RCN Nurses vote to strike…

Today, the RCN revealed that Nurses in the UK had voted in favour of strike action for the the first time in its 106 year history. It is a landmark moment and in many ways marks a new realism amongst the profession. Always being there, and going the extra mile no longer cuts it when it comes to being recognised and properly rewarded. Tougher responses are needed and Nurses are showing that they are up for those tough responses. There will be many who didn’t vote for action, and many who will be sorry that it had to come to this, but really, the alternatives have long been tried, and have failed.

There was no option left for Nurses – previous talk/negotiations haven’t led to anything useful and the last three years have been hard to take for most Nurses. Constantly being asked to do more with less, dilution of the workforce without thought for the effects on morale and well-being let alone on patient safety, staffing levels that should be totally unacceptable, and as always, an expectation that Nurses will fill all the gaps, pull out all the stops, and keep everything going. As the RCN says in their campaign – Enough is Enough. I’ve heard people talk about their concern for patient safety in the event of a strike, but what they don’t seem to realise is that it’s not always safe now, and that’s precisely why such unprecedented action is necessary.  

Poor pay and conditions have meant that Registered Nurses have left the workforce in droves and those that are still there are working in extreme conditions where the pressures on them are far greater than they should be.  I admire their courage and strength of character in taking the action of pretty much last resort – what else are they supposed to do? They have been taken advantage of for years, the presumption of them ‘always being there’ has led to them being under-valued, under-appreciated and hugely under-paid. People who actually use our NHS services know how bad it is, and will support Nurses. It’s those who know nothing about the working situations or the critical work that Nurses do every day who will be outraged. There will be talk of ‘the calling that is nursing’, ‘the vocation’, ‘the selflessness’. There should be more talk of the Nurses who are using food banks, the real-terms reduction in pay of £4,300 since 2010 and a reduction of £1,100 just this year. More talk about the Nurses who go home exhausted trying to hold everything together in seriously under-staffed clinical areas. More talk about the impact of Registered Nurses on patient outcomes and patient safety and what happens to that when there aren’t enough Registered Nurses. And there aren’t nearly enough.

It’s time that Nurses made their voices heard this way. Because this strike vote is not just about pay. It’s not just about grinding working conditions, or Nurses’ mental health and well-being. It’s about the safety of the people who need NHS services. It’s about the sustainability of the NHS. Without sufficient skilled Nurses it can not do what it was set up to do. This strike vote should be a wake-up call to everyone. For everyone’s sake, listen to what Nurses are saying. Support Nurses – or there will be no services to support you.

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It’s not about the uniform…

That afternoon in the Sewing Room I tried on my uniform and looked at myself in the long mirror.  The Sewing Room – that dates me too, together with having 7 uniform dresses and being told that they would be laundered for me.  All I had to do was drop the worn ones in at the Laundry and pick up a couple of fresh ones from the carousel marked ‘W’.  They were actually my OWN dresses, with my name marked indelibly on the collar; not a ‘one or two sizes fit all’ set of scrubs. Anyway, looking at myself in that mirror was a sobering moment.  Everyone around me was laughing and trying not to show how proud they were, calling each other ‘Nurse’, checking their new fob watches, showing off their scissors – ‘Look! I had my name engraved on them!’ – although engraved names didn’t stop scissors going missing on a regular basis. So much so that we soon discovered the little chains you could buy to pin your scissors to your pocket so they could be used without putting them down and losing them (infection control wasn’t such a hot topic, then). The person in the mirror looking back at me was a Nursing student, there was no getting away from it.  Blue uniform, pens in pocket, fob watch and name badge all proclaimed it. Sensible shoes and folded cap reinforced it. That uniform labelled me as someone who was in the process of gaining specialist education.  People would have expectations of me.  Expectations of behaviour, of knowledge, of dexterity, of decision-making.  Vulnerable people would have expectations of me; that I could, and would, help them.  Probably for the first time in my life I knew what it was like to feel significant responsibility, and this was before I got anywhere near a patient.  I was scared.

