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How did I get here?

August 13, 2015

By Basket Press

A couple of recent posts here (thank you Florian and GA) made me try a different tack to my usual, more politicised, management-critical one.

I didn’t take a “usual” path into nursing: attended a state grammar school in the ’60s and ’70s; did as ordered and went to university, emerging with a science degree. My mum swore my first word was “Why?” and that my first phrase was “How does it work?” and it was all downhill from there, taking nothing for granted and questioning pretty much everything.

My background includes pit village Methodism with its underlying ethos of public service, and the significant adults in my life did just that: nurses, physios, teachers. The parents of my school mates were similar: teachers, lecturers, doctors. This is what grown ups do it seemed to Junior Basket Press. I gave up the God bits, but still describe myself as culturally Methodist.

An oddity of my upbringing was that I didn’t meet a child my own age until I started school. It took until my early 20s to feel comfortable with people, and consequently I consider making a living talking to people an achievement.

Unfortunately I graduated in 1979 and became a Founder Member of Maggie’s Millions.

The next few years were a mix of dole, trying to convince myself I was a real scientist, dish washing, more dole, and 2 jobs working for environmental charities with youth and school groups.

Then the light dawned: the groups I most enjoyed working with were from schools for blind bairns, those with emotional and behavioural difficulties and other out-of-mainstream provision. I found these groups both more challenging and rewarding than others.

The last of these jobs finished and I was on the dole again. I should note that a previous bit of societal rejection had brought out my under-lying tendency to depression, which I’ve lived and dealt with the rest of my life.

A colleague suggested considering nursing. Luckily, I had a cousin who was a nurse tutor, whose advice I sought. Her sensible suggestion was to find a Nursing Assistant (NA) post in Mental Health (MH) to check out if it was for me.

I hit lucky. Responding to a generic NA job ad at the local MH hospital, I found the adolescent psychiatric in-patient unit was after NAs, preferably with a background working with young people. I interviewed well, referring to how my own difficulties could give me an appreciation of what others might experience. I got the job.
This went well enough for me to successfully apply for nurse training.
And the problems began.

It was obvious very quickly that graduates were unwelcome: I never referred to my degree unless directly asked, but the tutors knew, people in my group knew, and word got around. I found it hard to disguise my tendency to ask questions and challenge any lack of evidence. Assumptions were made about me by people I hadn’t even met, which were all negative (“Wants to be a nursing officer right off” was as polite as it got) . This meant I had to be better than anyone else at straightforward clinical care in order to be taken remotely seriously.

I wasn’t alone in these experiences: the two other graduates training at the same time as me went through this. Indeed it was one of them who advised me that I needed to volunteer for things which folk didn’t like doing, to play along with ward nights out and be better than excellent at day to day stuff to survive,. So I got a reputation as a bit of a smartarse, but one unafraid of hard, dirty tasks, who wouldn’t shirk and gave as good as they got in the black-humoured hospital repartee. It paid off in uniformly good ward reports.

If only it was just at work…All my immediate family, bar the afore-mentioned cousin, took a dim view of me “wasting” or “throwing away” my degree by not just going for nurse training but, even worse, MH nursing. This included two general nurses and two physios…OK, I was the first in the family to go to university and obtain a degree, but everyone else thought it belonged to them and they had a say in how to use it. Fortunately I had learned not to listen to most of my family, which was just as well as it never got any better; there was never any recognition that I was doing something useful and necessary that I was good at.

Apparently it was impossible for a graduate to carry out basic care, because I lacked common sense, was too airy fairy, too bothered about theory, didn’t live in the real world, came from another planet, didn’t speak English, had three heads…And yet the necessity for medics to be graduates wasn’t queried, because…No-one could explain that.

Yes, I questioned what we were told in nursing school, mostly because, when a paper was forthcoming, we were being fed misinformation and mangled statistics. I questioned things on wards. I asked consultants about their reasoning and how they reached a particular judgement. And I was always polite. I need to know why, and if a particular thing is justified and supported by evidence; I won’t just do as I am told.

What I learned from all this was that most medics do not mind sensible questions; nurse tutors didn’t understand statistics and got uncomfortable when questioned; many nurses in big MH hospitals and on my general placement rapidly get set in their ways and don’t like to be challenged, no matter how politely, no managers like being questioned or challenged and take against those who do so. The latter two phenomena made me question myself and nearly drove me out of nursing years ago, but didn’t.

Read some posts on this very blog by younger nurses: how much has changed? Not much, despite the efforts various of us have made over the years, which is very sad.

  1. I have a science degree and a PhD. I retrained as a nurse, choosing to study for a postgraduate diploma in nursing. Thus, my colleagues were all graduates like me. In University our background was valued and we were encouraged to question things and discuss things. In practice it was a different matter. I found I had to search people out who were prepared to answer my questions and valued my background. I tried to never mention the PhD but it would inevitably come up since I was a woman in my thirties and I must have been doing something all those years! The most asked question by nurses was and remains “why on Earth do you want to be a nurse?” In contrast, doctors always value my education. I, too, got involved with every aspect of care desperate to prove that my education did not make me less caring or less willing to do the more menial nursing tasks. I guess all I’m trying to say is that I would agree that things have not moved on as much as we’d have liked and I’m sad to say I feel it will take a while before education is truly valued in nursing.

  2. Basket Press permalink

    Thanks for the comments.

    It is interesting for me to hear/read the experiences of others who also have a pre-nursing set of experiences and qualifications, as at times I have felt I was imagining many of the things I saw and heard…

    I was considering a follow up piece (or 2 even) about what happened after I qualified, as that is pretty much where I left it.

    Steve, I have in other posts hinted at my thoughts about the quality of some nurse education, specifically around critical thinking and assessment of evidence: there is definitely room for improvement.

    Thanks again.

  3. obliquepanic permalink

    I know you posted this a little while ago but I’ve just come across it on one of my many visits to the Grumbling Appendix. I just wanted to say that, broadly speaking, your story is my story! The years are also similar. I suspected that because the profession for various sociological reasons tended to attract people with not great confidence or learning that many tended to be defensive and possibly many of those who found themselves managers more defensive than most and everyone rather afraid of the medical establishment. I don’t think this was a recipe for a progressive profession. I hope things are a little bit better today.

    • Murmur permalink

      Thanks for commenting!

      When I retired a couple of years ago I did not think there had been much improvement – many of the managers I refer to in my posts which are critical of NHS management culture are originally nurses by trade.

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