Last month, I was caring for an elderly gentleman who was having major surgery after fracturing his thigh bone. When I collected him after his surgery, I was told his breathing was erratic. I was concerned — it didn't feel right to return him to the ward because he couldn't be closely monitored, especially as I was one of only two qualified nurses working that shift, and caring for 10 patients (four of whom had also had major operations that day).
But the anaesthetist and the senior nurse in charge of the post-surgery unit said it was fine to move him; plus, they needed the bed space. So against my professional judgment, I accepted the patient. He returned to the ward, and coped well — for about 10 minutes. His breathing then dropped to dangerous levels, his blood pressure was low and he was responding only to me calling his name loudly.
It was now about 7pm, and I decided to get the doctor on-call. He was too busy to see me and the more senior doctor on-call promised to come in 15 minutes. But I still wasn't happy, so I called the critical care outreach team (CCOT), specialists in intensive care.
The CCOT sister came immediately and admitted the patient to the intensive care ward. I have no doubt that if I had waited until the doctor I first paged was 'less busy', my patient would have died.
I'm not trying to suggest that nurses are better than doctors, simply that most nurses are competent in their role.
When I am nursing I don't just attend to the medical needs of my patients, I also feel for them. Many times I have wept long after a shift has ended for a patient I know is really suffering, or for those that do not make it.
I wonder how Dr Anonymous would cope with one of my shifts — having orders barked at me by grumpy doctors, being asked the date about 20 times by a lovely but confused old lady, and trying to document everything that I've done as it happens.
All this while the phone rings non-stop because the ward clerk is off sick.
It's extremely stressful and I often get home unable to relax because I have so many things buzzing about in my head.
I have nursing students shadowing me, not always getting the best experience because I'm often too busy to teach them. I feel tremendously guilty for this. I trained for three years, earning about £5,000 a year — less than the minimum wage — so I understand the stresses of being a student.
I work weekends and night shifts, times when the ward is frequently under-staffed. In a 14-hour shift I barely have the time to go to the toilet, let alone read a magazine.
Doctors often talk to nurses as though we are second-rate. Some in my hospital (especially senior consultants) call nurses 'sweetheart', 'darling' or 'pet' — harmless nicknames, I know, but ones which undermine our authority.
Of course, there is good and bad on both sides. I have worked with wonderful doctors who come to the ward when their shift has finished, who will take the time to talk and teach the student nurses, and who learn the nurses' names, asking us questions and taking the time to remember our answers.
Likewise, I have known nurses who don't really care about their patients, who will be the first to leave and the last to arrive on a shift.
Ultimately, the good doctors and nurses I work with all have the same goal — to give the patient the best care possible, often at the expense of our own personal lives.
Medics often make terrible mistakes
Rob Harteveldt, 41, is a cardiac rehabilitation nurse at Stoke Mandeville Hospital in Buckinghamshire. He has been a nurse for 22 years. He says:
My wife was 26 years old when she died. An innocuous lump in her left breast turned out to be cancerous and spread quickly to her liver and bones.
A group of doctors stood at the end of her bed and announced to the whole ward that she was dying; this was the first time she had been told her prognosis. Over the next few days, she began to have uncontrollable anxiety attacks, often screaming in fear.
I heard one doctor say to her: 'You have cancer. You're going to die. Now stop this noise and get used to it.'
I was so shocked by his callousness I didn't say anything to him. But as a nurse, I knew, thank God, that he was not typical.
Over the 22 years I have been nursing, my interactions with my medical colleagues have, on the whole, been fruitful, reaffirming my faith that one bad doctor does not reflect the profession.
I could, however — like the doctor who wrote the damning article in last week's Mail — tell stories which would so alter public trust in doctors that people would never wish to set foot in a hospital again.
I've had plenty of experience of doctors putting patients' lives at risk by prescribing medicines inaccurately, or not at all. I've witnessed incorrect protocols being followed, struggled with illegible medical notes and seen blatant mismanagement of patients' cases.
