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Mark Radcliffe

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‘Nursing qualities make a difference to patient care’

A few months ago I had to see a specialist physiotherapist. She seemed skilled, talked fluently about ligaments and cartilage, which wouldn’t have worked if it had been a date or anything. It wasn’t though, so I nodded, listening out for the bit about what the MRI suggested must happen to make me better.

This bit didn’t arrive, so I waited for the nearest thing to a pause I could find and asked, ‘So what did the scan show?’

‘Aha,’ she said. ‘First I want you to tell me what you think the scan showed.’

I looked around for a TV camera, assuming I was on a quiz show. ‘I haven’t seen the scan,’ I said.

‘No, but if you had to guess what was on it, what would you guess?’

‘Why would I guess what was on a scan?’

‘Because I want to see if the symptoms you are still feeling are consistent with what is on the scan.’

‘Isn’t the point of scans to clarify symptom description and illustrate the damage?’

She just stared and I knew full well that here was a woman who could do more press-ups than me. I chose to break the silence.

‘So you want me to tell you what might be on the scan?’

‘Yes.’

‘Are there three very small men sticking pins in my patella? If you look at it a bit funny, is it Jesus’ face? Can you make out the outline of Peru? Might it…’

‘No. You’ve ripped a cartilage.’

‘I didn’t do it on purpose.’

‘That’s what they all say. You’ll need an operation.’ And with that, she left.

I didn’t need an operation as it happens, and I did see the scan and it does look a bit like Peru but it was an odd sort of exchange, premised as it was on the age-old healthcare assumption of knowledge being power.

This week, other knee, different clinic. The nurse specialist’s first words were: ‘I’m sorry you’ve been kept waiting (she was eight minutes late). I’m afraid I didn’t know you were here; my mistake.’ Said with a smile, without blaming a third party and with a pause after the sentence that invited, if required, a response. Quite skilful, I thought.

Anyway, she twiddled with my knee a bit, wasn’t sure it was supposed to be making the noises it was and said: ‘I’m not sure.

If you don’t mind I think I’m going to ask the consultant to have a quick look. It won’t take long.’ While waiting I thought,

‘I wonder if it’s hard for a nurse specialist to be “unsure” in today’s climate?’

The consultant came. They agreed. I was happy. Good intervention, I thought.

Personally I have no idea which one of these talented people would be considered the better practitioner. I do know, however, which approach was the more patient-centred and clinically effective. Hardly a randomised control trial I know but it’s good to see the essential nursing qualities still making a difference.

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