How many nurses does it take to change a light bulb? It would take one if there were any light bulbs - but there are no light bulbs, so forget about light bulbs and move on.
Bring in a torch or something, or one of those lights you strap to your head. And provide your own batteries. Just shut up about light bulbs for goodness sake, there are more important things to worry about. Honestly, I don’t know what’s the matter with you sometimes.
At last week’s RCN Congress a survey it had commissioned was discussed. The survey of 2,000 nurses illustrated what everyone in, close or even vaguely aware of nursing knows - nurses are propping up health services everywhere by working extra hours, skipping breaks or working despite feeling unwell.
A whopping 95% of respondents said they worked beyond their contracted hours and 25% reported providing last-minute cover for absent colleagues. In short, nurses keep things going through a mix of goodwill, necessity and perhaps not being able to live with the guilt of saying: “Yes, I realise we are short-staffed and two people have phoned in sick, but I haven’t been home for three days. I think my husband may have left me and my children refer to me as the strange woman with swollen ankles, so I can’t cover today.”
We know nursing goodwill has kept services functioning for ages and while this sort of survey is helpful in giving voice to that long-known truth, I wonder what else it might tell us?
The survey was sent to 100,000 nurses; 2,000 replied. What happened to the other 98,000? How many said: “Irony of ironies; I am too busy to fill out a survey telling the world how busy I am.” Or perhaps for many nurses things are just fine; they are not working extra hours or missing breaks and so felt they had nothing to contribute. Indeed, perhaps they downloaded the survey intending to fill it in on their extended break but then found the paper getting wet, what with them lounging in the ward hot tub sipping home-made smoothies. Or perhaps stating the obvious simply feels pointless?
I have a theory that I have mentioned before about the “nursing tunnel”. The nursing tunnel is something most, if not all, student nurses have to go through to become a “proper” nurse. It is a dark, transformational trip between collecting the qualities, skills and knowledge a nurse requires and becoming immersed in the culture of nursing - a culture that demands nurses feel some pain, make some sacrifice, do more hours, give even more of themselves and come to terms with the limitation of influence that is the political history of nursing. It is, in short, living with the harsh realities of being a nurse.
It is, I think, borne of kindness. Of doing what we can with what we have; of dealing with the harsh practicalities of the working world and making judgements around what needs to be prioritised. But it is a culture that may, sometimes, perpetuate the relative lack of political influence nursing has or, more importantly, needs.
Nurses are skilled and experienced in managing compromise - and working extra hours is compromise. It is impossible to imagine what would happen to health services if nurses withdrew any part of their practical goodwill and hard to imagine them choosing to find out. But you can’t help but wonder if eventually nursing may need to find a way to show the watching world just how much the NHS is dependent on goodwill. Who knows, it may actually help?