I was reading an article about a young man with a genetic abnormality recently.
It was a reasonably predictable piece about adversity, resilience and hope. Towards the end he talked about having a girlfriend who made things better. “She is a nurse,” he said. “Which means she is naturally caring.”
This reminds us of the underpinning assumption of nursing - yes, nurses will be trained in certain skills and educated to apply knowledge but also they will have certain qualities that shape and drive the application of those abilities. This is a third dimension if you like and, let’s be clear, nurses will not be taught these qualities or how to articulate, value, sustain or protect them. Rather the qualities will be assumed, depended upon, demanded. And therein lies the crisis facing nursing.
Mark Radcliffe is next weeks’ guest editor of nursingtimes.net 2 November 2011 - join him then for his webchat at 1pm
Last week the news was dominated by the “alarming” findings by the Care Quality Commission after unscheduled visits to 100 hospitals. It announced cause for concern in 55 hospitals and that a fifth of hospitals may be breaking the law because of low standards of care. Among nurses I have found anger, embarrassment and disappointment. I have not come across too much surprise.
Now, from here on I could write about anything from the failures of nurse leadership to this government’s assault on NHS resources. Or I could suggest union leaders might do well to begin to articulate that striking is not just about pensions but about services themselves - a strategy that worked well when nurses went on strike in 1989. Or I could light a torch, grab a pitchfork and run mindlessly up the hill claiming nursing is in crisis because the newer nurses are being made to have a degree. In so doing, I could collude with the nonsense that bad nursing is only ever done by new nurses and being academically capable somehow drives the capacity to be kind from your body.
But when I heard and later read the CQC reports my reaction was the same as it was to Mid Staffordshire. How long will we go on imagining the human quality of “care” is a bottomless resource that does not require attention, thought or replenishment?
The fundamental problems in care are not due to students, or degrees or the ridiculous idea that training a mind robs the heart. They may have something to do with the expedient and simplistic idea that nursing is a science and so we don’t have to address its required artfulness. But we need to stop looking at lazy solutions to profound problems, particularly as, too often, those solutions are about blame and divisiveness. The capacity to bring empathy, regard, attention and care to patients recurrently needs educational investment - and not just in pre-registration courses but as part of everyone’s continuing professional development.
Why is it that trusts will update everything from fire training to manual handling, invest in “leadership” courses and policy updates but not provide mandatory education in or around how nurses care? We can call it whatever you like, from reflection to replenishment - and, goodness knows, because it doesn’t look “technical” or measurable some bean counter somewhere will be confused - but if we want caring services we have to invest in caring. Let’s not say such things are too hard or too vague; that demonstrates a lack of will and a limited imagination. But it doesn’t indicate a lack of capability.
Reconstituting the best of nursing means investing in the emotional sustenance, professional nourishment and humanity of all nurses. Now where is the political will or courage to take that on?
Mark Radcliffe is a senior lecturer and author of Gabriel’s Angel.