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'Nurses aren’t immune to changes in etiquette'


It’s rare that I ever read anything in the papers about “a crisis in nursing” and actually agree with its sentiments.

Usually the columnist breaks my heart with the stories of poor care. But I know such incidents are rare (although always inexcusable), and I am confident in the profession’s ability because of the hundreds of nurses I meet every year, and hundreds more who write to me, telling me what they accomplish each time they go on shift.

I am usually left feeling saddened on behalf of those excellent nurses – whose abilities and motives have been called into question by the poor-performing few who are causing a haemorrhage of public confidence in the profession.

I feel differently about last week’s series on nursing in The Independent. There were some things that made my blood boil – the oft-repeated suggestion that student nurse education is getting worse because it’s moving to all-degree, for example. But, on the whole, many articles were measured. They acknowledged there were brilliant nurses, highlighted some of the extraordinary ways that they go out of their way to care, and reinforced the notion that we should not assume that all nurses are evil creatures, who enter the profession just so they can put drinks out of reach of frail, older patients.

What one of the articles, published last Thursday, also identified was that British culture is changing and that is influencing care.

It relayed the story of a lecturer who said it was not uncommon for student nurses to have to be told not to text friends while at the patient’s bedside.

In a week in which a coffee seller in Norwich banned customers from using mobile phones while ordering their cappucinos and americanos, it’s pretty clear to see that British etiquette is flexing. As a society we are losing some of the manners previous generations held dear.

Of course, a nurse’s focus should be entirely on the patient. Nothing else is good enough. But the public and the media should also recognise that nurses aren’t a special breed. That nurses exhibit some of these abbreviated manners is unforgiveable, yes, but it’s not a symptom that nurses are bad and uncaring – but that they are part of our modern society, and able to succumb to the pressures and distractions of the fast-paced world we inhabit.

This doesn’t mean we should not try to stop it. If a coffee seller won’t hand over a latte without gaining the full respect of a customer, nurses have every right to be the gatekeepers of good manners in their jobs – expecting and exhibiting full attention and focus.


Readers' comments (30)

  • Texting? from a patient's bedside?

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  • Still find it incredulous that student nurses need to be told that. Poor care is not as isolated as you think! As a nurse I am ashamed to say that some of the care and attidtudes expressed while my father was dying a couple of years ago, left much to be desired. The shining lights amongst the nursing staff were few. Professional standards are without doubt lacking and poor excuses for ignoring paients needs - "you can see I'm on the phone" -"I'm busy" - nurse stood around are not uncommon. If nurse recruits cannot be screended for their attitudes to those for whom they are likely to care then we are lost - or have we all got compassion fatigue?

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  • It is not acceptable to lose the manners that our older generations hold dear, and modern distractions should not be an excuse.

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  • I am a student nurse and find it unbelievable that someone would take their phone onto the ward in the first place. These students obviously havent learn't anything from their communication modules otherwise they would realise that using their mobile by the bedside portrays their disinterest in the patient.

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  • It struck me as very bad manners the other day watching the man in front of me having his goods checked without even acknowledging the cashier or making any eye contact with her because he was too busy talking on his mobile. He put his goods in his bag, put his plastic card in the machine, tapped in the numbers and took the receipt from the cashier, still chatting away and without as much as a smile or a thank you before walking away! Putting myself in the place of the cashier who may have several clients a day who do this must be quite disheartening and make one feel that one is being treated as a non-person and a robot just doing a job. I then thought of the difference it makes when one is greeted by a friendly cashier than by those who hardly bother at all.

    I then generalised this mobile phone behaviour to what one witnesses out on the street, in public transport, riding a bike, driving a car, crossing the road or on any other form of transport where there are pedestrians, including small children and the elderly, which can be downright dangerous. One has coffee with a friend or group of friends and invariably one or more are distracted by their phones. If you are in the middle of telling them something important which is interrupted by their preoccupation with their mobile phone or a call this can also be very distracting and disagreeable leaving one with the feeling that you are not receiving their full intention and even that they consider what you are relating to them is of less importance.

    So many people now seem to live in their own world and even when not engaged in a phone conversation they are often occupied in frenzied action with their mobile which seems almost pathological instead of being in touch with their surroundings and making any sort of verbal or non verbal contact with those around them. At worst one can feel ignored which, apart from being bad manners, can be dangerous in traffic. So much time spent in, or thinking about their virtual world and lack of contact with their real surroundings and engagement with other people, both known to them and strangers, must contribute to the feelings of malaise which many people now experience and also add to their stress as they are always on alert for a call or message and often involved in making or receiving one or using the many other functions on their phones.

    For a patient, feeling unwell and uncertain and with heightened sensitivity, it must give them even more profound feelings of not receiving the respect and attention they need and deserve. Even a mobile in a pocket means that there is an expectancy of receiving calls or messages which may distract people from giving their full attention to another or to a task in hand.

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  • Lansley refused to be interviewed by the reporter of the Independent for the series of articles mentioned in the above article.

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  • I've had patients continue to talk on their mobiles or refuse to take their tv headphones off when I am trying to do their medication or obs. I find that extremely rude and disrespectful.

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  • Anonymous | 18-Apr-2012 9:17 am

    so do I. When a ticket inspector on the train comes or somebody talks to me I always remove my ear plugs.

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  • Hi Jenni
    This is part of the conversation we have with our nurse leaders in the Leadership programme. Its an interesting debate!

    We sometimes forget, I think, that we have around 4 generations working as nurses in our workforce. If each one of us thinks about our grandparents and or parents we will be able to recognise that between those generations there are differences in terms of culture, manners etc. I don't think we talk about it often enough but I know most nurses would respond and say we do think about it and take it into account when we care.
    I think that the thing that seems to be affecting this most dramatically is the evolution and impact of technology (Mobiles etc). What this has made happen is that the pace of change is so fast is that the differential between generations is much much wider. So, for example, I can see where my grandparents were in terms of their expectations and manners and indeed they were broadly similar to mine; my son, in contrast, sometimes gets frustrated with us, his parents, as he thinks that we don't understand how his generation communicates and so on. I think he might have a point.
    If we are seeing in the media, as you say, cafes refusing to serve people coffee if they are using their phones, perhaps this is the start of society starting to take a bit more ownership of this mass of complicated social change going on around us. I think nurses are not confused but I think society may be confused and nurses are obviously part of society. Has society cemented what the normal polite behaviours in the world look like in the connected mobile working world?
    I am an optomist. I value nurses and nursing and I think this is easily resolved if we have more conversations about it. At the end of the day its partly about communication which is at the heart of nursing (whether that be using technology or not :0) )

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  • I think it rude not to give whoever is in front of you your undivided attention - cashier in Sainsburys, colleagues and friends, patients. Anyone really.
    I have reminded students that unless they have little children, ill family or are epecting a new child any day I don't want to see their phone in their hand whilst in the clinical area and amongst patients and staff. Gets me a few strange looks but then, they don't see me with my phone in my hand so try to lead by example. I suppose i don't view my phone as an accessory organ!

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