Coming Out Day

Today is #ComingOutDay. Serendipitous that it comes after #WorldMentalHealthDay.

I always knew I was “different”. Aged five, my first ever crush was the Little Mermaid’s Prince Eric (I mean, who didn’t love those blue eyes?).

And I vehemently do not buy into the fact that sexuality is a choice. But I wish I was braver and came out earlier, saving myself years of trauma. But only do it when it’s right for you.

One of the reasons I didn’t come out till I was 18 and essentially ran away to London to study acting, where I could come out and be my authentic self, was because I was scared of letting my family, my parents and especially my dad down. However, they are now among my biggest supporters.

I know that sadly everyone isn’t that lucky. Coming out will always be difficult. For me, coming out to myself was the hardest thing. I was heavily involved in the church as a child, and couldn’t understand how God could have made me “wrong”. Also, I grew up in the times of Section 28. A devastating time. I was bullied at school for being “gay” before I’d even acknowledged it to myself. But teachers couldn’t discuss with me that being gay was okay. Therefore, I internalised my homophobia: the biggest regret of my life.

That is why allyship and supporting our #LGBT+ communities is so important. No one should feel forced to come out if they don’t want to. Never forget: your journey is your journey. If you ever need to talk, though, my dms on Twitter are always open.

Live your life, be you, and love whoever the hell you like! #ComingOutDay2020

All my love now and always, Craig www.twitter.com/CraigDavidson85

5 words that describe a nurse…

There are a plethora of words that could be chosen to describe a nurse. In this current climate, undervalued, exhausted, overstretched and underpaid are a few that come to mind.

Nurses have faced years of hardship and have been beaten down during a period when services have been stretched to breaking point. First, there was the pay freeze, then the pitiful extended 1% pay cap. Workloads have increased, often to unsafe levels, and many nurses have left the profession, burnt out, disenchanted, and genuinely fearful for patient safety. Also, there’s been a decrease in student nursing applicants, threatening the very future of nursing. The removal of the NHS nursing bursary being the direct cause in certain parts of the UK.

This all adds up to a disaster: for our profession, for the NHS, and for the public – we all deserve better. Nurses deserve to be treated with respect and dignity, just as patients are too. Nurses deserve to be paid appropriately for the work they do. And student nurses deserve bespoke nursing funding to support them throughout their studies for what is not a conventional degree programme.

Nursing requires the essential values of compassion and empathy, amongst many others, but it is also so much more than that. It’s a degree-educated, graduate-entry profession, requiring constant critical thinking and the use of the best evidence-based practice to protect patient safety and deliver the best outcomes. Nurses are often the coordinators of care, and they’re also researchers, educators, pioneers.

However, the purpose of this 30-day blog challenge is to transform the perceptions of nursing. So, I would rather focus on the positives of nursing. I love our profession and being a student nurse, and despite all the negativity surrounding it, I cannot wait to be a nurse.

I think the 6Cs of nursing describe nursing well – care, compassion, competence, communication, courage, and commitment. However, perhaps they are a little basic. So, what can I add to these in my “5 words that describe a nurse“?

I have purposefully not chosen the word resilient. Though, I agree nurses are resilient and have to be so – for both themselves and patients. ‘Resilience’ is often used as a buzzword. I do not believe nurses or nursing students are offered enough mental health or emotional support in what is a very demanding, all-consuming profession. Nurses are expected to be able to deal with anything that is thrown at them. If they are struggling, they have to be more resilient. Do they? Is that the answer? Would it not be better and more healthy to have reflective conversations with peers or senior members of the team that could identify ways to help them cope; rather than tell them to toughen up? Resilience is, of course, important, and nurses could not be freely weeping on the wards all day. But they should be supported in this resilience, and I don’t believe resilience is a badge to be worn with pride and honour. It’s a bit ‘stiff upper lip’ for me. With regards emotional and mental health support, I am aware this is different for mental health nurses – so I speak for adult nursing, which is what I know.

