TwitterNurse – sixth instalment

This week I almost resigned from my nursing post.  The reasons are complicated but relate solely to my feelings towards patient care in our current NHS.

When you become a nurse I think you have an intrinsic desire to do good, to help out, to make people feel better.  You are a rescuer.  Sometimes this desire translates into clinical care – injecting, bleeding, cannulating – sometimes into emotional support – listening, talking, watching.  As practitioners, we all want to deliver holistic care, that is to ‘read’ our patients and thereby interpret their needs; in this way, we give what the patient needs, not to be mistaken with what we sometimes want to give.  When we can’t give what the patient needs it creates a tension – we can’t do our jobs and we feel bad about not being able to give our best to our patients.  We don’t feel good and, no matter how hard we work, we feel we have delivered sub-standard care.  Or importantly, we work so hard to try and avoid a drop in our standards of care that we become tired, lost and sad.  This happened to me this week.

These feelings are not good and have an impact on professional confidence and mood.  They appeared in my mind because, this week more than usual, there were significant demands on my time, not all of them directly relating to patient care: sometimes in my job I am asked to do things other than direct patient care – audits, responding to emails, delivering talks to other healthcare practitioners, to name but a few; sometimes these demands impact on direct patient care.  I am not always asked if I can fit these these other tasks, I am instead told they are necessary.  At these times this means that my patients are left waiting for me while I carry out these other tasks that take me away from the department.  Let me be clear, I am instructed to carry out these tasks by people senior to me and I have no choice but to carry them out.  These tasks are varied and can be undeniably important, and multi-tasking is a very much a part of a nurses’ job – these issues are not in question. What leaves me feeling sad and professionally disillusioned is having to leave my patients because someone tells me to do ‘other things’, taking me away from patients who need my time, and patients for whom I am directly responsible for.

It can be difficult to say ‘no’ to a person.  My patients do not deserve a ‘no’; they are the ones who come to me for help, but with the best will in the world, there is only one of me. I cannot be with two patients at the same time and the demands on my time this week have meant that this was essentially needed.  To not be able to adequately care for your patients is a soul-destroying thing for a nurse, as much as it is life-affirming to help them.  Because my shifts this week have been full of conflict, my days have been full of tension, and this tension has lead me to believe I cannot do a good job.  As a nurse, this feeling is dismal and profoundly professionally damaging.

The NHS matters to me.  I want it to survive, not just because I love its heritage and original intentions but because I see its beauty: it gives real help and hope to millions of people in their darkest moments, it provides a form of sustenance seldom seen anywhere else.  But I cannot let the people who currently ‘own’ the NHS take my vim; this week I felt  truly hopeless and some of the people who are supposed to be part of a ‘team’ did this to me.  It strongly occurred to me that the NHS has people within it who are not being honest about what we can achieve and who show no compassion for their colleagues.  They are Machiavellian in their desires to succeed and step on colleagues to climb the ladder to professional success.  This week, I felt stood on and ignored with my professional opinion not even asked for. If these people are to stay in the NHS, I am afraid it is doomed to fail.  ‘Getting through it’ as a mantra for a difficult shift is no longer good enough because the cost to staff is too great; the NHS has to recognise this and to be heard you have to shout.  Stay or go, I will always support our wonderful NHS.

I am shouting.

I hope you will too.