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.