Professor Maggie Kirk reflects on her time as a student nurse in the 1980s and how the profession needs to be allowed the time to simply ‘be with’ patients
As a student nurse in the mid-1980s, once I had got to grips with my shyness and realised it was up to me to help ward patients feel more relaxed, I found I really enjoyed spending time with them.
Whether it was helping someone to feel a little fresher with a wash in the privacy of a cubicle, talking with someone who was feeling lonely or afraid, or just sitting holding someone’s hand, I loved this aspect of nursing.
“I was distressed when the sister decided we didn’t have enough cover for someone to sit with a dying patient”
I also enjoyed ‘playing to the crowd’ occasionally with patients in the smaller side wards, jeopardising the stitches of surgical patients with my particular brand of humour (much to the displeasure of the consultant surgeon whose stitches they were).
On a busy shift, it wasn’t always easy to find the time to ‘just sit’ and talk or listen, and on one particular occasion, I was distressed when the sister decided we didn’t have enough cover for someone to sit with a dying patient.
I’m sure it wouldn’t have been an easy decision to make then, but I wonder how often it has to be made today with the further constraints on ward staffing levels?
When I qualified, although I worked in the relatively ‘high tech’ specialty of coronary care, the appeal for me was the high nurse: patient ratio, which meant you spent more time caring for an individual patient.
“The appeal for me was the high nurse: patient ratio, which meant you spent more time caring for an individual patient”
Having sufficient time to ‘do for’ and ‘be with’ a patient or other individual is embodied in the concept of nursing presence, a fundamental component of holistic nursing care.
The concept is a complex one though, going beyond simply physical presence or the straightforward delivery of ‘basic’ nursing tasks such as giving a bed bath. As such, it is difficult to measure to the satisfaction of those who like to count the cost of everything without appreciating the value of those elements which cannot readily be quantified.
Two initiatives I have been involved in evaluating, one by the British Heart Foundation to fund nursing posts in cardiac genetics services, and the other by Tenovus (funded by the Burdett trust) to introduce a nurse-led cancer callback service, have both highlighted the value of nurses having the time to ‘be with’ those in need of care and support.
“There is a growing body of evidence of the value of nursing presence; of having time to care.”
Last October, the University of South Wales was privileged to host Professor Linda Aiken to deliver the RCN Winifred Raphael Memorial Lecture. Her world-leading research across nine countries has demonstrated causal links between nurse education, staffing levels and patient mortality.
Nurses have probably recognised it for decades but now there is a growing body of evidence of the value of nursing presence; of having time to care.
Let’s hope this next government listens and responds to the evidence.
Professor Maggie Kirk is Professor of Genetics Education, leader of the Centre for Research & Innovation in Care Sciences and the Genomics Policy Unit (GPU) and former President of the International Society of Nurses in Genetics 2013-2014 - the 2nd non-U.S. nurse to take up this role in ISONG’s 25 year history