      In this context, it was good to be scared.  Ignorance, in a health care setting, is most definitely not bliss.  Knowing that you are ignorant is a very welcome insight.  Being conscious of limitations is what helps to keep nurses, and their patients, safe.  Confidence can come later, when there is some knowledge and some practice experience; enough to know what to look for, how to respond to it, and how to recognise when you are out of your depth.  This is what nursing education is really teaching.  Trust your knowledge, and when you’re not sure, get help. All through my career I’ve seen people who have taken a while to develop that insight.  A little knowledge creates self-confidence, but it’s not enough to recognise the more subtle signs and changes that need fast appraisal. This takes time, more education, and experience in the field.  Sometimes I have seen those with the least knowledge talking with the most confidence about what they can do.  Beware.  That is much more frightening, and likely to be much more unsafe. If I was talking to nursing students now, I would say ‘Embrace your fear, acknowledge your ignorance.  They are keeping you and others safe.  Keep learning, more and deeper knowledge. Be mindful in your practice and notice when things go well and you are having a positive impact. The right sort of confidence will grow.  It’s less about self-confidence, and more about confidence in your knowledge and skills.’

Memoir. First day in the School of Nursing….

There are about 120 of us, sitting behind rows of tables in a large hall.  It is sunny outside, but the golden light of autumn doesn’t penetrate the dark tint of the windows. This building is known as The Black Box, because that is exactly what it is. A two-storey, oblong slab faced in black glass.  I think it’s supposed to feel edgy and modern, but to me it feels cold and uninspiring.  I am apprehensive and slightly bewildered.

The room is noisy with chattering and calling, chairs scraping, coats being flung off and bags thudding down on tables. I look around at the group of people I will be spending most of the next three years with. We are a cohort of our time – the early nineteen seventies – overwhelmingly female, white, and young.  I can see two men, sitting next to each other, safety even in small numbers I suppose.  There are four black women, later on I learn one is African, two are black British, and one Seychellese.  Youth is a common feature.  I’m guessing, but I would say there are not many over twenty-one, most of us are straight from school.  A knowledgeable person in the next row tells me that two girls have already been through university, she points them out – they seem far more composed and mature than the rest of us – they have the slightly bored look of having done all this meeting and greeting of lots of strangers before.  One of the men looks to be about thirty and has a wedding ring – he’s married, (I wonder how that got past the interview process?) and there is a grey-haired, middle-aged woman who on closer inspection turns out to be a nun – another sort of wedding ring.  

      We are split into class groups, seated alphabetically like back at school. Being a ‘W’, I resign myself to sitting at the back of the classroom for the duration.  Sitting next to me is one of the men (the younger one).  He is friendly and we introduce ourselves:

“Hallo. I’m Alan”.

“Hi, I’m June. Weird isn’t it? Like being back at school!”

This casual opening is the start of a friendship that will last 45 years and counting.                        

      Before we can have a proper conversation, we are trooped out of the room, filling the corridors to make a tour of the School – classrooms, a coffee lounge, library, a huge lecture theatre and then, The Practical Rooms.  A hush falls as we take in the large space in front of us.  Hospital beds down each side with pushed back bed curtains, neatly made up with bedlinen and the famous hospital corners on display, lockers standing next to the beds. Some of the beds have what look like life-sized dolls in them.  Mannequins, we are told.  Pretend patients for practising purposes.  They are all white, well, a kind of plasticky pink.  There are sundry items of equipment that we can’t name now, but soon will – drip stands, bed cages, linen skips, dressing trolleys.  The gleam of polished chrome and stainless steel is everywhere.  I swear I can smell disinfectant. The sense of ‘hospital’ is powerful. This is where we will practice our skills before we are let loose on real people. Real people.  Am I the only one feeling anxious about this? The noise level rises again as we are ushered into another room, split into groups to suffer ice-breaking exercises.  (Ice breaking exercises were as excruciating then as they are now, but slightly less inventive). 

      ‘Now, tell your group your name, and then tell them one thing that no-one knows about you.’  What? This is a room full of strangers, none of us knows anything about each other. We could share shoe sizes and it would be a surprise. Or are we supposed to tell them one of our deepest secrets? Something that really NO-ONE knows? Good grief. I am frozen with terror, desperately waiting to see what others will tell. It is a great relief to hear someone laugh and say ‘I’m not really a blonde’, and someone else ‘I live less than a mile away’.  I think about offering ‘I don’t know what I’m doing here’, but instead, settle for ‘I’m probably much more scared than I look’ which goes down well.  We begin to laugh and chatter in that over-excited way that so often accompanies nervous young people trying not to appear nervous.  After a while, we meet more Tutors and mingle over a buffet lunch.  I am exhausted – by the numbers, by the confidence of others, by the ease with which they seem to chat to total strangers, how grown-up they are, how anxious I am.  In the afternoon the timetable says we are going to be fitted for uniforms.  Uniforms! The excitement is palpable, even amongst the grown-ups.  

