16 May 2018

When I approached my agent with separate ideas – to write something fictional about nursing, and to  try and write some non-fiction – I was looking for advice about which project to approach first. But Sophie simply shrugged and said, ‘combine them’. It was a lightbulb moment, not least because I’d spent years reading narrative non-fiction written by doctors: Oliver Sacks, Paul Kalanithi, Henry Marsh.

And I’d scoured the libraries. Spent hours in the Wellcome and British libraries looking for non-fiction written by a nurse. By a female nurse. I found Notes on Nursing by Florence Nightingale. And pretty much nothing else, but rows and rows of books written by (mostly male) doctors.  I began thinking about what this suggested in terms of values and gender.

I am deeply ashamed of our values in the Western world. Of us valuing the wrong things: fame, celebrity, power, money, external beauty, the cult of youth. I am ashamed of how we treat our older people, with so little respect. But the lessons of nursing carry outside the hospital, and any one of us who has been through a serious illness, or lost someone, realises the importance of kindness, care and compassion. We will all get old, or we will get sick, then die. At that time, the only things that will matter to all of us are kindness and love.

I’ve seen so much tragedy over the years. Cared for elderly people after strokes, pregnant women suffering aneurysms, heart attacks, head injuries, burns, assaults, babies with meningitis, patients with sickle cell crisis, asthma, pneumonia, heart failure – so, so many people suffering cancer. People who are dog-bitten, broken-boned, broken-hearted, respiratory-failing, drug-overdosing, fallen from a roof, mentally-ill, impaled on a spike, shot and stabbed.

Because nurses care for patients before birth and even after death, and everything you can imagine in between. And although presenting a strong exterior for patients and families used to be a concern of mine, as the years wore on I realised that families want nurses to be human, to cry, to show their emotions. It is healthier for the patients and their families, and much healthier for the nurse. The Code of Professional Conduct states that nurses must ‘remain objective and have clear professional boundaries with patients and relatives in their care at all times.’ I disagree entirely. There is no objectivity in good nursing care. To nurse is to love.

Saving the NHS

There is no objectivity in good nursing care. To nurse is to love.

And for every case of suffering or tragedy, a nurse witnesses extreme love. The capacity we all have for hope and kindness and dignity in the face of adversity is the thing that binds us.

In hospitals, you see it everywhere.

But the medical model we have lived and died by is driven by money: drug companies and technology, insurance companies, and hospitals themselves, are making enormous gains from the prospect of cure. Yet this is a time of great societal change. Now, as we age, as so many of our health problems are caused by emotional and social factors, cure is often not possible. Increasingly, sick people are sick because they are suffering existentially, not from any disease or pathogen but from loneliness, self-harm, crippling anxiety.

So the things that matter are kindness and compassion. We need a conversation about the reality of contemporary healthcare. Nursing cannot cure. But nursing can save us.

Which is why it’s so disastrous that nursing application figures are so far down in the UK; that people are leaving the profession faster than they are joining. This is fast becoming the worst nursing shortage ever seen, and if there is no international nursing workforce strategy we will witness – very soon – crippled healthcare systems across the world.

I am immensely proud of our NHS. It offers access to the best doctors and nurses in the world. For all people. From birth to death. Because healthcare is a human right. But we are going to lose it unless we all speak out collectively. Funding is one part of the issue, but social care and public health are even bigger concerns. And we need nurses as policy makers, in government roles, working at a senior level on saving nursing.

There is much to be done in terms of training, fair pay and working conditions (nurse consultants, for example, are not paid anywhere near what medical consultants are), but to attract people into the profession in the first place, we also need to make an honest portrayal of the job available to the public.

So I am proud to have written a book that finally describes the realities of nursing, and to be developing a television series with Mammoth Screen to put a realistic drama about nurses on screen.

It’s a challenging profession, but nursing gives more than it takes. A nurse lives a full life – she has seen too much not to. And as Florence Nightingale reminds us: ‘Life is a splendid gift. There’s nothing small about it.’

Christie Watson

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