A friend was reflecting recently on witnessing what she described as inspirational nursing.
She was talking about accompanying a nurse who was working with a dying patient and his wife.
The patient had explained how he wanted to spend his last few days and how he wanted to avoid medication. As his pain grew, his wife of some 50 years became uncertain. Staying true to his request seemed overwhelmingly important. It was about honouring him and them; it was the last act of protectiveness, of love. However, seeing the excruciating pain was tearing her apart.
That level of dismay, confusion and fear must come out somewhere, so it came out at the nurse. Well not so much at the nurse as near the nurse. If it was at anything, it was at the universe or god or cancer or life, but it manifested itself as rage and involved howling at the moon.
You can read the webchat transcript about emotional intelligence with Mark Radcliffe here
The nurse, it seems, stayed present. She did not make any excuses to leave nor did she try to distract the woman from her pain. She did not, because she was focused and generous, try to “boundary” the language or limit the outpouring of emotion. Nor did she try any magic words that might ameliorate the woman’s feelings.
My friend said the nurse managed to “hold” the woman without touching her. This may sound a little vague and ill defined for these dot-to-dot days. It makes sense, I think, to suggest the nurse “sensed” her way through what was probably one of the defining moments in the life of the woman in front of her.
As it was, the woman decided that she wanted her husband to have more pain relief. She felt that, had he been able to express a wish, he would wish for less pain and she also decided she was not willing to live with the sense that she was causing him pain by keeping a promise. He died peacefully and she expressed relief that she had held his hand as he did so.
I know the problem with talking about such brilliant nursing is that one can use it as an example to support any position you like. You could say: ‘“They don’t make them like that any more.” Or: “You see, you can’t teach that sort of ability - it comes from within.”
In both cases you would, in my view, be wrong. First, the nurse in question was a student and my friend was her mentor.
Second, I think you can teach it. I think it is hard, it requires a lot of time, will and a collective commitment to the value of emotional intelligence and a willingness to review our own sense of moral action - but I think it can be taught. You may not necessarily be able to teach it to everyone, and I certainly don’t think once it has been “taught” you can consider it to be another skill like having a good injection technique. Complex abilities - particularly those that are integrated with our own humanity - require revisiting, reinvigorating, re-energising.
Perhaps I’m wrong. Perhaps the “good and intuitive” nurse is made in the womb rather than in the world. And we mainly need to keep teaching ourselves to be technically adept and policy aware to reclaim the nursing profession from the shadow of Mid Staffs and the recent Care Quality Commission report. But I doubt it.
Sooner or later, we are going to have to address the fact that the best of nursing requires complex emotional intelligence and, unless we start to focus on how to promote, protect and extend that quality, the wise and inspirational nurse will become little more than a myth.
Mark Radcliffe is a senior lecturer and author of Gabriel’s Angel.