FMM 2 21 2020 Who’s job is it anyway?

“In a gentle way you can shake the world.” ~ Mahatma Gandhi.

My sister went to nursing school about eight years before I did, in the days when nurses wore big dresses with huge wrap-around starched aprons.  By the time I enrolled in the traditional, hospital based program they had modernized the uniform to a simple princess-line dress (panels and pockets), but still with the stiff nurse’s cap perched on the top of our heads (hated them!).  The dresses had to reach our ‘popliteal space’, the nook of the knee, so that we were decent.

The uniforms changed, but the tasks were quite challenging.  My sister often joked about the time she had been busily tidying up after evening rounds, when cups of hot drinks were given to the patients who were permitted. This is a typical last event before bedtime in England (maybe a couple of biscuits too if you were lucky!).  Staffing was minimal on evening shifts, so she tidied up the cups, wheeled the cart into the kitchen and began to wash up.  Sister (the name given to Head Nurses and Supervisors in the English system of healthcare) came in and yelled at her: “What are you doing nurse? That’s not a nurse’s job, go and clean up the sluice!” The sluice was the name given to the room where we cleaned out such exotic items as bedpans and emesis basins – not a very elegant place at all!

That was a time before disposable everything – we had stainless steel (cold!) bedpans, glass urinals (we joked they looked like funny shaped wine carafes!), and glass pitchers of water at the bedside.  But a difficult concept to teach about the role of the nurse is that you are quite literally the port of last resort for patients.  I remember one Ward Sister that I looked up to who said she would never hire a nurse who belonged to a union, because if a union called out the members to go on strike, that nurse would walk away from patients, and that she could not permit.

It was not that long ago that I worked as a nursing supervisor, a role that makes you the ultimate decision maker, especially at night, when all of administration is home in their beds sleeping.  It was very challenging, but for a brain that needs a lot of stimuli, it could be great fun, no two nights were ever the same.  But it also meant that you filled in as housekeeping, dietary, staffing coordinator and transporter.  It was years later that another nurse passed on greetings from a physician I had worked with in a couple of hospitals.  His comment was ‘She’s a great nurse’.  I was curious, I wondered what qualities he had observed in me that made him say that. He actually responded when she dug deeper. ‘Beth would do anything! If she needed a bed in ICU, she would move out the patient, mop the floor, clean the bed, everything!’

I am not sure that I was flattered at his definition, but it came back around to the concept that the nurse’s role is to fulfil those needs that a patient cannot complete on their own.  So, if by doing ‘menial work’ like making a space clean for a patient to be cared for in the right place, then so be it.  This is a hard concept to sell new nurses on.  Old school nurses (like us mid-century modern types, aka the baby boomers) are triggered by certain phrases: “not my patient”, “not my job”, “isn’t that a Nursing Assistant’s job?”  From the experienced patient’s perspective, phrases that scare them are: ”your nurse is on a break”, “it’s shift change” or worst of all, “we’re short-staffed today”.

But quite apart from the state of healthcare in the USA, a place where the studies show that life expectancy, patient outcomes, patient care indicators are all positively influenced by better staffing ratios, there is a bigger picture out there.  When we talk about people doing their job, we talk about them having a sense of ownership.  They say that the most productive workers are those who feel as if they own a piece of the company they work for, that they are invested in the success of the institution.  When you feel as if what you do matters, you are more likely to do the right thing, not because you will be ‘written up’ if you don’t, but because it is important to your belief of your own self-worth.

Some of us live on this planet without a sense of ownership, as if what we do has no effect on the welfare of others.  Or perhaps we look at how others are living, and like little kids, if they aren’t doing the right thing, why should I? I recently heard this referred to as the ‘what about’ defense.  When Hunter Biden is accused of profiting from his father’s name, we say ‘what about the entire Trump family?’ Well your mother wouldn’t let you get away with that excuse!

It can seem daunting as we look at the direction our planet is headed in, all of the advantages of modern living have speeded up its demise, and we are looking at our beds burning, our ice caps melting.  But we have to face the facts, if we don’t take ownership of our planet and its problems, we are doomed.  I have no idea if the changes I have made in my own life have moved the needle even one thousandth of a degree, but I am trying.  I carry my reusable shopping bags (getting much better about remembering).  I do not use Styrofoam cups at work.  I try to make sustainable choices whenever possible and have become addicted to finding treasure in other people’s trash at our local ‘Restore’ and Salvation Army stores rather than buying new.  A school friend who gives very generously of his time and skills to raise money for our alma mater once said (in patwah of course), ‘a fi all a wi school’ (it’s all of our school – in other words, we all have a role to play).  So I would like to remind everyone: A fi all a wi planet! We may think that our influence is small, but think of the image of the pebble dropped in the middle of a pond, or the flap of a butterfly’s wings – we may never know the impact our actions have, but at least we tried.

On this Friday morning may you have the opportunity to appreciate this wonderful planet we call home.  How many sustainable choices have you made? Can you do more? Can you encourage others to do so to? If not your job, then whose?

Have a wonderful weekend, Family!

One Love!





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