In short

I suppose in some ways training to work in healthcare is similar to having a parental figure, you think they know everything & try to take on all the information. Then when in a job you start to realise, they don’t know everything & you’re going to have to learn many things as you go. One of those things the most important skill of all, knowing how to heal yourself.

Codes of conduct

They may have been written with good intentions, but our two largest professional councils have standards that call for ‘Good practice’ or Good standards. If ‘good’ is our aim I’d say we’re often not far off. However, I don’t know anyone who set out to be ‘good’ at work, in fact, it’s my understanding that med school suggests, one needed to be outstanding to get on their course to study medicine.

I don’t know any patient who wants ‘good’ care, they need safe & effective care but they deserve so much more. We all deserve so much more. The good practice covers such things as putting patients first; forget putting the oxygen mask on yourself first. Working in partnership with the patient; just…you know, do it quickly! & promote the health of the public; I’m not sure when this bit takes place… maybe it’s intended as homework. 

While standards are important, they are often extremely challenging to achieve. Even to a sad ‘good’ standard. In my experience, most staff are late for breaks, return early from them & stay late. I realised early on, I’d rather leave late feeling a sense of meeting my ethical standards. Taking time to document or holding space for the patient to be heard & allow them to feel my presence. If I didn’t do that, I would think about work as I tried to sleep or first thing when I woke.

Sphere of control

Many of the standards are haphazardly compiled, in the sense that being kind, compassionate, maintaining dignity etc; written in various ways, add to the quantity but are of no particular quality. We all come from that place to begin with, we don’t need a guide. Also, many standards are simplistic & we do them out of habit; such as asking for consent, and discussing with & advocating for the patient.

If anything we need reminders that in many circumstances, compassionate truth is required. There are so many points in both standards that there is little to no focus, the long list seems unachievable because it’s overwhelming & lacks clarity. While I appreciate it, I am critical, it stems from knowing we can be so much more, contribute with greater quality & be energetic.

I’m proud to see the language & content has been developed over the years. Though much more is required, we know this because it doesn’t work at present. An example of a particularly unattainable standard is maintaining public confidence. In my experience, I can only influence others’ perspectives, I’m better off focusing on maintaining my confidence in myself; by embodying a ‘can do’ state of mind I achieve more, of better quality & that in turn those around me might notice.

Together we stand independently

Sadly, our training & work barely touch on creating cultures where we value ourselves appropriately to achieve such standards. Responsibility is in part with the education & healthcare provider but ultimately responsibility sits with individual workers. We’re often hyper-aware of our responsibilities, striving for high achievements & simultaneously suppressing tensions to maintain professionalism. This conflict of interests is further complicated by a disconnect to the individuals’ values. Throughout the mayhem of work tasks I’ve often momentarily lost sight of my values, cos I was so focused on others.

While all roles continue to involve variety, a doctor’s role has become primarily entrepreneurial; to present the problem, explain possible options, review & move the patient on. A nurse role is dominantly becoming a managerial role, including managing investigations, treatments & side effects; while maintaining a healing environment. Often less praised, the auxiliary nurses (HCA’s, CSW’s etc) have become the most creatively orientated, they’re being increasingly invited to diversify, their contributions integral to the systems. Each role is independent while requiring the others as a whole.

The truth is, I’ve known distant colleagues who were tragically successful in ending their lives. It’s been many years since then, and I’ve managed to grieve to an extent, but every now & then I think of how the system failed them, I feel angry like it happened only yesterday & my drive to do something to develop our practice is replenished. A trained healthcare worker ending their own life; should be a never event. With these things in mind, I have created my own personal, standards of care. My code has healing myself as the number one focus; it enables me to have sustainable energy, to lead by example & to know with greater certainty, that the choices I make are to the best of my current knowledge.

3 Proactive steps forward

1. For obvious reasons healthcare workers don’t primarily work in healthcare for the money. We do it because at some point we once knew of great or poor care & we’re inspired to give great care. With this in mind, the most important first step is to preserve that spark. The urge that our soul knows that this is the way we want to contribute. If there are pillars of health, I’d say Rest is the foundation on which the pillars stand. Restful sleep (that’s not a number per se). A rested heart through expressing ourselves creatively. A rested gut our work rarely sets us up for this one because we’re so busy. I’m aware it’s very challenging but I’ve come to learn in my own life, where I’ve had a will, I’ve found a way. Also, a rested mind, I’m not greatly consistent at journaling but especially when I feel irritated by something I write out my thoughts, review the truth behind facts & remember that we’re all merely human; quit being so harsh on ourselves at least for one night.

2. Another avenue I’m a keen advocate for, is continuing to ask for various types of support to be implemented into job roles. I wouldn’t be surprised if all ideas were turned down but at least we’ve done our part in representing a need. In recent years I’ve realised it’s very much like healthcare workers to minimise their achievements & worries; we’re used to focusing on other people’s problems. However, shedding light on a challenge can change our perspective on it, find new solutions & even eradicate them. Somehow when I hear about colleagues’ challenges, I feel less alone in my own. Personally, I find some fulfilment from supporting them, whereas in work I wasn’t always able to have closure, particularly in acute settings where patients are herd like cattle.

3. For a long while, I kept hearing nurses use the phrase ‘I’m just a nurse’. I don’t think I used it aloud myself but I’m aware I had that energy within me in my early days. It rang in my ears like an echo when I lacked the confidence to contribute to a patient’s case. Thankfully, over the years I’ve made sure to recognise when I’ve gone above & beyond, which has helped me have a greater perspective. I make an active effort to use language to speak myself into existence & encourage others to do so also. I’ve often been on shift on ‘Black Wednesday’, those first few weeks of August with the newly qualified or new rotation of doctors. I made great efforts to orientate them & let them know they can ask anything. Reflecting on these times, I naturally often use very casual language, maybe cracking a joke, or offering an orientation. I saw the value in everyone feeling welcome & able to get a good grounding for the type of team culture that was required.

FREE 3-minute practical

• Take a minute to reflect on the ways you heal yourself. I’ve managed to think of 20 small things (a bottle of water with lime in the morning, a short walk, shared with a friend) & 5 life choices that have ultimately been for my own care (choosing a part-time hours contract, taking on the challenges of locum work, going on a 3-month sabbatical). The task is to reflect not compete, by doing this you can give yourself some recognition for all you already do.
  • Take a moment to ask a colleague how they feel about the words to heal themselves. I get the impression many think it is a strange, unprofessional word; funny if we say the wound is healing it sounds a lot more professional. However, on the larger scale of healing throughout the body we say, hold on there…that’s a bit far, let’s not think too much of our bodies, despite us understanding processes such as apoptosis, autophagy, & we are witness to people recovering, sometimes to a miraculous extent as part of our job.
  • If you got to focus on one standard above the others, from your code of practice, what would it be? Why is that so important to you right now? How will you emphasise it in your work from now on? This could be picking a break time, setting an alarm, telling your senior, or asking your colleague to support you. If you don’t see this through… why?

In association with Interpractive nurture consultant Ltd