I like a nice tattoo. They are not for everyone, but I have many and plan to have more. Sometimes people who don’t have, or like, tattoos ask “what do they mean?” To which I reply as gently as possible, “mostly, they mean I like tattoos”.
There is, perhaps, a sense that having a tattoo functions as a memorialisation of something – after all that is one of the traditions of body art: they are scars we choose to have and colour in. A friend, who recently recovered from cancer treatment is planning to have a tattoo to mark that process. The tattoo becomes part of an important story, a mark of completion or survival.
“Good nurses are changed, traumatised or simply bruised by the emotional labour and responsibility of what they are quietly expected to do”
I was thinking about this after reading research stating that nurses have been “forever altered” by their experiences during the Covid-19 pandemic. Survey participants talked of being parachuted (my term) into clinical areas with which they were unfamiliar, of being stretched way beyond safety, of the loss, despair, isolation, relentless pressure. Of wanting to leave. Of their own suffering.
It is a subject close to my heart. I did research into this long before Covid-19 hit. I was interested in what happens to nurses who – because of perpetual systemic crisis, poor staffing, overwhelming need and inconsistent support structures – are, essentially, asked to collect trauma on behalf of the NHS. Nurses who see need that cannot be ignored, try to address it and, over time, are altered by what they experience. Obviously, Covid-19 dragged that professional instinct even more starkly into the light but, before the pandemic, there was a decade of austerity that put pressure on services and professionals, pressure that was often – is often – internalised. Good nurses are changed, traumatised or simply bruised by the emotional labour and responsibility of what they are quietly expected to do.
I have been writing about this for years and I will stop very soon. Not because I believe it less than I did – it should be obvious to anyone looking at nurses’ work or talking to them about what nursing feels like. I will stop because it has become so normalised, so obviously the key unwritten part of most nursing job descriptions that one might as well remind the world that nurses require sensible shoes. I will stop because, really, nobody is listening.
Why is that? Why is this fundamental issue of addressing staff retention, clinical standards and workforce wellbeing greeted with what amounts to a shrug? In part, it is because addressing it would be complex. And perhaps expensive. It may be that service planners feel that, yes, we may lose or damage staff profoundly but, like soldiers in a long-running war, there will be others to fill their shoes. Or maybe it will involve a philosophical shift that feels too difficult?
Modern healthcare is about outcomes. Sustainability of organisations, not flesh. And, there is no election to be won in telling the electorate that nurses require some sort of systemic protection. Nurses are not meant to have needs, that is the job of patients. There may be some traction in staff retention plans but, when it comes to the general wellbeing of staff, frankly, who has time to care about that?
The study used the words “forever altered”. That is a powerful phrase isn’t it? Anyone who has nursed has a sense of being transformed by the experience, but this is more insidious. It’s less of an awakening and more of an intractable urinary infection. It is a shame we don’t know how to respond helpfully to that. It is even more of a shame that we don’t know how to care for the carers anymore. A shame for nurses and, ultimately of course, for services.
Mark Radcliffe is author of Superpowers, a collection of short stories
