I AM responding to J. Fargher’s letter ‘Nursing needs a close inspection’ (Manx Independent, May 17).
My response is on behalf of, and at the request of, many nurses who have contacted me after reading the letter. They have asked me to respond – but, before doing so, I have asked those nurses if they had the opportunity to talk to J. Fargher themselves, what would they want to say?
The first thing that nurses have told me is that they want to express how saddened they are to read that a patient, and their relative, has had to endure such experience in our care.
I cannot write on their behalf and justify or defend the profession in light of the experiences J. Fargher had. It would be wrong of me to try and do so.
We are often left saddened on behalf of those excellent nurses whose abilities and motives have been called into question by the poorly-performing few who cause a drain of public confidence in the profession.
We must accept that we don’t always get it right and that sometimes we fail our patients and their families.
However, most nurses are dedicated professionals and they work in extraordinary ways every day to care for their patients. These nurses reinforce our belief that the vast majority of nurses are good people who want to do their very best for their patients. However, nurses aren’t a special breed and just as in all other walks of life there are a small minority that let the rest of the profession down badly. Unfortunately, it is often on their actions that the rest of the profession is judged.
Nursing is a highly-regulated profession. Qualifications are necessary to ensure the safe delivery of care to our patients. Patients would expect their doctor and the physiotherapist who treats them to hold a relevant qualification. Why should patients expect any less of nurses?
Nurses work in an ever-changing and advancing environment. So much has changed for the better in healthcare. Advances in technology, care and treatment, as well as changes in demography, leading to patients living longer and surviving serious illness, means that the profession has had to advance too.
From the skill and compassion to look after the frail and elderly, to the high-tech care of premature babies, nurses must be able to practise their science and art of nursing care with an ever-developing research and evidence base.
They have to be able to analyse and assess complex information, make complex decisions and implement complex packages of care. Much of what we do is evidence-based, it requires experts. We owe it to our patients to be experts.
The education nurses undertake combines both the theory of nursing and the practice of nursing. Throughout their training, student nurses work full-time shifts on wards and in other healthcare settings. They work with patients, alongside qualified nurses who mentor them and monitor their progress.
Their degree is a product of that learning process, it does not replace the prerequisite that to be the best nurse that you can be, you must have the ability to show compassion and kindness to every patient you care for.
This, together with advanced knowledge and skills, is what makes you a nurse. This is what I personally convey to every student nurse at the start of their nurse training. It is important that we dispel the myth and misunderstanding that compassion and care can be separated from knowledge, skill and competence. One of these aspects alone is not enough.
The nursing profession strives every day to try to improve the care it delivers to patients and their families. We recognise that, whilst we continue to advance our roles and practice, we must not lose sight of the fundamentals of care which our patients and their families deserve and hold dear. It is upon those values that our nursing practice should be based.
We have initiatives within the Isle of Man nursing profession, such as ‘Transforming Care’, that keep these fundamentals at the heart of all that we do. Fundamentals like treating each and every one of our patients with dignity and respect; making sure that everybody is safe and comfortable, pain free and have enough to eat and drink whilst in our care.
Patient and public representatives are involved every step of the way in developing these initiatives and in the monitoring and auditing of our patient care.
One example of how we are trying to promote these fundamentals of care is the dining companions initiative highlighted by J. Fargher.
For most people in their everyday lives, mealtimes are a social event, an opportunity to spend time with others, to talk and to share experiences.
Research evidence shows us that if patients have the opportunity to share this time socially with others they are more likely to eat and more likely to enjoy their mealtime experience.
Illness can very often have a detrimental effect on a person’s desire or ability to eat sufficiently. The dining companions are volunteers who share the lunchtime experience with patients, chatting, reminiscing and using this social opportunity to encourage patients who have little or no appetite to eat a little bit more. This encouragement and companionship can make all the difference.
However, it is in no way a substitute or a replacement for the qualified nurse, who during protected mealtimes will plan, oversee, monitor and assist patients. The companions work alongside nurses and healthcare assistants, who all have the same desire to help patients during their recovery from illness.
The public image of nursing is out of date in many ways. Nurses are not poorly-educated handmaidens to other professionals.
Other professions seem more able to consign outmoded role models and practices of the past to the history books. However, for nurses, the public still like to celebrate and remember the ‘good old days’ and cling to the belief that ‘it was better then’.
Those of us who were part of the ‘good old days’ and remember being nurses then, would tell you that it wasn’t better. Our care wasn’t evidence-based, it wasn’t individualised – it was ritualistic and routine, and was institutionalised. For the sake of our patients, the nursing profession can’t stay in that place.
I would like the opportunity to meet with J. Fargher and listen to his/her story personally. There is much that I could learn from hearing their experience. Experiences like these, when used in a positive way through the appropriate channels, can only help us as a profession.
True, compassionate care is skilled, competent, value-based care. Its delivery requires the highest level of knowledge and professionalism.
Condemning poor practice is not sufficient – we need to understand why it occurs and how to prevent it.
To restore the confidence of patients and relatives who feel about nursing as J. Fargher does, the nursing profession itself holds the key.
We need to demonstrate professionalism at every turn and have pride and passion in all that we do if we are to strive to provide the very best care that we can to every patient every time.
Department of Health.