When I was asked to do a presentation at a conference on Careful Nursing, I began to reflect on the meaning of the word careful, and the many contexts I heard my Dad speak that word over the course of his life.

I grew up on a small farm in the west of Ireland, pre the machinery era (we did have a small tractor), and at that time when children helped with the farm work. We, like so many other families, grew our own vegetables. One of my tasks was to keep the weeds at bay, especially in the first weeks after sowing. When my Dad coached me in the task of weeding the carrots he would caution 'be careful'; careful in this context meant: be attentive, and gentle and delicate in touch, so as to remove only the weeds, while not damaging or disturbing the soil around the root of the fledgling carrot.

When lambing season arrived (my favourite time of year) we would go frequently to check on the sheep in the field and on these occasions, especially if the weather was very cold, I would be required to help carry a baby lamb back to the barn, while he directed its mother and carried its twin brother or sister. When I would pick the baby lamb up in my arms, often recoiling from its wet and cold body, he would softly say 'be careful'; careful in this context meant give it shelter and warmth, gently and sensitively hold it close under my coat. Being careful was also, very sensibly, about reassuring both the lamb and its mother that my intention was not to hurt so they both could relax as we made our way across the field. 

Later in the year we spent time together in the bog cutting turf. As my Dad cut the turf with a two –sided spade called a sleán, he would often call out 'be careful', as he fired the wet and soggy sod of turf up to me on the turf bank. Being careful here meant be alert, vigilant and not get distracted; it was about staying in tune with the rhythm of his cutting and throwing, otherwise he may be hurt by a falling sod if I missed my catch.

When as a child I went to visit my grandmother who lived close by, as I left the farm I would often hear my dad call after me 'be careful'. When he used the word careful on these occasions, he meant be circumspect, cautions and vigilant with traffic, animals and any strangers I may meet on the road. Later when I started to earn my own money he would say 'be careful'; meaning be prudent, and sensible but generous without judgement to those less fortunate and less privileged. 

When in his last years of life he had a stroke and I, with my mother and other siblings, cared for him at home he frequently used the phrase 'be careful'. When he spoke the word careful in this context he meant be protective and watchful, thorough and meticulous, and care in a manner that ensured I avoided potential dangers, mishaps, or harm that might befall him when lifting, walking, bathing, or doing other things with him. Being careful was also a reminded to me to compassionately help him navigate life's tasks in a way that supported him to do as much as possible for himself, while at the same time not accentuating his 'inabilities'. Being careful was about protecting his dignity and identity, seeing behind his disability, attentive to the essence of his being, and above all enabling him to be my Dad, who continued giving advice and cautioning me to be careful right to the end.

To me Careful Nursing is about all of the above; it is an embodied practice, a way of being that requires me to use my entire self, merging my heart, head and hands, to understand, connect and care for and with another person.

Agnes Higgins PhD; MSc; BNS; RPN; RGN;
Professor in Mental Health,
School of Nursing and Midwifery,
Trinity College,
Dublin,
Ireland