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'How long can the ‘Dunkirk spirit’ in nursing be endured?'


I have bought a wetsuit. I’d like to say it makes me look like a rubbery ninja but in reality I look more like a seal with a funny head.

Still it’s not a fashion item, my plan is to go into the sea as often as possible, for as much of the year as possible. I have also bought a new pushbike and another hat. It appears I have also started nagging the family about the possibility of hiring a camper van. Currently they are ignoring me. This happens a lot in our house.

It seems I am increasingly finding a need to spend as much time as I can under the sky rather than under various roofs. I think it is a work thing. I have spent all my working life working indoors - indeed I have spent all my working life working with people, not things, and people often have a more complex set of needs than most things. In short, I find myself seeking out some kind of environmental antidote to my working day. It started as an instinctive thing but later I began to design it - hence the wetsuit, which is, of course, wholly inappropriate for work.

I was very struck by the recent words of the former chair of the Healthcare Commission Sir Ian Kennedy when giving evidence to the Mid Staffordshire public inquiry. He spoke of delivering despite difficult circumstances and referred to “something of a Dunkirk spirit” within the NHS. He said this was especially true among nurses and was “taken advantage of by others who know that nurses in particular, and some doctors, become guerrilla fighters against a system, which doesn’t provide what they need”.

An interesting insight I think. Many nurses will be familiar with the difficulties designed by a heady mix of circumstance, need, chaos and that bit of the organisation that exists in all organisations and is referred to as “they” - as in ”they don’t care/understand/know what it is really like”, “they just tell us to do things” and “they will punish us if it isn’t done”.

Managing in difficult circumstances, and somehow not only surviving but also helping others to get through too, is a bit like guerrilla warfare. I remember talking to a nurse recently who was cross about a patient who described her post-operative experience as adequate. “Adequate,” said the nurse, with outrage. “Adequate. She has no idea how much effort went into making it ‘adequate’.” And, of course, the things that define guerilla warfare are the sense of fighting against the odds, the self-sacrifice that goes into the struggle and, most tellingly, the increasing absence of rules or guidance. It is an expression of desperation, a final resistance and a loss of part of oneself.

I think it is important to try to understand what happens to people who work in places where care is sub-standard. And I think the analogy with guerilla fighters throws up a range of possible discussion points for nursing from issues of leadership to education to professional power - all of which need discussing and all of which I will no doubt bang on about in coming weeks.

But I think the analogy also suggests something about our relationship with ourselves - our capacity to protect and look after not just our patients but also our own bodies and minds, our ability to work with emotion, to judge ourselves and to nourish ourselves. In this sort of climate such “soft” knowledge can get lost. I wholly believe that without some attention to such things a person cannot nurse well over any period of time. And they definitely can’t ensure that they stay healthy at the same time.


Readers' comments (7)

  • Not for much longer. There is a natural breaking point for everything and everyone, and I think our profession is teetering on the edge now.

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  • Indeed Mike, and a lot of nurses are realising that they just can't do it any more and either getting ill. or quitting.

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  • tinkerbell

    i realise i'm geting older. I don't have the energy levels i use to have and would find it a struggle to work a long day as i use to do. After an early now i have to go home for a lie down. I love my job but sometimes think there is too much of it, after 6 to 7 shifts on a row my 2 days off are a time to relax and get ready to go back to do another stint. I have developed a ninja/sas type of approach. Get in, get out and do the best i can whilst there. I no longer do overtime, can just about manage my full time. I realise that unless i take care of myself and manage my time then there is no one else to blame but myself if i don't look after me too. I am due to retire next year, but will probably continue as i can't afford the yacht yet. I have given up trying to be wonderwoman and no longer wear my knickers on the outside of my costume.

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  • re Boots4daisy - I am in the same position.

    Since I stopped trying to be super-nurse, my life has got much better and I have even come to enjoy my work much more.

    I no longer feel the resentment associated with continually sacrificing myself on the altar of the NHS. Like you, I do what I can the best that I can for the short time I am there - then I walk away.

    Perhaps with age comes acceptance and with acceptance, peace.

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  • tinkerbell


    sounds like we've finally realised then, shame its such a long time coming, think its called learning the hard way, but hey, better late than never. You might enjoy a book called 'women who run with the wolves', its not a feminist full on book, just helps us understand when its time to reflect on the damage we are doing to ourselves whilst trying to be everything to everyone and leaving no time to take care of ourselves.

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  • George Kuchanny

    Good article Mark,
    Written with humour (where would we be without it, yep, severely depressd that's where), but dares to throw light on a pivotal set of home truths. We do indeed have to pace ourselves. If we do not look after ourselves how can we look after others? I fell into this trap myself many times. Sometimes it takes a long time to learn something which is clear and simple.

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  • Mark,
    BUY a camper van. I did & it's the best thing I ever did!

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