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Radcliffe: ‘Every nurse has their own priorities and targets’

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I have just got back from Iceland. Yes the country. I know, get me. If you haven’t been then I do suggest you put it on the list. It’s lovely. We saw frozen waterfalls, glaciers, geysers, hot lagoons and loads of beards

We didn’t see the Northern Lights but I’m going to tell you about the trip anyway, mostly because it was ridiculous.

Our first trip was cancelled. It was snowing hard and the sky wasn’t visible. The following day it was still snowing hard and the sky still wasn’t visible, but if your tour is cancelled twice you get your money back. If you go on a tour and don’t see the lights, you simply get the chance to go another time. So the tour was on.

So do we go? Secure in the knowledge that we won’t see any lights? Or do we say “No you’re OK thanks, it’s snowing and I can’t see my wife and she is actually very close”? – knowing you won’t get your money back and that you are missing out on maybe seeing something remarkable? We – and about 430 other people – opted for, “Oh go on then, what else am I going to do?”

Now our guide knew we had no chance of seeing the lights. He spent an hour saying things like “Of course you can’t guarantee solar activity” and “Sometimes people see the lights and don’t know it – oh look, what’s that over there!”. And we all knew that we had more chance of seeing Elvis riding a unicorn than of seeing the lights, but there we were, in a field, at midnight, staring into the sky and getting thick bits of snow in our eyes while listening to the driver tell the guide that he can’t see the road let alone the sky

But we all went along with it – a triumph of hope over reason. Bad faith, collusion and delusion. Like your average day in most NHS trusts? The people running things know the conditions aren’t conducive to success but are heavily incentivised to carry on regardless, while the people invested in it – the staff and the patients – know that they cling more to hope than reason, but that the desired outcome transcends any fear they have of wasting their time.

Most of the nurses who began their career expecting to see aurora now no longer bother to look up. What they do however, is look forward at what or who is in front of them, what can be done, what small help can be constructed and what helpful change can be engineered.

Now I don’t mention this because I want to find yet another way of saying that the NHS is in a mess and we all know it, and politicians don’t care and it’s all going wrong. I say it because it reveals something about the essence of the modern nurse that is not often articulated.

Nursing is – for all the talk of teams, specialisms, branches and ‘the profession’ – a fundamentally individualist endeavour. Every nurse has an inner world, established and contextual priorities and a series of professional targets. Small gains perhaps, incremental changes and little victories that both make sense of the nurse’s day and seeks to bypass the things they can’t control, be they solar activity, health policy or underfunding.

We construct meaning in small ways don’t we? All of us do I think. You affect individuals in profound, transformational ways, be it by intervention, manner or advocacy. A nurse said to me recently, “I don’t get involved with politics, I don’t care about what I can’t do anymore. I concentrate on what I can”.

There is something defiant and dare I say, uplifting in that, and maybe given the working conditions she is presented with, something very empowering?

Mark Radcliffe is author of Stranger than Kindness.

Follow him on twitter @markacradcliffe

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