      I had no idea then what nursing would mean to me, or what it would mean for me in terms of my future.  I didn’t know anyone who was a nurse. (Actually, that’s not true. The woman who lived opposite my parents was a nurse. But she was retired and therefore didn’t count).  I hadn’t considered what it would entail beyond moving away from home and some notion of doing something ‘useful’.  When I look at the cohort photograph taken that first day in our brand-new uniforms, I see a child. The slightly too big dress, my slightly too thin arms poking out of the short sleeves.  Hands clasped demurely in front, long hair tied back over my ears in that seventies neo-Victorian style; a white, square, card cap pinned on my head. I am not smiling.  I look awkward and uncomfortable and it seeps up out of the picture and through the years, reminding me of my long-ago innocence and naiveté.  I’m sure I was feeling out of my depth – although I think my ‘depth’ was pretty shallow at that time.  I certainly felt ill-equipped.  What, over the preceding summer months, had seemed like an exciting step into the future was now an absolute reality, and was hitting me square in the face.  Like it or hate it, I knew I would never go ‘home’ to live again, I would never go back.  This was going to be my future, whatever it brought.

oOo

Memoir. Loosening the ties…

     If you want to read the piece immediately before this, then go here; it ends with me standing in the Nurses Home, on my first day, wondering what I had done…

 What I had done was begin to break the mould that had been cast for generations of women in my family.  From school, to job – preferably in an office, or maybe the superiority of working in a Bank, but failing that a good shop did nicely (haberdashery, or a department store), a steady boyfriend (a local boy), a suitable period of engagement (at least a year), then marriage and family.  In that order, of course.  A profile that had always filled me with claustrophobic horror.  So constrained, and so expected.  But how else did you get away from home, if not through a husband?

I was a bright child, but it came as a surprise when I passed the 11-plus exam and was able to go to the local grammar school.  I remember it was a reason for teasing rather than congratulation, leaving me slightly confused about whether I had done something good, or whether I had just brought untold expense down on the family:

 ‘What?  THREE blue shirts? ‘

‘And a separate summer uniform?  A special skirt for gym?’

 ‘Gym?  That’s posh, isn’t it?’

I am sure my parents were pleased, but I’m also sure they didn’t understand what it could mean for me in terms of future opportunities.  Even grammar school was beyond their horizons, and because of that, it was almost beyond mine.  There was no-one to help with homework – maths very quickly surpassed anyone’s ability to assist, and history was a closed book, other than what parents and grandparents held in living memory.  Physics and chemistry just drew shrugs. Literature?  I remember only two books at home, before I started buying my own or borrowing from the library. They were tucked away in a cupboard under the stairs with the jigsaws and the board games.  They were my mothers, but I never saw her read them.  One was Daphne Du Maurier’s Rebecca, a thin hardback with a home-made cover of wallpaper, and the other was Lytton Strachey’s Elizabeth and Essex.  I don’t think the latter had ever been opened (until I discovered it when I was about twelve).  I remember a nursery rhyme book with pictures of Polly Put(ting) The Kettle On, and Wee Willie Winkie in His Nightgown, and I remember alphabet books with letters and pictures – Aa is for Apple, Zz is for Zebra – but beyond that I don’t remember there being books to read at home, and I don’t remember being read to. Once I had mastered reading at primary school there was no stopping me – I loved it and was good at it.  I whizzed past my contemporaries in reading age, left Blue Books One to Four in my wake, powered through Ladybird fairy stories (oh, the pictures!), and in the final year joined the Library Club.  Library Club was a revelation.  Every Wednesday afternoon eight of us would be taken to the local Children’s Library (imagine that, a whole public library devoted to children…) to be introduced to a thousand different worlds: Alice; Toad and Mole and Ratty; Dickon; the Secret Seven; the Moomins; Bilbo Baggins; Arthur Rackham’s illustrations for fairy tales; Dulac’s illustrations too…  It was heaven. I quickly developed the compulsive reading habit that has lasted all my life. 

