Hazel McHaffie

Royal College of Nursing

‘Calm down, dear!’

In a former life I used to be a midwife working in an extremely busy labour ward (I’m third from the right in this photograph). In spite of the fast turn-over, we spent long hours with the couples in our care, and often developed warm relationships. We were, after all, sharing one of the most special, intimate and precious experiences in their lives.  And for me certainly, it was always a privilege and a thrill as well as a relief to see the infants safely in their mothers’ arms. Indeed, I always said that, if it ever ceased to be a miracle, I would quit the job. It never did; I left for other reasons – good ones.

However, it wasn’t all a bed of roses. One day a mother registered a complaint against me with my boss. Why? Because apparently, I had exhorted her to ‘push into your tail end.’ It demeaned her apparently, reducing her to the status of an animal! Now this was fifty years ago, at a time when we’d never even heard the term ‘political correctness’, never mind become obsessed with the notion, but even so, I confess I felt mildly irritated. When you’re spending a good chunk of a day/night with a woman, encouraging, supporting, reassuring; working through official breaks and long past your shift-hours to deliver continuity of care, you don’t tend to doctor every word that comes out of your mouth. You’ve got more important priorities, I’d suggest. Especially if the woman hasn’t a clue what she’s supposed to be doing and has no knowledge whatsoever of the anatomical names for the parts of the body she’s employing for the mysterious but monumental effort of giving birth. But hey ho! I could only apologise and try to learn from the experience. Fortunately the Superintendent of the Labour ward was a no-nonsense, straight-speaking, hugely experienced woman who fully shared my values, and she generously let me know (without words) that I had her sympathy and confidence.

When I watch Call the Midwife on BBC1, I’m often reminded of those days, since the programme’s set shortly before the time I’m talking about. The Nonnatus midwives even use terms of endearment when encouraging the mothers in their care – ‘sweetie’, ‘love’, ‘pet’, ‘darlin’!! Ppphhhwww!!! It’s some years now since real-life carers were told to eschew such expressions, lest patients/residents/clients, felt patronised, although I’m quite sure they were used in all innocence as terms of affection and engagement, not slights.

Nevertheless, all these decades later, I’m feeling a sense of disbelief. The Royal College of Nursing has just issued a document for its practitioners in which it advises against addressing women as ‘ladies’ to avoid causing unwitting offence … hello?! Other terms now off-limits include ‘pensioners’, ‘alcoholic’, ‘mankind’, ‘manning a ward’, ‘gays’ … Oh, and don’t forget to be scrupulous about selecting the preferred pronouns for people who don’t subscribe to the usual binary classifications, and … You get the idea. Nor is the RCN alone in this; it’s about three years now since the British Medical Association deemed the term ‘expectant mother’ to be taboo, lest it offend transgender people …!!!

Really? Seriously? Has the world gone completely mad?

In the security of my own blog, I think I might be allowed to voice a personal opinion and declare that I honestly think the powers that dictate these things would be well advised to concentrate on gaining more time for clinicians to do their jobs, without the colossal pressures currently hedging them about with stress and restrictions. Time for them to save lives, to ensure safety and the best care, in the first instance. Giving them breathing space – time to attend to those niceties and refinements without burning out themselves. Easing the chronic under-staffing and over-working they labour under, instead of putting even more pressure on them to examine every word before uttering it. Pphshaw!

It appears I got off lightly all those years ago!!

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Assisted suicide – revisited

Serious week. Calls for a serious blog. Especially from the author of Right to Die.

Because assisted suicide hit the headlines again this week, big time, and some of my readers have contacted me about it. Prompting me to offer a couple of comments.

First the Royal College of Nursing officially withdrew its opposition to seriously ill patients seeking help to end their lives. It’s important to note that the RCN is not saying it approves the practice; full stop. Of the roughly 30% of their members who participated in their recent consultation exercise, 49% supported assisted dying; 40% opposed it. What the College is recognising is the variation in opinion amongst the health care professionals who work most closely with very sick patients, and the public mood.

The plan now is to issue guidance to help nursing staff to have a properly informed discussion with those who broach the subject with them. I just hope this process won’t take too long. What about all those patients and families who read the headlines; misread the signs; and confront unprepared nurses?

And there’s another issue which isn’t often raised. Nurses are certainly very close to terminally ill patients, but they aren’t the ones who actually do the deed or write the prescription. Important distinction.

The RCN news coincided with a poll in The Times – carried out a week after the conductor Sir Edward Downes and his wife died at the Dignitas clinic on July 10 – which found that 74% of people (well, Times readers anyway) want doctors to be allowed to help their patients in this way. If you’re one of the people who say assisted suicide should be legal, ask yourself: would you be willing to carry it out? Actually help someone to die, I mean. And if you wouldn’t, can you justify requiring others to do so?

Now today the Law Lords have issued a milestone ruling. Debbie Purdy, a lady with Multiple Sclerosis who has been campaigning for clarification of the law on assisted suicide has, they say, the right to know if her husband will be prosecuted if he helps her end her life. Guidance must be provided. The Director of Public Prosecutions has promised to issue an interim policy later this year. Ms Purdy herself says, this is not about a right to die but a right to live longer; if her husband is able to help her she will not be forced to end her life prematurely to protect him.

As I say, a serious week. Major challenges. Worrying questions. No easy answers.

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