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Too clever to care, or too caring to be clever?


(Or 'Do-ers can be thinkers too')

On leaving school aged 17 to start my nurse training, I knew I wanted to be a nurse. I felt it.

It seemed a natural choice. In my family, I was the practical one, the one with get-up-and-go, with initiative (and money – three jobs on the go from age 12 supplying more cash in my pocket than I've ever had in adult life). A worker.

I was the good-with-people one, the smiley one, the caring thoughtful one, the nice one. The nice girl.

My brothers were the clever ones. Oxbridge-bound, easy-going yet razor-sharp. Straight-A boys, rolling out of bed and breezing through exams.

My parents (bookish academics) and their friends (bookish academics) seemed a different species to me. They were thinkers. I was a do-er.

But when I started my training, something strange happened. Suddenly I was the thinker in the room. The least efficient do-er. On an early placement, a nurse laughed, "You're not very practical, are you?" It was crushing.

And this gets to the nub of all the current nurse-bashing. The care catastrophe.

The papers ask 'Why don't our nurses care any more?' How has a profession that used to be nice turned nasty?

They've all got degrees now – that must be it! They've turned clever! Our nurses used to be nice, caring, practical do-ers, but now they're hard-hearted, too-clever thinkers. We want nice nurses, not clever ones!

I seethe when I read criticism of nursing degrees, and calls to go back to the good old days when nurses were very nice, and not completely thick, but not quite clever enough for university.

It's a massive red herring. There never was a golden age of nurse training. When I trained, the concept of supernumery status was still new in nursing, and it was controversial. Every placement brought hostility from ward staff, resentful that we students were no longer 'counted in the numbers.'

There were only a few nursing degree courses in the UK back then. And those poor students were hated most of all, BA student nurses being known as the Bloody Awful nurses. Today, a quick UCAS search yields only one nursing BA (midwifery has double that, out of far fewer midwifery courses).

But we need more BA nurses. Because nursing is an art, not a science. Oh!, for nurse training today to have as much time and attention paid to the art of nursing, and ethics, sociology, social policy, history as to the sciences.

And then, double-Oh! for nurses to be free to practise their art.

Today's nurses are forced to work within brutal systems – ward systems, hospital symptoms, NHS systems. Nurses don't come out of university hard-hearted, but many are turned hard-hearted by the gross undervaluing of the art of good care; by working in fear of 'breaching' – when ward budgets are docked for failure to comply with arbitrary targets imposed by managers; by being forced further and further away from their patients - cheap, untrained care assistants delivering 'nursing' care to society's most vulnerable, to people with dementia.

We still live in a society where many believe cleverness in women costs niceness. Combine this with the commonly-held belief that you don't need to be well-educated, or even well-trained, to look after people with dementia (the bottom of the NHS patient pile being looked after by the bottom of the NHS staffing pile) and there is your recipe for dismal care.

It's taken me years to understand that there are different ways of being clever, different kinds of intelligence. I am a clever woman and I am a good nurse, but I'm angry now, and I refuse to be shut in the 'nice' box. Perhaps if nurses felt permitted to be a little less nice they'd put up a bit more fight, and then we'd deliver much better care.

A passionate nurse who doesn't want to give her name

Tags: female roles, nursing, workforce Written 2014-07-21

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