In my choice of 5 words that describe a nurse, I have also not included the words kind, caring, empathetic and compassionate. Not because I do not consider these to be necessary skills or words that describe the nurse, quite the opposite. However, these words I feel are a given. All nurses should possess them. The purpose of my chosen words is to help transform public opinion of the nurse – to educate them on our role further. So, here they are.

ADVOCATE:

There is a reason nurses come out on top time and time again in polls regarding the most trusted professions. I believe advocacy is a significant reason behind this. As is laid out in the Nursing and Midwifery (NMC) Code (2015), nurses must advocate on behalf of their patients. When patients and their families are at their most vulnerable, they need someone to be championing their cause and making sure they fully understand everything that is going on with regards their diagnosis, treatment and continued care. When they do not, or if they do not have the capacity, then the nurse must act in their best interests at all times.

For nurses, advocacy goes beyond this. Or at least I believe it should. They should be advocating for their peers, for student nurses and championing the profession as a whole. Some nurses have often felt as though their voice cannot make a difference. But it can. I would always encourage nurses to make their voices heard. If they feel they can’t, then it is up to other nurses to advocate on their behalf. If we don’t make a noise and raise our concerns, then we can’t complain about our poor treatment.

COORDINATOR:

Nurses are more often than not the coordinators of care for patients. They liaise with other members of the multidisciplinary healthcare team and social care services to make sure that care runs as seamlessly as possible.

Nurses are the backbone of hospitals and care in the community; without them healthcare as we know it would cease to function, which is why the profession deserves to be respected and valued.

ADAPTABLE:

No two days are ever the same. This constant change is part of the reason I find nursing so exciting. But it is for that reason nurses must be adaptable. They have to be able to react in the moment and adapt.

Being adaptable helps protect patient safety and achieves optimal clinical outcomes. The need for constant adaptability is why I am against the “this is the way we’ve always done it” mentality and the rose-tinted nostalgia of nursing history. We can adapt because we are critical thinkers who rely on the best most up-to-date evidence to guide our practice. Another reason why it’s so essential that nursing remains a degree educated profession, fostering this level of academic thought.

NON-JUDGEMENTAL:

Nurses should treat all people equally, free from judgement, regardless of any personal views. I believe this to be such an integral quality of a nurse. In practice, when I have seen nurses and other members of the healthcare team exercise judgement, I have found it galling. There is no place for it in healthcare – or in the society, in my opinion.

REFLECTIVE:

Through reflective practice, we improve not only our practice, but we improve healthcare as a whole and the patient’s experience of their care. Of course, we will make mistakes – it is inevitable, we are human. However, it is how we reflect upon these instances and develop from them that speaks more about us as nurses and as a profession.

I look forward to your thoughts and to reading your words describing a nurse.

Craig

@CraigDavidson85

What are my nursing pet peeves…

Well, today is the day where I am going to sound extremely critical of our profession, but it is what the question entails. And we are encouraged to be critical thinkers to improve services. However, I am aware that I am still studying and only at the very beginning of my career with lots to learn. So, I in no way think that I have all the answers. Anyway, here goes. I have addressed several of my nursing pet peeves in previous blog posts:

  • Poor patient care due to understaffing or poor communication and interpersonal skills.
  • Patient choice being neglected in favour of ease for healthcare practitioners – particularly concerning end-of-life care.
  • Insufficient understanding and delivery of palliative care.
  • Lack of emotional and psychological support for nursing students and nurses.
  • The failure of the government to secure bespoke funding for nursing students. In Scotland, the bursary is not enough. Elsewhere in the country, the student loan system, where students are getting in massive amounts of debt to become nurses, certainly isn’t working.
  • Incorrectly measured and documented observations endangering patient safety and health outcomes.
  • Lack of respect for nursing as a degree educated profession, which applies to both fellow nurses and society in general.
  • A nursing workforce that is not representative of the communities we serve.
  • Nurses being resistant to or unwilling to adapt and change.
  • The varied roles of the modern nursing not being understood.
  • Nurses who are not politically active or using their voices to affect real change and champion the profession – you can’t complain if you aren’t doing anything about it.
  • Nursing history being viewed with rose-tinted glasses. It is time to look forward.
  • The lack of education around nursing history at universities. How can we improve the future without understanding and improving upon the past

However, there are a couple of nursing pet peeves that I haven’t previously discussed.

