Has Downing Street become the new Bermuda Triangle?

There were two stories last week that caught my eye, both about nurses, but first, here is a Zoom Quiz question for you. From what animal do umbels come from? Well it’s an old fashioned word for offal, which actually can come from any animal, but the Zoom Quiz answer (according to Samuel Pepys in 1663), would be deer. The offal was used to make an umble pie, for the huntsman, whilst the Lord and Lady got the good stuff, and ate the venison. The English courtier and philosopher, Kenelm Digby, is credited for first describing Humble Pie with an H in 1665. Today, it is a dish that has been dropped from many menus, but if you want to try it, here’s a recipe, and if you don’t eat meat here’s a vegetarian version.

This week I’m having to eat a rather large portion of a slightly different type of Humble Pie: the one that’s about making public your apologies, or in my case admitting that I got something wrong. Back in April I wrote a blog about heroes, and in that blog I gently reproached the Chief Nursing Officer for England, Ruth May, for appearing on TV at one of the Covid-19 daily briefings wearing her uniform. I was concerned about the obvious infection, prevention and control implications of this decision, and I thought she was playing into the hands of all those who have such an old fashioned and inappropriate view of nurses. In my eye she was lowering the perceived value of nursing as a profession – none of the doctors have ever appeared wearing their scrubs, complete with stethoscope slung round their neck, nor have any of the scientists worn white coats and carrying a handful of test tubes.

Yes, I was a tad frustrated and annoyed at whoever had advised her to appear in uniform. And there would have been someone doing just that. Despite the protestations to the contrary that the briefings are unscripted, and the press and public questions unknown before the programme is aired, it’s clear that this is unlikely to be the case – we can see evidence of prepared responses, and responses that contain a great deal of detailed and contextual information. The espoused story has to be consistent and agreed. However, yesterday, the media was full of stories of the disappearing experts from these briefings. If these stories are to be believed, it’s because they have expressed a view contrary to the one the Government wants told. In my lighter moments, I imagine there is a house somewhere where they are all being stored until the ‘new normal’ is bedded in and stops being the new normal, and they can all be freed once more. We learnt from these media stories that the so-called Special Advisors take all those appearing at a briefing through a series of ‘practise questions’ before they go live.

The entirely credible and human face of modern day medicine, Professor Jonathan Van-Tam, England‘s Deputy Chief Medical Director has not appeared since being on the 30th May briefing. Then he was asked a direct question about that not-so-special Special Advisor, Dominic Cummings and whether he believed that those in authority should lead and obey the rules. Professor Van-Tam’s response was a brilliant piece of television. In a calm and measured voice, he replied: ‘In my opinion the rules are clear and they have always been clear’ – pause – ‘In my opinion they are for the benefit of all’ – pause – ‘In my opinion they apply to all’. If he is not locked away in that house of dissidents, I hear say that the University of Nottingham is a lovely place at this time of the year. I wish him well – he is my kind of academic, expert, doctor and person.

Likewise, although not a medical doctor, (although she holds a couple of honorary doctorates), and not an academic in the same sense as Professor Van-Tam, Ruth May is an expert, and as I found out yesterday, my kind of person too. Two things made me consume that large slice of Humble Pie – the first was that the uniform she wore at that briefing was an example of the ‘gender-neutral’ uniform she is advocating as part of her objective or challenging the stereotyping of nurses – so I got that wrong big time! The second thing was in the media stories yesterday, Ruth May was cited as being another one of those disappearing experts from the daily briefings. Her alleged crime? – well in one of those ‘practise sessions’ she was asked about Dominic Cummings, and after refusing to publicly support the Prime Minister’s Advisor, she appears to have been unceremoniously dropped from the briefing. She has not appeared since. Now if it were possible, I would like to shake her hand and say both thank you for her firm stance and apologise for calling her out. I was wrong. She has done much through her values-based approach to the Dominic Cummings debacle to promote the profession of nursing. I don’t think I will get to meet her, but one never knows.

For example, last week I took part in a webinar, during which Andrea Sutcliffe presented her thoughts about nursing and midwifery in the Covid19 era, and I was able to ask her a question. Andrea is the Chief Executive of the Nursing and Midwifery Council, taking over from Jackie Smith, an equally formidable and brilliant person. Andrea, is not a nurse, nor a doctor, but in 2015, she was acknowledged to be the third most influential woman in the NHS. My question was around whether the ‘new normal’ perhaps gave rise to a new way of thinking about nurse education and training, particularly, the EU- imposed requirement for 50% of time to be spent in study and 50% in practice. She was very positive about the opportunities, and as with Ruth May, I wish her well in her endeavours.

Andrea also talked about the role mental health nurses have to play in dealing with what she foresaw to be an emergent mental health consequence of those working in healthcare services dealing with the pandemic. This was the second nurse story to catch my eye. We already know that patients who spend time in intensive care (ICU) can also experience severe mental health problems, particularly post-traumatic stress disorder (PTSD). Last week, I read this paper ; it’s ‘open access’, so you can too. It’s a great paper, but not as good as the one written 20 years ago by my sadly deceased PhD supervisor, Joel Richman, see here (unfortunately this one’s not ‘open access’). Andrea recognised that the nurses and doctors are also likely to experience mental health problems as a result of their Covid-19 work. Whilst, (no pun intended) Ruth may have disappeared from our TV screens, I’m confident that with the likes of both her and Andrea and the teams with which they work leading the way, such needs will be acknowledged and absolutely met.