The hop from primary to Grammar school was my introduction to a wider range of reading – to more children’s fiction, to literature, to textbooks, to information far beyond what I had, or could gain from my parents.  I was the proverbial empty vessel waiting to be filled, drinking up as many words as I could, bursting with them. But there was no one at home to share or discuss them with.  The only book that caught my mother’s attention was D H Lawrence’s Sons and Loverswhich I was studying for ‘O’ level.  We had to have permission from our parents to read it. She didn’t think it was ‘suitable’ reading material, but she didn’t object, fortunately – imagine the mortification if she had.  Apart from expanding my reading horizons, I met boys and girls who had very different lives, who’s Dads worked in offices and were at home every evening, who went on package tours to Spain for their holidays, who didn’t have broad Black Country accents. I met friends’ parents who talked to me like an adult, who drove us off to parties and picked us up again at the end of the evening, and who gave me wine with a meal.  One friend’s mother wore maxi dresses and twisted a scarf around her hair (so Bohemian!), another was a divorcée who would give us boyfriend advice (so cool!), another took us to the theatre (so sophisticated!).  So different from my own who thought that Mothers should look respectably like mothers, like their own mothers.  Unfashionable but smart and clean, regularly permed hair, no going out unless it was with my Dad.  No friends unless they were other couples, and preferably relatives of some sort.  I made a lot of friends, and my good friends were boys and girls.  My mother saw all the boys as ‘boyfriends’, she had no concept of the platonic male friend.  Even much later in life when I was working in academia and used to travel overseas regularly, she always wanted to know who I was going with.  If I mentioned a man she would give a disapproving sniff and say ‘Aren’t there any women going with you?’  I was in my fifties, for goodness sake! She was always prudish, almost as if she was from a generation before even her own.  She was 90 when she died – had never been out of the country, never been in a ‘plane, I don’t think she had ever been to London.  Was she happy?  I don’t know.  Perhaps she was, but I don’t know.  Anyway, back to my education.

My time at grammar school, was a rounded, thought provoking seven years of liberal education that began to open my eyes to the limitations of my circumstances.  It chafed at me without my really knowing why.  It made me feel ‘bound’ in a way that was both loyalty to my upbringing and guilt at wanting to free myself from it.  This thread of conflict between who I was and who I might be was woven in these early years and stitched all through my future.

 On that very first day at the Nurses Home, it wasn’t a twitch on that thread that caught me, it was a sense of the thread loosening and slackening. Unbinding.  I was Somewhere Else, and the old constraints were falling away.

oOo

45 years – and counting…

This morning I received confirmation of revalidation from the Nursing and Midwifery Council. I wrote about my previous (and first) revalidation experience on here but things have changed quite a lot since then. I’m retired from paid employment for one thing. I do occasional paid consultancy work, but I do most of my work on a pro bono basis now, and of course, no-one pays me to write articles or to blog or Tweet or try to influence by any means I can. All of which I consider to be legitimate use of my Registration and a contribution to the profession, and indirectly, to care.

I was anxious about revalidation because in the back of my mind was that little niggling thought that what I do now ‘isn’t good enough’ to count. It was surprising how persistent that thought was. I’m a very experienced Registered Nurse with two successful careers in practice and in academia; my advice is sought almost every day both formally and informally; I keep up to date and I keep learning. I’m confident in my knowledge and expertise, in the quality of my advice, in my ability to support development in and of nursing. But – the feeling of not having a ‘proper’ job kept popping into my head and making me anxious about revalidation.

As Confirmer and Reflective discussion partner, I chose someone who also works in a ‘portfolio’ way – some paid work, some self-employment, some voluntary work. This really helped me to think about how my work was meeting the different parts of the Code, and to reassure me that all the different aspects of my work could contribute. There is a great deal of flexibility in the revalidation process and with thought and reflection it’s not difficult to fit in the areas of work that don’t automatically, or superficially, seem legitimate. As previously, I learned a lot through the process, and gained some clearer perspective of the contribution I was/am making. My Confirmer also insisted on seeing all of my documentation and evidence, and they asked for a little more in one area. Very diligent and reassuring. Friendly, but not casual. Exactly as it should be.

