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‘A grandiose vision of nursing threatens to lead to lower standards of patient care’

There was an article in The Guardian before Christmas on the covert language that some doctors tend to use when they are describing patients to other doctors and healthcare professionals. Former Baywatch star David Hasselhoff is the latest celebrity whose surname has become a commonly used medical code.
A ‘Hasselhoff’ is used to describe a patient whose presenting history does not easily match the findings of the clinical examination, after the actor presented at hospital having hit his head on a shelf (in some reports a chandelier) while shaving and sustained a laceration to his arm.
Another new term is the ‘MacTilt’ – no, not a new addition to the hospital menu, but the tilt of the head by Macmillan cancer nurses while conveying sympathy to patients and relatives.
Reading this article made my partner chuckle, and he asked me over breakfast how many Hasselhoffs I see in an average 12-hour shift. Thinking about it later in the day, it made me consider other abbreviations, acronyms and insults we use in clinical practice, and how some of them are more covert than others.
Recently I’ve noticed another new word on the block. This is an abbreviation that is so covert it is unspoken – but its practice is becoming rife in the nursing profession.
The new term is NMP. Several of you will be thinking, non-medical prescribing is not such a new term. No, the new kid on the block is ‘Not My Problem’, which nurses throughout the profession seem to be using more and more and, in doing so, are trying to pass on the responsibility for patient care to other clinicians, making it their problem.
What am I talking about? A recent example occurred during a discussion with a practice nurse regarding what I considered to be the inappropriate management of a post-operative wound.
After I made a complaint to the manager at the practice where the patient was registered, the practice nurse concerned telephoned to speak to me. The subtext of the conversation was that the nurse knew the practice was inappropriate and wouldn’t normally have done this but had no other option – and knew that the patient would be seen within my service at the weekend and that we would pick up the pieces. This smacked of ‘not my problem’.
This is happening more and more and is being experienced by colleagues and friends in various specialities across the country. It makes me wonder what the root cause of this problem is. Have nurses suddenly become uncaring? Are they
only interested if there is a Department of Health target or a quality and outcomes framework point attached to the outcome?
I have a yet untested hypothesis to do with the almost pandemic spread and prevalence of NMP. I think it is partly to do with the focus being on achieving targets set from on high, and partly to do with the general change of focus that nursing has brought upon itself – that nursing and the nurses in the profession view their role as being more than it actually is.
By this, I mean that nursing now sees itself as being about much more than just patient care.
It is time to stamp out the grandiose vision that the profession has developed of ‘nursing care’. Let us instead deliver the highest standard of care based on evidence, and let’s vaccinate the profession against NMP, and put patients back at the centre of nursing.
It is time to grab back the basic fundamentals of patient care that we have tried to pass off as being unimportant.
I was shocked when a person from The Secret Millionaire show on Channel 4 was taken on as a hospital volunteer to feed patients, because the ward sister felt that the nurses had more important things to do. Surely nutrition, washing patients and providing basic nursing care are the fundamentals of everything we do?
So, come on fellow nurses, let us banish NMP to the cupboard in the corner of the sluice, and let us get back to the heart of what we do – putting the patients first.

Paul Cornforth is a consultant nurse in south-west London

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