Sunday, 17 May 2020

Nurses may be the heroes of the day, but we will also need them for tomorrow


Way back in March 1981, I happened to be out, driving on my way to milk my father-in-law’s herd of Welsh Black cows, when I saw a milk tanker drive off the road and plunge 20 feet into a fast-flowing river. It happened in the blink of an eye and for a moment I didn’t quite believe what I had seen. I parked my car and scrambled down the banking to the water’s edge to look at the lorry and see if I could help the driver. He wasn’t in his cab; the windscreen was completely gone. Looking up, I saw him wedged in a tree in the middle of the river.

Now I hate water. I can swim, in a swimming pool, but only if my feet can touch the bottom. I don’t like being on a boat, and would never contemplate taking a cruise. The tanker driver didn’t appear to be moving or responding to my shouts. I scrambled back up the bank and fetched a rope from my car. Using this, I was able to tie one end to a tree on the bank and wade out to the driver holding onto the rope. He was just about conscious, but clearly in shock. By the time I had reached him, other folk had appeared and together we were able to get the driver back to the bank, and with the help of the police and fire brigade, get him back to the road. He was taken off in an ambulance, and after giving my name and details to the police, I drove off to milk the cows.

The driver survived, but I never got to meet him again. A couple of months later, I received a letter from the Royal Humane Society to say that, at a recent meeting of their Board, the tanker incident had been discussed and I was to be awarded a Certificate of Commendation for my praiseworthy actions. This Royal society was founded by William Hawes and Thomas Cogan, both doctors who were keen to promote the techniques of resuscitation. Ironically perhaps, given my dislike of water, it’s original purpose was to recognise those who had rescued people who had apparently drowned or were in danger of drowning, but essentially, it rewarded those who put their own lives in danger in trying to save others.

I duly attended a lovely award ceremony, received my certificate and have been embarrassed by the award ever since. I don’t think my life was ever really in any danger and other people helped in the rescue. I was not, by any stretch of the meaning of the word, a hero. I thought about this incident last week, and it came to mind while reading the words of Ruth May, Chief Nursing Officer for England. She had been speaking at St Thomas’ Hospital, in London at an event to recognise International Nurses Day, which this year also marked the 200th anniversary of Florence Nightingale’s birth.

Indeed, 2020 had been designated the Year of the Nurse and Midwife by the World Health Organisation. Many events had been planned across the world to celebrate and honour the contribution nurses and midwives have made and continue to make to the lives of others. Then Covid19 arrived and sadly much of these celebrations had to be shelved.

It was something Ruth May said about nurses working in the pandemic that struck a chord with me, and made me think of that day all those years ago. She made the point that nurses are ‘expert professionals, not heroes’ whilst also acknowledging the critical work ‘that nurses deliver day in and day out’. I’ve had a growing sense that ‘heroes’ was the wrong term to use, but have struggled to articulate why I thought that might be the case. Indeed, back in early April this year, I wrote a blog that looked at those who might be considered ‘heroes’ today, which included many healthcare professionals. Unlike Ruth May, I’m not sure I even qualify in having an opinion. My contribution to dealing with the current pandemic is neither on the frontline, nor in ICU, nor in Covid19 positive wards or care homes. I sit in the relative safety of my home office, using virtual meetings and conversations in making my contribution.

However, Ruth’s words really resonated with my thinking. What she said, in full, was: ‘No, we’re not heroes – we are expert professionals who are doing our jobs and providing skilled, compassionate care, and nurses and midwives across England should be very proud of themselves right now’. There are, of course, countless examples of how people have gone the extra mile, have done extraordinary things to ensure services are kept running and people are cared for in the best possible way – each and all of these should rightfully be celebrated and acknowledged. The struggle that I have possibly stems from the use of the ‘war’-based narrative in the current political and contemporary public messaging. Unlike those in the armed forces, no healthcare worker agreed to risk their lives to do their job. Yet, to date, over 173 health care workers from all professions and backgrounds have died from Covid 19. The actual number is probably a lot higher.

But there may be something we can learn from the military and how wars are fought and the way we look after the mental health of our armed forces. Last week, I took part in a webinar that saw ProfessorSir Simon Wessely outlining his thoughts about the mental health of healthcare staff dealing with the Covid19 pandemic. He is undoubtedly one of the world’s leading authorities on the nature and treatment of medically-unexplained symptoms and syndromes, clinical epidemiology and military health. In one of his recent papers, he notes how the military have for hundreds of years, recognised the critical role junior leaders have in supporting the capability of troops to fight, even in the most stressful of situations. He argues that managers in the NHS, particularly those in supervisory positions, need to also acknowledge the challenges many staff are facing and find simple ways to minimise the psychological risks that will be present, as people continue to try and deal with the unremitting demands of the pandemic.

And there may be some early green shoots which demonstrate that this might be happening. Sir Simon noted that early results from staff surveys are showing that many healthcare professionals are doing very well. Whilst the consistent availability of appropriate PPE is still the single biggest factor in reducing their anxiety and anger, many are finding they are benefitting from the heightened supervision and effective team working that is becoming the new normal. In a strange way Ruth May is absolutely right. Our nurses are not so much heroes, as professionals who have the skills, knowledge, compassion and resilience to keep coming back and doing what they first chose to do in becoming a nurse, and in so doing, embrace all that being a nurse might entail. However, it will take more than a weekly gratitude clap to ensure they continue to be able to do so in the future. 
           

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