I felt called to nursing. Or you could even call it a vocation, though it preceded my conversion to Christianity and Catholicism. I fear, though, that I represent an increasing minority in British nursing today.
More than 40 years ago, in the process of completing a doctorate in biochemistry at the University of Sheffield, I was in despair. I had lost interest in biochemistry – it was clear I had no future there: I had little flair for it and could not bear the thought of a career working in laboratories. Contemplating my unclear and daunting future, I all but felt a tap on my shoulder and a clear voice saying: “Train as a nurse”.
Between 1982 to 1984, I trained in London at St George’s Hospital and have never regretted the decision for a second. What nursing has done for me is immense: I have never been out of work (I pursued a short clinical career before moving to the university sector where I have worked since 1989), I have fed and housed my wife and eight children, and I continue to travel to the ends of the earth due to my nursing career.
Since discovering my Faith, I have always been convinced that God spoke to me in advance. If He did not, then how does any atheist find Faith?
The public remain generally supportive of nurses, even after the nursing strikes, often viewing them as terrestrial “angels” who are dedicated to their jobs. However, at the same time, against that angelic background, accounts appear in the Sunday broadsheets and more conservative daily newspapers of horror stories associated with people’s encounters with nurses in hospitals and care homes.
It’s certainly not as simple as the view we are often exposed to that things were better “in the old days”. Back when I trained, we were using harmful treatments for pressure injuries, thus making them worse; we were restraining older patients with blankets tied around them in geriatric wards, while the concept of patient involvement in care barely existed.
Many present nursing practices are significant improvements. But there has also been a marked change to the appearance of nurses and, following the law of form equals function, a change in attitude. This has nothing to do with the uniforms, which were still antediluvian when I trained. It’s what is going on around the uniform in terms of appearance: nurses were not obese; they did not have luridly dyed hair; they were not tattooed, and they were not adorned with face piercings.
Now nurses display all of these features and stand in complete contrast to the majority of their medical and paramedical colleagues. As a university teacher I could always identify a group of nurses from far off on the campus; they were always the ones wreathed in cigarette smoke. Something has clearly changed amid the raw material that is coming into the nursing profession and, if my own recent brush with the UK National Health Service is typical, changes in appearance are accompanied by a deeply worrying change in attitude.
After an emergency admission and triage, I was taken to a room where I lay for an hour alone, until my wife and daughter returned from the tearoom (where they assumed I would be getting attended to). During that time the nurses were sitting outside my room exchanging Christmas pictures and videos on their mobile phones. Nobody came to say hello or check on me, and not even eye contact was made with me. It was three hours before a nurse came to introduce herself (obese and tattooed) and to gleefully announce that, while she was my nurse, she would be going home soon.
We never saw her again. She paid no attention to the fact that my daughter had been standing for hours and it took a passing porter to offer her a seat from the nurses’ station. Sadly, I have other such anecdotes from family and friends; this incident appears typical. Here was a nurse who did not, in any conventional sense of the word, appear to “care” about her patients.
Anyone can have a bad day, but does her failure, and that of her colleagues, to connect with me in any way, and her desire eventually to project herself into the situation – as well as the manner of it: visually and verbally – suggest a much wider problem at the heart of nursing? Is there, perhaps, an expanding moral vacuum whereby increasing numbers of nurses are focused more on their own needs than that of their patients?
Quite recently, I was involved in a disciplinary case with a nursing student who ran and posted sexually explicit videos of a sadomasochistic nature featuring herself to a website. It probably takes all types to become nurses but what shocked me, over and above some of the images I had to view, was her utter lack of contrition. Exactly what attracts someone like that into nursing?
The existence of an expanding moral vacuum is a troubling likelihood when you consider that, according to the Royal College of Nursing, they maintain a “position of neutrality” over the issue of assisted suicide – increasingly referred to, as by the RCN, “assisted dying” – which reflects their “members differing views on the issue”. It is hard to envisage a nurse who would admit to being willing to end rather than save a life. It is also hard to envisage the largest nurses’ organisation in the United Kingdom not condemning assisted dying. But apparently both these things are the case.
For the time being the regulatory body for nursing, the Nursing and Midwifery Council, maintains that any nurse participating in assisted dying would be in breach of UK law. But they are not opposed to it in principle and, presumably, if the law changes – as is being pushed by some – so would the position of the Nursing and Midwifery Council.
Then there is the stance of the Royal College of Midwives on abortion. In 2016, it came out as backing abortion up to birth. It’s current position on abortion is that “access to safe abortion services is a fundamental healthcare issue for women wherever they live”. It’s merely a “healthcare issue” – for women. No consideration of the obvious silent partner. The cognitive (if not moral) dissonance here is beyond unsettling for an organisation responsible for in addition to looking after the mother, the safe delivery of healthy babies.
I have worked closely with and learned a great deal from good people in nursing who expressed no sense of calling. Many are atheists or from other religions and some are Christians. It’s a real mix, and in order to adequately supply our hospital wards with nurses, we clearly can’t only educate or employ people who feel called. In any case, such a dynamic could not be tested. And yet the evidence abounds that something is deeply wrong and has shifted in nursing.
With the move of nursing education into universities, the educational qualifications required to be a nurse have increased over the years. The popularity of nursing programmes, which are routinely oversubscribed, means the grade point averages for nursing schools are often some of the highest in universities. There is also copious evidence that you are more likely to survive an encounter with healthcare if you are cared for by highly qualified graduate nurses.
Thus, arguments about the current state of nursing being the fault of a shift to university education are vacuous. The same accusation is not levelled, for example, at doctors or physiotherapists. There is also a myth that current nursing students do not get enough clinical experience: yet they spend half of the time on their programme working with patients and developing clinical skills. This has not changed since before nursing degrees occurred in universities.
Nevertheless, while universities may not be to blame for the current malaise, they are clearly unable to address the issue, as passing through their hands are all these intakes of nurses, many of whom have these questionable appearances and attitudes. This isn’t going entirely unnoticed. The current appearance and attitude of nurses is often described as “unprofessional”. But what it takes to be professional is often poorly articulated, especially to nursing students.
While nursing can, clearly, be both a calling and a career, the extent to which a calling is a requisite good thing, or the extent to which that would make the current situation in nursing better, is moot. My recent encounters with healthcare in the UK have brought me into contact with doctors, paramedics, phlebotomists, ECG technicians, radiographers, receptionists and porters who have, universally, been wonderful. I have no idea if they felt a sense of calling to those jobs, but they have been universally caring and clearly had my welfare foremost in their minds.
It simply saddens me to report that I cannot say the same about many of the nurses that I have met. The preponderance of body-altering adornments, the unhealthy appearance, accompanied by the smell of cigarette smoke, of so many of those whose job it is to promote health, is surely an expression of the extent to which they wish to express themselves in the workplace, regardless of what that workplace is.
The situation seems yet another example today, among a widening ensemble, of how the importance of “me” exceeds the importance of “thee”. And when that is happening in a “caring” profession such as nursing, there is clearly going to be problems for all of us who rely on our country’s healthcare service.
Photo: NHS workers hold placards as they gather for a march through the streets of London to demand a pay rise, 8 August 2020. (Photo by ISABEL INFANTES / AFP) (Photo by ISABEL INFANTES/AFP via Getty Images.)
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