Firstly, the reticence of certain individuals and institutions to encourage and support younger, newly qualified and student nurses in leadership roles. Sometimes the best leaders are not those with the most experience. In fact, having a fresh pair of eyes, different perspective or new vision – whatever you call it – and being on the shop floor, working directly with patients day-in-day-out, can be what makes them the best people to advocate for patients and nurses and to champion the profession.

Lastly, as a student nurse, one of my biggest pet peeves is being called “the student”. Luckily, this doesn’t happen very often, and when it does, I jokingly say: “my name is Craig”. But it is just rude. Don’t do it. Respect is a two-way street, and students are people too. We are the future of the profession after all.

Sorry about the rant – I promise that tomorrow I’ll be back to my usual chipper self. Would love to hear if you agree or disagree with my nursing pet peeves and any additional ones you have.

Craig

@CraigDavidson85

What’s my favourite nursing topic…

I know this is becoming somewhat of a recurring theme, but again I am finding it so hard to pick a favourite nursing topic as I genuinely enjoy them all.

At Glasgow Caledonian University, where I am currently a student nurse, our academic year is built around five modules, on top of our placements, which develop each year as we progress through our studies. These are values-based nursing practice, evidence-based practice, interprofessional practice, professional skills for practice (which includes physiology, pathophysiology and pharmacology), and our specific nursing module that relates to our field, which in my case is adult nursing.

My favourite subject this year was our adult nursing module, Anticipatory and Alternative Approaches to Adult Nursing. This module was built around case studies of patients living with the chronic conditions of COPD, heart failure and diabetes. We discussed the role of the nurse when caring for a patient throughout their illness trajectory, which included exploring strategies to support them in their homes, early interventions, and better access to safe and effective alternatives to avoid unnecessary hospital admission. We also identified appropriate responses to crises, deterioration in condition, and end-of-life care.

The reason I enjoyed this module so much was it encompassed elements of all our other modules, bringing them together in a such a way that we could utilise our critical thinking skills. It required us to fully understand the pathophysiology of each condition in addition to the pharmacology behind its treatment. We also had to identify the best, most up-to-date evidence, the role of the rest of the interprofessional team, and how we could use our values-based nursing skills to educate patients and navigate difficult conversations. I am looking forward to the next stage of our nursing module in my third year, Adult Nursing to Empower, Enhance and Enable Person Centred Care.

Palliative & End-of-Life Care

Throughout my studies, I have developed a keen interest in palliative and end-of-life care, which this year’s nursing module, alongside my experiences on placement, has only served to intensify. From my experience, not enough is known about effective palliative care, and some nurses often refer to specialists for fear of not understanding how to manage long-term conditions best. I believe it is vital that nurses can distinguish between palliative and end-of-life care, as often the two are confused. End-of-life care is an element of palliative care, but it is not all palliative care encompasses.

The Palliative Care (Scotland) Bill (2010) defines palliative care as “treatment which controls and relieves pain, discomfort or other symptoms caused by or related to a life-limiting condition with the intention of improving quality of life”. The Scottish Government (2015) adds that “palliative care is not just about care in the last days and hour of life, but about ensuring the quality of life for both the person and their family at every stage of the life-limiting disease process from diagnosis onwards”. No one should have to live in pain or symptomatic discomfort, and as nurses, we should always strive to improve or at least maintain the quality of life, which is why quality palliative care is so critical and is an area I have become interested in.

Dignified, respectful end-of-life care, which respects the wishes of the person and their loved ones is also essential. Death is an eventuality for all of us, and we should all be able to live out our last days and hours as we choose. Wherever possible we should be respecting the patient’s preferred location to receive end-of-life care and should have an anticipatory care plan put in place for when deterioration occurs.

So that’s been my favourite nursing subject this year, and my developing professional interest. I look forward to reading about your favourite nursing topics.

Craig

@CraigDavidson85