After the reflective discussion etc, I went online to complete the process. Within seconds of submission, two emails had popped into my inbox. One to acknowledge submission, and one – oh, horror! – to say I had been selected for verification. The niggly voice came back. Somehow, within seconds, the NMC had decided my submission wasn’t up to scratch! Oh, no! A minute later, all was calm as I actually read the communication. All I needed to do was to send additional information and evidence about two areas of the revalidation process. It was simply a question of providing the information I had been keeping on the online forms over the three years previously, to the NMC. I was able to do that immediately. They also contacted my Confirmer for information. Within a couple of weeks I received an email confirming the verification assessment was successful and that my revalidation for the next period was complete.

Now, I have never met anyone else who has been asked to verify their submission and neither has my Confirmer. Given the self-assessment nature of revalidation, I think it would be quite tempting to try to pull it all together at the last minute. But, when that request for verification comes through, if you haven’t got everything to hand it’s going to be really stressful. I had, as I’m sure everyone does, kept a three year portfolio on-line of all the requirements, using the NMC’s documentation. Whatever they asked for – whether it was a breakdown of hours, evidence of CPD, or reflective accounts and pieces of feedback – I had it all, in writing, done. How else could I have had reflective discussions and a confirmatory meeting? It meant that I could respond to the verification request immediately, by return. No scrabbling around for different elements. I offer this as a cautionary tale – one day, that verification request may drop in to your inbox. Don’t skimp and think it will never happen to you. Not only do you risk your own registration, but that of your Confirmer, too.

I am very pleased that I can continue to call myself a Registered Nurse. I am entitled to use that term for another three years. Whether I call myself Registered Nurse, or Nurse, I’m not deceiving anyone. Some people do – some people use the title Nurse when they are not registered and let people believe that they are. When I think what it takes to become, and remain a Registered Nurse, when that title is improperly used it makes me angry. Which is why I’m part of a campaign to prevent it happening and to protect the title ‘Nurse’ only to those who are Registered Nurses. If you are as proud of your title as I am, you can join the campaign by signing our petition at the link below: ⬇️ and thank you, if you do.

https://petition.parliament.uk/petitions/587939

So, I’m still a Registered Nurse. I qualified in 1976 and have never lapsed my Registration at any time since. That’s 45 years straight, so far. I’m proud of that.

New arrivals…

      The Nurses Home.  My parents left me with my suitcase and meagre pile of belongings and I waited in a queue of similarly aged girls to register at a large desk, with an equally large woman behind it.  I was handed two keys – one to the front door and one to my room.  MY room.  My own room!  I had never had a room of my own.  As a young child I shared a bedroom in the pre-fab with my sister and my grandmother, my cot squashed against the wall.  Later, as the family grew and we moved to a slightly bigger house, I shared with my sister and my brother until my grandmother died and my brother took possession of her room. I shared with my sister until we left home. 

There I was, suddenly independent.  My room was on the fourth floor and my luggage had already been taken up.  Everywhere looked and felt, and smelled, institutional: cream-painted walls, hard floor, dark wood doors, a faint whiff of floor polish.  There were high ceilings and nothing soft on the floors to muffle the sounds.  The open hallway was noisy with the excited voices of new arrivals; I remember thinking it was like the first day at school after the summer holidays.  The lift doors scraped open and shut, porters carried bags backwards and forwards, small groups taken to the upper floors.  There was a wide stone staircase to the left with a stern notice in red lettering on the wall: ‘MALE NURSES FIRST FLOOR ONLY’.

Occasionally nurses in blue uniforms appeared on the staircase, walked down and made their way through the crowd of us and out of the front door, crossing the road to the hospital.  They wore white caps with a blue stripe and some of them wore navy blue cloaks with a red lining.  There was much nudging and looking from the crowd: 

‘That will be us soon!’ 

practically appeared in thought-bubbles above us.   They smiled at us, not without a little condescension, probably remembering how awed they had felt themselves on their first day, and enjoying the sudden power over us newbies. 

“Walters!  June Walters!’ My name was called, and I hurried across to the lift before the doors closed.  Squashed inside, there was a moment of embarrassed silence and then half a dozen of us shared tentative hellos. 

‘Which floor are you on?  Four? I’m on three!’

 ‘Oh, I’m on four too!  I wonder what the rooms are like?’

