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It was Christmas Eve in the office and not a phone was ringing to herald the provision of agency support. The managers huddled around the duty rota with increasing glumness. The nurse on duty for Christmas day had succumbed to the lurgy and not a soul in sight could volunteer to cover the shift.
A few weeks previously, the vacancy situation had become critical and we knew that even with a recruitment drive bordering on conscription, we were facing a tough few weeks ahead. Added to this the fact that everyone was dropping with a nasty cold / sickness / fever combination and we were struggling to stay safe.
So here we were on the last day before the management scuttled off for their traditional break, staring down the barrel of the blank rota, a gradual realization dawning. There was only one available nurse. All other avenues had been explored and rejected; the only nurse left standing was me.
Out of mothballs
Now, before you get the impression I am some sort of 1950’s matron in a starched pinny and ludicrous hat (although indeed I have sported both these items in the past…) I am actually a groovy sort of civvies-wearing nurse who has managed to maintain enough skill to stay registered. Truthfully, it has been rather a long time since I actually laid hands on a service user in the interests of their wellbeing, but I have managed to stay on top of best practice and am certainly not terminally rusty.
However, I confess to having more than a few collywobbles as I set off to begin my shift on Christmas Day.
I had been careful to ensure that the team of social care workers around me were so blindingly competent as to be able to function safely despite any bumbling about on my part. I gamely approached the most senior and suggested she treat me as an agency carer and not the service manager, since actually this would be the wiser tactic. I would then be able to trot around in her wake doing as I was asked, rather than attempting to tackle anything I was patently not capable of doing (like setting up the feed pumps)
This prospect seemed to fill her with mirth, but she took me at my word, and pretty soon I was hefting laundry and labeling linen, making coffee for visitors and countersigning the medicines round.
Fresh pair of eyes
As I carried out these menial but important duties, I was able to get under the skin of the team around me, noting the challenges they were facing (damaged equipment, late delivery of clean linen, not enough lockers, running out of batteries for communication aids)
I saw the way the smokers on the team held on for a lull (not that there were many) to slip out for a very swift cigarette break. I saw them come back from the freezing wastes of the smokers shed and make a big deal of washing hands and spraying clothes to make sure the service users didn’t have to suffer the smell. I saw them helping each other to manage the work so that efficiencies were possible, allowing them more time to interact with the young people and their families, enabling games to be played and singing, mirth and music. I saw the poetry in motion of two carers supporting a young person with a ventilator to have a bath; an exercise in calm, planned and perfect teamwork.
I ended up with three shifts over the festive break. I can now state I am safe to deal with technology dependent kids, I can rig up the feeds like a pro, understand the way to manage the various medicines regimes so as not to completely drown under the pressure. I never stopped being a nurse. But more importantly, I helped the team to think about their routines in a different way, I responded to their requests with good grace and understanding and I showed them that I was prepared to give up my cushy break to keep the service safe.
Enriching and enlightening
The benefits to me have been an insight into life at the front line. The benefits to them have been the chance to laugh at the boss fumbling with a leaky catheter. I think the benefits to the service user are more long-lasting, a recognition of the challenges and an understanding of what life is like for people living in our care.
If you are reading this and you are a senior manager, I’m going to suggest you get back in the field sometime soon. Learn that your pressures and challenges are not necessarily greater than the ones your staff face, just different. Learn that the people who are the backbone of your service have daily rounds of strife, but keep on delivering in spite of it. Learn that there is much more to this job than you thought.
Research into workplace safety culture has recognized the value of management ‘walk rounds’ to reinforce the commitment to good practice and to see at first hand the issues faced by staff. Get out of your office and get into the mix with your workforce. You’ll be amazed what you learn about them and you may just learn a bit about yourself while you are at it.
Although I should add this final note: to remain in the good books of your nearest and dearest, probably avoid doing it at Christmas, eh?