Chris Caldwell is the Director of Nursing and the Director of the National Workforce Skills Development Unit at the Tavistock and Portman NHS Foundation Trust. Chris is currently redeployed to Health Education England to support the COVID-19 response across the London Region as Director of Nursing COVID Response. She talks here about the celebration of International Nurses’ Day 2020 and reflects on the different labours involved in nursing.
This week we have celebrated International Nurses’ Day 2020. It was fantastic to see nursing receiving such a high profile across the press and notable that the nature of the press coverage has started to change and the way nursing was represent showed an markedly more realistic and varied image of a nurse in 2020.
As many writers have already pointed out, 2020 was intended to be the global year of nursing and midwifery, with a huge global campaign through Nursing Now to raise the profile of the essential role that nurses and nursing leadership plays in global health. Coronavirus has meant the campaign and the celebrations have not been able to progress as intended, but ironically the virus has gone some way to achieving their aim.
The coronavirus pandemic has undoubtedly raised the profile of nursing across the globe and that perhaps is a silver lining in what might otherwise be seen as a rather dark cloud over recent weeks.
However, the Chief Nursing Officer for England, Ruth May, did still have to stress in her speech on Nurses’ Day, that nurses are not heroes, as still commonly portrayed, but highly skilled professionals whose contribution to global population health needs to be recognised, valued and acted upon.
What is made refreshingly clear from the media portrayal this week is that nursing is a widely varied and ever-changing profession, career and role. The BBC portrayed nurses working with older people and in the community. We saw nurses locally at the Royal Free and Barnet Hospitals depicted in an incredibly powerfully documentary on TV responding with courage and agility, along with the whole hospital team as the pandemic surged through North London. We know that at the same time clinical nurses, nurse managers and clinical educators across the country were similarly thinking on their feet, flexing services, rapidly training and mobilising colleagues into unknown areas in the face of an unknown epidemic without wavering.
Nursing Now, the global campaign, launched a film to coincide with Nurses’ Day created with the royal family which showed the full range of nurses working across the globe: From mental health nurses working in the Caribbean, to children’s nurses working in Malawi, and nurses in Sierra Leone applying their learning from Ebola to fight the coronavirus.
Florence Nightingale whose 200th birthday we celebrated on Nurses’ Day, in her writings, was clear that nursing is both a science and an art. She writes that is it is possibly the finest of fine arts because rather than working with clay or canvas, the nurse works with a human being across the full range of their experience of life.
Florence Nightingale was also clear that to be a nurse is not an easy choice and it involves significant hard work. In order to maintain ones enthusiasm and passion and to thrive through a lifelong nursing career, requires that we hold on to the things that drive and motivate us, which draws on both inner strengths and external sources of energy in our outside lives. The support of family friends and colleagues and a workplace that values us, engages, supports and develops us. For me that passion is like an internal light which needs to be kept charged with energy from these sources to remain burning bright.
American nurse theorist Jennifer Jackson writes about the four different kinds of labour involved in nursing. First the physical labour of tending to the patients’ needs, providing physical care over the period of time, the many miles walked around a hospital or community visiting patients and managing nursing across different departments. At the moment working in PPE or using virtual media whilst trying to build an interpersonal relationship, all of these demand significant physical labour.
Jackson also talks about the cognitive labour of nursing – the assessment of need, analysing data from various different data sources, hunches, juggling between paying attention to the patient and observing the impact that other people and their environments on them and using all of that data and processing it to make decisions about care and intervention.
Organisational labour is the third kind of labour Jackson talks about. The work of caring for the individual patient or working as a nurse educator, researcher or manager within the context of the whole team or service, as part of a bureaucratic organisation: the juggling between the demands of one person and another, one part of the service and another, in order to achieve the best outcomes for all.
Finally, and perhaps most widely written about, but often not paid much attention to, is the emotional labour of being a nurse. Being besides our patients and out nursing colleagues, sharing their experience and helping patients them with the impact of ill-health or changing life circumstances and supporting them to adapt or recover and supporting those in our teams and services to engage in this emotional work too and to achieve their own full potential as nurses and professionals.
Thinking about nursing in terms of these four different types of labour helps us to understand its complexity and the skills it requires but it also helps us see the potential toll of our remarkable profession on us if left unchecked.
To be able to continue to thrive as nurses we need to work in an environment that has structures, processes and systems which support us, so that our labours are as effective and fulfilling as possible, rather than wearing us out. But we also need to draw on our own personal resources to remind ourselves why we do this, what inspired us to become nurses in the first place and to ensure that we engage in those activities that bring us new energy and enable us to keep our inner light shining.
This week the public were encouraged to shine a light in celebration of nursing. Today and every day as you go about your work as a nurse on your own and with other nurses, don’t forget to engage in activities that ensure that you keep your own light shining, and that you support others to sustain their energies to keep their lights shining too.