 ’Maybe we’ll be near each other?’ 

It felt, unnervingly, like something out of an Enid Blyton jolly-girls-at-boarding-school book.  A lot of fresh-faced, excited girls starting a new term.  Was this how it was going to be? Was this what I wanted?  What had I done?

Will the RCN please stand up?

Last week I posted about the importance of protecting the title ‘Nurse” here and I’m going to say a bit more, because there are some responses to the campaign that have been interesting. First of all, and most encouraging, is that I haven’t had a single negative response to many, many tweets I have put out urging people to sign the petition. I have had lots of RTs, lots of positive comments and some surprising endorsements – the author Elly Griffiths has supported our campaign by retweeting – she heard campaign instigator Professor Alison Leary on Radio 4 Womens Hour talking about the fact that anyone can call themselves a nurse and was shocked to find that out. It’s a good listen at about 15 minutes in. Plus there has been clear and unequivocal support from The Queen’s Nursing Institute via its CEO Crystal Oldman, who leads her organisation without fear or favour. That institutional support is really important.

In amongst my retweets of the petition I sent a tweet out asking if the Royal College of Nursing was supporting the petition, as I hadn’t seen anything from them on this important issue. The response was a surprise and a concern. There is a thread to read if you want to look at the whole conversation – and it is worth looking at but I can’t reproduce it all here. The tweet that first bothered me was this one:

There is a debate within the college and particularly relating to our many members who aren’t registered nurses. Where there is debate on an issue it is important that this is properly discussed and agreed by the various elected members.

— Dave Dawes (@davedawes) July 3, 2021

We know that the College has a membership of Registered Nurses and nursing support role holders. This petition is in support of a principle to protect the title Nurse to use by Registered Nurses in UK law, to prevent its misuse by imposters and/or those who seek to gain in some way by playing on the trust and expertise implicit in the title. I gave some examples in my previous blog and I won’t revisit them here. It is a petition to support the integrity of the professional title for the benefit of patients and Registered Nurses. It has no relationship to, or effect on, those members of the College who are not Registered Nurses. So why is the College even making this point?

Representing Registered Nurses and nursing support workers requires the ability to distinguish clearly between them. These strands of membership are not a homogeneous group or one big happy family. They have different requirements from both a Trade Union and a Professional organisation and, in my view, the College seems to be struggling to come to terms with that, and sees conflict of interest where there is none. This appears to mean it may sit on the fence for fear of alienating or upsetting single groups. That’s not good. And it also seems that this petition has brought this dilemma to the fore – and maybe that is good, because it needs dealing with openly and transparently and with maturity of thinking.

The stance of ‘needing debate with all of the membership‘ looks a bit fearful of ‘stepping on toes’. The matter of title doesn’t concern ALL of the membership, the matter of support for patient safety and truth and transparency in providing care does. And it’s hard to see how this particular organisation or any of its members could object to that. To me, this hesitancy appears unsophisticated, even anti-intellectual. As if it can’t cope with supporting one strand of membership because it interprets that support as automatically denigrating others. It is very muddled thinking. Worse, it indicates to me a lack of ability to think and respond in a way that is necessary for a modern, progressive political organisation that should be at the forefront of public protection as well as professional support and representation.

There are other issues – in that same thread of tweets it was suggested that members of the RCN should contact their elected representatives if they wanted to make their support for this petition felt. What? This isn’t a Trade Union issue, it’s a professional issue. It doesn’t need debate and discussion and vote and consensus. It needs clear professional leadership. And if Registered Nurses don’t use this route? Does that mean that the College can dismiss their views because they weren’t obedient to TU process, or that their ‘voice’ wasn’t loud enough? Not good. Not good at all.

Registered Nurses and nursing suppport workers need, deserve, better leadership than this.

You can see and sign the petition to protect the title Nurse in UK law here:

https://petition.parliament.uk/petitions/587939

Call yourself a nurse…?