The point of this is not to shift the blame on to the doctors, but to defend the much-maligned nurse. At the same time, we should remember that, ultimately, doctors and nurses are working to achieve the same goal — the provision of the best care we can, given our resources.
It is the system that is the problem, not individuals — and the system fails us by not providing enough staff or funds for us to do our jobs in the best way possible. The key word here then is teamwork.
My nursing colleagues and I are well aware of the fact that doctors are overworked, and indeed, many nurses have taken on doctors' tasks, such as phlebotomy (taking blood from patients) and cannulation (putting in a drip to administer medication), to name but two.
It would be wrong for me to suggest that every nurse is perfect. However, to call all, or even most, lazy and uncaring is unjust.
We were also criticised for lacking a sense of vocation — apparently, we've become 'too posh to wash' and to do the hands-on work, and are far more interested in making our way up the management ladder.
For too long, 'vocation' has been a justification for keeping nurses badly paid and poorly regarded — the attitude is that we don't need any better because we do the job out of love.
But why shouldn't nursing be seen as a career? What's wrong with nurses trying to achieve senior management positions? Surely most junior doctors would want one day to rise to be a consultant, so why shouldn't we progress, too?
Yes, training is far more academic now, to account for the ever changing face of our NHS, but the textbooks never overshadow the importance of providing basic care.
Emptying bed pans is not solely the responsibility of the healthcare assistant, but a duty of every nurse.
Nurses are not trying to become pretend doctors by taking on roles which have previously been considered the domain of the medic — such as prescribing medication or discharging patients. We are not stupid. If we are unsure, we will seek advice from a more senior nurse, or indeed a doctor.
I know that one day it will be our nursing expertise that saves the disgruntled house officer in last week's Mail from making a terrible mistake. I am also sure that he will come to appreciate how the extended roles of the nurse free him up to carry out his numerous other tasks.
But most of all, I pray that he appreciates the contribution that nurses make to the care of our common interest — the patient.
WE WORK OUR SOCKS OFF
I work so hard I can go for a whole shift without having a drink of water. We have 35 patients on our ward and their care and nursing requirements vary, but I can guarantee you that not one of my nurses would sit reading a magazine if there was work to be done.
Nursing is still a vocation — not many people would put up with the hours, the stress, the violence and the fear that we work under — and I pride myself in working my socks off.
More importantly, I love my job. Most Junior Sisters I know do a lot of paperwork at home and go in on days off to sort things out — please don't write us off as lazy. Lisa, a nurse for 14 years and a Junior Sister
Most doctors appear not to give a damn about what goes on with a patient's care. Indeed, when you do need a doctor — and if they do reply to their bleepers — they're still nowhere in sight hours later. Nurses go into the profession knowing the money isn't brilliant, but we enjoy the satisfaction that the care we provide on a daily basis is as holistic and as professional as the system will allow. Ian, a cardiac nurse for seven years
People still become nurses because they care about others. How many nurses do you know who drive a BMW, or holiday in the Far East? No one would carry out the kind of work we do every day for the money. We could get more working at Tesco. But doctors seem to forget that we are human, and that we all have days when we are tired or fed up. We can't all give 100 per cent of ourselves all the time. June, a paediatric nurse for 10 years
Lazy? In nine years of nursing I could probably count on two hands the number of times I've had a break. I've rarely left the ward on time. Each shift is nonstop — and a lot of that time is spent chasing doctors.
The extra roles that are being pushed on to nurses are not wanted by most of us. As it is I don't have time to give quality care, and now I am expected to insert drips, take blood and take on more doctor roles. No wonder patients are left in wet beds. Give me an extra pair of hands and I will do it. Laura, a nurse for nine years
PS: OLD SCHOOL WAS BEST
When I trained, we were taught to treat our patients with respect. These days there's far too much emphasis on academia and an overwhelming desire to achieve an equal status with doctors.
In my day, discipline was paramount. Our uniforms were inspected daily and if the observation charts were not filled in correctly, we faced the wrath of the ward sister. We quickly learnt to be diligent and thorough.
The nursing profession needs to return to these traditional and rigorous standards of training. Louise, 44, a nurse for 20 years
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