So, I know
you hear a lot about the NHS, about nurses tirelessly campaigning for safer
staffing levels, about the whole system being underfunded. And we’re all inundated with politicians
using it as their bait in upcoming elections.
One sides telling you they’ll invest x amount, another that they’ll
recruit z amount more. Both blaming each
other for the chaos that’s the current climate.
And in between all this, the power of social media means we’re flooded
with stories of the queues outside emergency departments, about patients left
needing the toilet and delays in getting treatment. And only if you look more
closely, do you see the positive stories shining through like the first shaft
of sunlight after a storm.
But I’m sure
you’ve had your own experience? There’s not one of us who hasn’t at some point either
visited a family member or been the receiver of hospital care.
I’m a nurse,
but I have a family, and I’m not immune to illness, disease and tragedy, I understand,
and I’m in this job precisely because I care. About you.
About your family and loved ones, and about your home situation. But I also see it from this side. The misunderstood job role, and how it must
seem to you. So this is hopefully going
someway to explain.
In each day,
I may have 9 people to whom I have a duty of care. 9 people who are acutely unwell and who’s
current condition, medical background, mobility, skin condition, treatment
plan, social situation and prognosis it is my job to not only know but consume. When I’m not talking because I have a meds
trolley in front of me, and I ask if you could either wait 10 minutes or ring
your bell if its urgent – I’m not being ignorant. I’m not simply reading a chart the drs have
written and dishing out a pot of pills.
I don’t need a degree for that. I’m
looking through at your last blood pressure and heart rate and cross checking
the corresponding medication for any contraindications. I might be questioning the dose in order no
harm comes to you. I’m talking to you,
yes to introduce myself and make sure you know who I am and that I’m looking after
you today, but as you’re answering me, I can see how you’re breathing, I can
see if you look or feel unwell. Are you
working harder to breathe? Are you talking in full sentences? Is your breathing
equal?
Behind every single question and action that you’re subject to – what our
entire job is based around – is evidence based practice. You’re being asked if you’re pressure areas
can be checked regularly, because the evidence tells us illness, infection, poor
nutrition and decreased mobility for any reason are contributory factors of
developing pressure ulcers. Which, evidence
tells us are almost entirely preventable.
We want to get you up and moving after surgery because evidence tells us
this leads to the most positive outcomes.
We’re not winging it, we’re not making it up, its all been studied and
its all to improve patient outcomes.
The very
nature of the NHS, and why its so wonderful is that its there for everyone. No matter your background, financial situation,
previous experiences, age or gender – if you’re ill – it’s there. All this means there might be 9 completely
different reasons for being in hospital.
And we’re trying our best to reach the best outcome.
But to do
this effectively, we need more staff.
Believe me, we’re just as frustrated as you. We have to prioritise the sickest people. And I understand how frustrating this must be
for you, you haven’t seen me for an hour.
But I’m working with a team - cannulating a patient and getting fluids
and antibiotics for them, putting up an urgent blood transfusion for them, taking
bloods to diagnose the problem.
Or I may be
in a side room, holding the hand of a man with no family, who’s taking his last
breaths in this world, making sure he’s as comfortable as possible, and
reassuring him that he’s not alone. I’m
here. And taking a few minutes after the
last breath has left his body, to close his eyes, to tell him I hope he’s at
peace, and tell him that he’s still not alone.
Its not a policy but a personal belief that – we don’t come into this
world alone and wherever I can possibly help it – no one should die alone.
And then I come
out of that room and I see you’re call bell ringing. “I’m sorry you’ve been waiting, I understand you’re
frustrated. I’m here now, lets get you
sorted”. I would never tell you what’s happened
before I got to you, or why I’m late. I
know that’s not part of your journey. As
I talk to you, I’m remembering my handover.
Why you’re in, that you’ve been short of breath and can’t walk far
without stopping, that you’re anxious about being in hospital, and I apologise
again for leaving you waiting. Then I’m
gone again. But this time, I’ve gone to
make up IV medication for another patient, to order meds for another, to pass
on my concerns about another to the drs; to check the blood sugar levels of 3
others, and if needed, give treatment on these results; to change a wound
dressing on another patient; to re-check the blood pressure of another; to ask
the family member of another patient how they’re coping at home, and if they
feel they need more support.
And in
between all this, I hear you “I’m sorry to bother you” (NB: you are NEVER
bothering me, I need you to talk to me – tell me whats wrong, tell me you’re
worried, tell me your dad isn’t normally confused like this, tell me you didn’t
understand what the drs said, tell me you can’t cope at home- all of it- I want
to know. It’s why I’m in this job – I want
to help. I’m not ignoring you when I’m
writing, but unfortunately – for every procedure, every conversation, for everything
you see me do – there’s a pathway, there’s a policy and there’s paperwork
attached to it. What maybe doesn’t get
advertised is that in our world - if it’s
not written down – it didn’t happen. And
we’re reminded constantly “just doing it won’t stand up in a court of law”. I am caring for you, but in order to consistently
provide the best evidence based care for not only you but future generations,
this involves accurately following guidelines and documenting that I have done
so. But, I don’t mind working through
breaks, and staying late after my shift to catch up on this, if you need me
now. And I’m there, to help you get back
on your feet; to hold your hand when you’re scared; to put cream on your legs,
to help you to the toilet, to answer questions about your medication, to
explain why we’ve changed your treatment, to explain why we need another blood
test - any of it. All of it.
But the sad
fact is, however you dress it up with politics – there isn’t enough of us. The very evidence our job is based around
tells us we need more staff for this to be safe. Safe for you and safe for us.
The NHS is full of the most wonderful people,
working together as an amazing team under incredible pressure. Honestly, every day I meet the most devoted
and committed people dedicated to helping others.
Long after
you’ve left hospital and you’re name has left my memory, I remember you. How much more I wanted to be present by your
side, how I wish I’d been able to answer that call bell quicker, how I hope you’re
safe and doing well at home – that you’re coping. How I hope you knew how much I cared. I know
this is quite possibly the worst time of your life and I’m here to help. I’m busy and we’re short staffed but we’re
only stressed because we want you to receive the best care.
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