I’m a Nurse. I call myself a Nurse because I qualified through three years study and a final examination and was awarded the title of Registered Nurse, and most importantly, I am currently on the Register of the UK Nursing and Midwifery Council. I am a regulated and accountable Registered Nurse. That’s the reason I can call myself a Registered Nurse. Only when someone has undertaken the required education (a Bachelors or Masters degree today), has applied to and been accepted on to that register, can they call themselves a Registered Nurse. In order to continue to call themselves a Registered Nurse after that initial registration, a three yearly validation process is required and the annual payment of a substantial fee in order to stay ‘live’ on the Register. If someone’s registration lapses i.e. they stop practising, they don’t revalidate, they don’t pay their fee, or they are struck off for some serious disciplinary reason, then they can no longer call themselves a Registered Nurse. This is UK law. But, and here is the really important thing – in the UK anyone can call themselves a Nurse. And that’s a problem.

It’s a problem because we rarely go around workplaces or caring for patients proclaiming that we are Registered Nurses. We are called ‘Nurse’, and a host of other titles with ‘Nurse’ in them. We respond to being called ‘Nurse’. It is the title ‘Nurse’ that is in common usage, ‘Nurse’ that the general public use to attract our attention, or to describe us, ‘Nurse’ that is the shorthand for a safe, competent, accountable, and professional practitioner of nursing. It is generally interpreted as being the contraction for Registered Nurse. If you say you are a Nurse, then most people will assume that you have the required education and the correct validations to be a Registered Nurse – with all the trust and safety assumptions that go with that.

Unfortunately in those workplaces, we know that there are people in roles that have ‘Nurse’ in their title who aren’t actually nurses at all. They are probably a support worker or an associate or other helper role – all valuable within their own scope. They may have some specialist education, but they may have none, and they are not Registered Nurses yet their job title probably leads the public to believe they are. Hmmm. Apart from the ethics of such use of title, perhaps this is how we get the ‘50,000’ more nurses promised by Govt? (Note that it is ‘nurses’ that are promised and not Registered Nurses).

We also know that there are people who set out to deceive by calling themselves ‘Nurse’ – like the parliamentary candidate who referred to himself as a ‘Nurse’ in his campaigning, but was forced to admit that he wasn’t actually a nurse, but a health care assistant. I suppose he thought calling himself a Nurse would help him win votes. And he could do so, with impunity. We also know that there are people who have been struck off the NMC Register who can continue to call themselves a Nurse, again with impunity. It’s not against the law to say ‘I’m a Nurse’ when you are not. I think it should be.

I believe the title ‘Nurse’ should be legally protected for the sake of patient safety and patient trust. So that when someone needs a Nurse, that’s exactly what they get – a Registered Nurse – or at the very least, they are clearly told and made aware that the person in front of them is NOT a Registered Nurse. This could be done most simply by a job title that properly reflects what they are. It’s not a difficult thing to do, and it would be open, honest and transparent – who could possibly object?

I believe very strongly that the title ‘Nurse’, so long in common useage, has become synonymous with ‘Registered Nurse’ in the minds of the public. I believe because of that common and general interpretation that the title ‘Nurse’ should be protected and used only by those who are current Registered Nurses. To not do this is deceitful and potentially dangerous. Professor Alison Leary has set up a government petition to get the title ‘Nurse’ protected and used only by Registered Nurses. You can follow the campaign on Twitter on #ProtectNurse and #PatientSafety. You can find the petition here, it takes just two minutes to sign. I have signed it, and I hope you will too. Anyone can sign it, it is an issue for anyone who may come into contact with health care services now or in the future and who believes in safety and transparency. Do sign it if you think this is important too, and do share it via your own social media sites.

Thank you.

https://petition.parliament.uk/petitions/587939

1. In The Beginning….

 There is a photograph of me, aged about two, distinctly chubby, frowning straight out of the picture, maybe on the verge of a serious tantrum.  I am sitting on the swing in the back yard of our prefab and I am dressed in one of those toy nurse’s uniforms – I have an apron, a shoulder cape, and a cap with a red cross on it on my head.  My mother always said that in spite of bribes, cajolery and eventual threats I flatly refused to smile for the photographer, who had been specifically engaged to take sweetly charming pictures of me.  I look decidedly unimpressed and quite cross.  Being a nurse was clearly not a childhood dream.

