'Now I see the true value of nurses' writes Dr. Eoin O'Brien, in a recent issue of The Sunday Times [Irish Edition] (2016, p. 19). Dr. O'Brien explains that much of his life has been spent in hospitals, from his days as a medical student through his years as a consultant. But the recent hospitalisation of a sick family member has opened up for him the 'perspective of an anxious relative' and bought him to reflect on the importance of how sick, injured and vulnerable people are cared for in our hospitals.

Dr. O'Brien compares and contrasts care provided by health professionals generally and the adverse influences of managerialist care strategies and limited government funding. But it is the role of professional nurses in the provision of healthcare that strikes the deepest chord in him. Singling out for particular praise the nurses at St. Vincent's University Hospital in Dublin, he writes;

I had to admonish myself for failing in my years on the wards to appreciate the uniqueness of this aspect of our health service. I took nursing for granted.

The following Monday when word of the article spread around the hospital wards there was a great 'buzz', fuelled by the warm glow of being recognised; by feeling valued. Nurses very much appreciate the tribute Dr. O'Brien paid them and their profession. 

The taken-for-granted phenomenon

Dr. O'Brien's previous failure to appreciate the uniqueness and importance of nursing would not be uncommon. It seems to be a natural human tendency to take for granted things that are so vitally important that they are always present; things such as water to drink and personal friendships. Nursing as the fundamentally important, 24/7 presence in healthcare; the bedrock of healthcare systems; can also be easily taken for granted.

It is discouraging to be taken for granted and the nursing profession cannot allow itself to be manipulated and treated unjustly by managerialist-type forces who try to take advantage of the taken-for-granted phenomenon.

What we can do about our taken-for-granted phenomenon

For the nursing profession, being taken for granted; having its value underestimated; might be an occupational hazard; but whether or not it is an occupational hazard, it gives us the opportunity to ask: do we ourselves have some responsibility for being taken for granted?

Do we take ourselves for granted as professional nurses? Do we mostly 'go with the flow' of the multidisciplinary team, picking up things left undone, following the idea that we are the indispensable caring force in patient care but rarely being specific about what this means? If we answer 'yes' to these questions, then it is very likely that we are being taken for granted.

Or, do we make it very clear exactly what it is that we contribute to the multidisciplinary care of patients? Do we take the lead in creating a healing ward culture, a therapeutic milieu for patients? Do we identify clearly and name the patient problems that we are responsible for addressing by making nursing diagnoses? Do we name and measure the nursing outcomes we are helping patients to achieve? Do we name and document the nursing interventions we are implementing to assist patients to achieve their outcomes?

In other words, do we articulate and document clearly nursing diagnosis-driven patient care plans for all to hear and see? Do we demonstrate professional nursing as a distinctive collaborative presence on the multidisciplinary team? Do we articulate clearly that our 24/7 nursing relational continuity with patients gives us the 'big picture' of patients' recovery status at any given time? If we can answer 'yes' to all these questions, then it is very likely that we are not being taken for granted.

Therese Meehan

Carolyn Donohoe

Reference

O'Brien, E. (2016) Now I see the true value of nurses. The Sunday Times [Irish Edition], 4 December, p. 19.