I faced a moral dilemma this week.
Buying a birthday card for the child of a friend, I found one with the badge saying “I am 2” – an essential for a child who has just stopped being 1 – only to find on the back of the badge a sticker that said “Not suitable for children under the age of 36 months”.
Legally, where do I stand? More importantly, could I fall out with my friend of more than 20 years if I give her daughter the badge and the child stabs someone in the head with it? Will my friend point to the sticker and say: “It says very clearly in small writing she is not old enough for this. What’s the present? Bombay Sapphire Gin? A bazooka?”
So, I opted for a sticker instead. You can’t go wrong with a sticker. Unless the crazy child eats it but it clearly said “Do not eat” so it’s not like everybody wasn’t warned.
We live in litigious times, so manufacturers everywhere are afraid of being sued. The last time we bought an iron, it came with the warning “Do not iron garments while wearing them”. And our new fridge-freezer (we’ve just moved house; it’s chaos, thank you for asking) has a sticker saying “Do not stand on this appliance”. Apart from making you waste 25 minutes trying to imagine the circumstances in which you may stand on the fridge and manage to iron the trousers as you are wearing them, this simply tells us that everyone is scared of being sued. Everyone feels defensive.
Nurses know what defensiveness in practice can mean. I wonder – against a backdrop of low morale, a lack of political respect, lowering public goodwill and variable leadership – how able they feel to protect against it? Because defending oneself against complaint can shape the way we practise, can’t it?
This is particularly so in a culture that is being taught to almost resent public servants for holding together services that are being eroded. And nurses know it. As a friend of mine remarked recently: “Sometimes it’s just about getting through and trying to keep people safe.”
Someone else asked me recently – on finding out that I taught nurses for a living – if I was one of those who filled their heads with rubbish. “Probably,” I said, ever anxious not to appear defensive. “Too many books, not enough nursing,” he said, managing to design a sentence that is so wrong it requires a new word to be invented that describes extreme wrongness. “No such thing as too many books,” I offered, as neutrally as I could. “Too much thinking, not enough doing,” he said. “In the old days, nurses didn’t need all that nonsense.”
Which begs the question: what is “that nonsense”? Thinking? Education? Ideas? I’m not convinced there was ever a time when those things were not helpful to nursing and I believe one of the great myths of modern nursing is that developing the ability for critical thinking or helping to discipline and inform the nursing mind is anything less than essential.
Indeed, I wonder if there is an ulterior motive to those who oppose a full and intellectually disciplined education for nurses? Something to do with reducing the voice and influence of nurses? Returning them to a position of demure handmaiden and marginalising the key qualities they make manifest?
Nursing is being forced onto the defensive, defending not only standards but also jobs. Critical thinking skills can only help nurses protect themselves from the pitfalls of defensiveness and, with luck, may even help them from the back foot and on to the front one.
Mark Radcliffe is a senior lecturer and author of Gabriel’s Angel.