      I don’t remember what my childhood dreams were – or even if I had any.  I’m not sure I ever thought about work, let alone a ‘career’.  On a rail track of constrained horizons, unambitious parents, and no family role models, I drifted through school – bright, but not stretched or stimulated.  Like many working-class girls of the early 1970s, my future was not significant enough to plan.  When I failed ‘A’ levels at 17, those failed exams could have been the nudge into the repeat experience of every woman in my family – a bit of a job, then marriage and children.  But it wasn’t.  Sitting on a wall in the school courtyard, miserably wondering to a classmate how I would ever get away from what felt like a ready-mapped future, she said something that would change things forever: 

 ‘I’ve got a place to be a student nurse. I think they’re still taking applications. Why don’t you apply? Give it a go? The course starts in September, you can live in the Nurses Home, still get away.  Go on, why don’t you just do it?’ 

      So, I just did it.  I applied and I was offered a place. The freedom I had longed for beckoned seductively.  I wasn’t absolutely sure what I was freeing myself from – and I certainly wasn’t sure what I was moving towards – but movement it was.   

      Three months later, I was sitting in the back of the family car about to start a whole new life, looking eagerly through the rain-spotted window. Autumn sunshine lit the wet road and caught the golden leaves on a short avenue of beech trees – a left-over from when this land belonged to a Cadbury, of chocolate fame.  We drove through a campus of large buildings, past glass-windowed blocks, and turned in at a barriered gateway.  My father wound down the window (no electric windows in those days) and spoke to a uniformed man:

      “I’ve brought a new student nurse! Where do we go?” 

      There was pride in his voice, I noticed it. I suspect more pride than if I had opted to go to university.  The value of a university education was not something that would have made much sense to my parents.  Neither of them had had, or wanted, education beyond sixteen. They were, as we all are, the product of their time, their families, their environment.  My father was a steelworker for all of his working life until the decimation of manufacturing industries in the nineteen eighties. When the steelworks closed, a major part of his life, and of him, was gone.  It made him angry and sad, and from time to time both helpless and hopeless.  My mother was a housewife. She never gave any indication of thinking about anything else.  She was impressed by ’a lovely line of washing’ and a clean house and being respectable.  Careers were for others – we were solid, working people and we knew our place.  Go to University? What for? They had no conception of the benefits of higher education, and so it seemed to them a waste of time and, more importantly, a waste of earning potential.  But being a nurse was useful and respectable, something for them to be proud of.

      Through the barrier we drove between more brick buildings; on the right, the main hospital, five stories high, a clock tower rising from the middle; on the left, the School of Physiotherapy, the School of Nursing (‘Look! Look! That’s where I’m going to be!’) and then a large, double -fronted building, with ranks of small-paned windows facing the road and a wide, stepped entrance. The double wooden doors stood open, and above the entrance the carved lintel proclaimed ‘Nurses Home’.  We pulled up outside.

      It was two days before my eighteenth birthday, and I was on the brink of a career that would last more than 44 years.  Obviously, I had no idea at that point how it would turn out.  I didn’t have much idea about anything, to be honest.  A few months earlier I had been wondering what I was going to do with my life and now this seemed to be it. 

      My teen-age self was taking a chance on nursing, and fervently hoping that nursing would take a chance on me.  

It’s all about me…

Well, this post is, sort of. I am 26,000 and a few words into writing a memoir. That’s all about me, too. About being a nurse. About having anxiety and depression. About learning how to make a career with sometimes crippling insecurity. About achievement. About self-doubt. About the fun and the sadness and the anger and the frustration and the success and the laughter and the friends and the life and the growing and the nursing – of others and of me.

I have written for myself for a long time, not necessarily for publication. I have written for others more recently – this blog, my other blog, a bit of academic writing, plus I have notebooks and electronic folders full of writing ‘starts’. I’m a great starter, a finisher not so much. But last autumn I committed myself to writing the memoir that I have wanted to write for a long time. I have a story to tell, but it’s quite hard knowing how to tell it. Not how to start it – I have a file full of starts just waiting to be used – but how to keep it going. How to make it run, jump and fly and keep it on the page. It’s hard.

In that 26,000-odd words I’ve got a few good bits, one or two really good bits, some messy don’t-know-where-they-fit bits, and some crappy stuff. I have no idea (yet) how they’re going to hang together, or even if they will hang together. I hope the crappy stuff will become a few more good or really good bits. Like I said, it’s hard. Even this, which I am telling myself is pre-marketing, is really procrastination because the real writing isn’t going anywhere today.

If I ever get it done, you will have read about it here first. If I ever get it published – you’ll be able to read it for yourselves. I hope. 🙂