushed the good old style ones with whom we had a good working relationship out, tried to stop this as well so it had to be done covertly.

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  Adam Roxby | 8-Dec-2011 6:26 pm

  Hello Anonymous - I have to say that is rather different to what I am use to and might be a little extreme to some. I think a good mix would be best.
  
  I think this is also a good cautionary tail of how management can affect the delicate ballence of a ward.
  
  Glad you managed to find your comment as it was fun to read.

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• Anonymous | 8-Dec-2011 7:31 pm

  Adam Roxby | 8-Dec-2011 6:26 pm
  
  Hi Adam
  I meant to mention that the ward referred to in the first para was a mental health ward. maybe the staff there have a different attitude and maybe it isn't even a new attitude that they have to look after themselves and leave on time regardless.
  
  I worked on acute medicine so maybe there is a difference and this was sometime ago now. It was hectic at times and sometimes there was a cardiac arrest or other emergency or even machines going wrong in the middle of a shift which one was involved with so it wasn't possible just to down tools and leave even though the remote coffee-drinking managers/bosses (upstairs in the the admin offices) seemed to think, and in fact ordered, we should. They were rather out of touch with reality at times even though the carried all the clout. Also we couldn't always just go and leave a nurse just coming on duty with all the work left over from a previous shift plus their own on the next one.

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• mike | 9-Dec-2011 8:16 am

  Adam and Anonymous | 8-Dec-2011 7:31 pm, I do not think that the ward or the staff (mental health or otherwise) Anonymous | 8-Dec-2011 1:17 pm mentioned was extreme at all, to me it was staff working to rule, and rightly so. It is about time that Nurses realised that we are not the ONLY ones responsible for patient care, we cannot do everything, we are only human. We SHOULD do our shift and care for our patients to the best of our ability yes, but we should also take our breaks and leave ON TIME, because it is MANAGEMENTS responsibility to ensure that enough staff are there to take over to enable us to do so without it affecting patient care. Those that DO NOT do that, are simply allowing management to get away with unsafe staffing levels and skill mixes. Of course there are occassions such as emergencies where you wouldn't down tools and walk out, I have stayed over my time on occassion to deal with a crash or whatever, but I have ensured that I got that time back on break the next day. Why can't you leave the work left over to the next shift? It is called handing over in 24 hour care! It is management responsibility to ensure that there are enough staff, not yours to make up the shortfall!
  
  

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  Adam Roxby | 9-Dec-2011 9:37 am

  Hey mike.
  
  I guess your right, I suppose it's extreme to me in that I find it rare. Perhaps with a new influx of nurses the culture can begin to change to make it the norm?

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• Lauren G | 9-Dec-2011 11:44 am

  Hi Adam, as a relatively newly qualified Nurse (last year) I have to say I agree with your last statement. I think a lot of older Nurses where this martyrdom was seen as a strange badge of honour for some reason I cannot fathom are retiring, and a lot (but strangely not all) 'younger' newly or recently qualified are less willing to accept conditions like this. I don't think it is selfish as much, but like Mike rightly says more like we are finally starting to stand up for ourselves. I hope as more and more of us start saying enough is enough, it will become the norm.

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• Anonymous | 9-Dec-2011 12:08 pm

  "Why can't you leave the work left over to the next shift? It is called handing over in 24 hour care!"
  
  because the next shift was sometimes only one nurse and besides if you had been involved in an emergency on the early afternoon shift you still had to order the pharmacy before it closed for the evening and at that time of day the computers were overloaded with other wards trying to do the same, and you had to finish off clerking any admissions and update any patients notes you may not have had time for if you had more urgent and practical nursing on your hands. it all depends how the work on the ward is organised and although managers were responsible for the coverage we were entirely responsible to the patients and our colleagues for our own work.
  
  If wards such as mental health and any other can find different methods of organisation and adequate staffing levels I do not disagree with mike | 9-Dec-2011 8:16 am and I hope since my time things have improved but it seems one just has to work with the resources one has, although I am sure you disagree with that!

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  Adam Roxby | 9-Dec-2011 12:34 pm

  Hello Lauren
  
  Firstly, congratulations on your qualification. I have actually found some of the 'worst offenders' to be in their 30's. Not sure why that would be the case. I think the majority of the older nurses I have know have just got worn out by it and want to think of their own health after so many years of neglect.
  Let me know how you get on.
  
  Hello Anonymous - You make a good point and I think we all agree that if a patient would be put directly at risk if you worked by the book then we would stay later etc. However if it was becoming routine then thats the time when things need to change. That shows that there is something wrong with the setup and you can't rely on the nurses and other staff to prop it up at the expense of their well being.
  
  Thanks for both of your comments.

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• Anonymous | 12-Dec-2011 4:56 pm

  There was a time when many nurses (not all) used to leave nursing when they had children and returned to work when said children were older. Nowdays it is all but impossible to run a home and raise children on one wage, therefore we have no choice but to juggle motherhood and nursing. I returned to work at 10 weeks post c section. I became a single parent 4 years later. It is becoming harder and harder to work within the hours I am given. In my last position another nurse, also a mother, asked me why I couldn't stay late that shift and when I explained why she continued to question my rationale. In the end I became quite cross with her, at which point she accused me of being rude. Would it have been more polite for me to just say "mind your own business" after the first question?!

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• Anonymous | 12-Dec-2011 7:34 pm

  those who worked part time and had children were always given the choice of which days off they wanted or justified that they needed. those of us who worked 100%, unmarried and without kids, had to cover the rest of these hours of the 24/24h 7/7d 14/14h fortnight whether we liked it or not, as if we had no priorities outside work or private or social lives at all. even though we had been told that to be better nurses we must broaden out outlook with cultural activities, sports, classes etc. and a good social life outside the workplace. Such activities often had to be cancelled, sometimes at very short notice, even though some were regular, already paid for and agreed with the ward in advance, in favour of those who needed the time off for their children.

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• Anonymous | 13-Dec-2011 10:01 am

  From my position as a former ward manager ( now retired) all this sounds very familiar to me, and never more so than under the previous Conservative administration and especially around the time of the formation of NHS Trusts. I found myself going to work earlier, going home later, forgoing my lunch time and spending increasing amounts of my own time doing "things" that would "improve " the way in which I worked and trying (unsucessfully) to rduce my work load.
  One Sunday I opened a broadsheet newspaper and read an article by Professor Cary Cooper and it changed my attitude to work completely. After that I realised there was little point in making myself stressed and ill. If I couldn't do it in the time allotted then it waited until the next day, I got my lunch and I went home on time. I slackened off on my staff and put the focus on enjoying coming to work for them and me. It worked!
  Heres the gist of it.
  
  http://www.stressbusting.co.uk/articles/presenteeism-for-goodness-sake-go/

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