By Tracy Churchill – Clinical nurse and founder – Nurse professional advancement
Many people think Nurses and Doctors are kind, compassionate and fair to ALL people.
After 15 years of working in the emergency department, I believe that this claim of fairness could be a baseless myth.
In the healthcare system, we are bound by a code of conduct which states that we need to treat every person with respect, honesty and fairness. Nevertheless, Doctors and Nurses might be the most unfair people I have ever met. They are unfair to themselves and unfair to each other. And it needs to change.
Over the past few years, I have noticed a positive trend in our society. There is an increasing focus on equity, tolerance, kindness and an awareness of the benefits of diversity (fairness). These values underpin wellness. We use events such as ‘Wellness Week’ for Emergency Department staff, and groups such as WRaP EM to promote wellness in every aspect of living. This group of Australian ED staff promote an educational course in Mindfulness for Emergency staff. It is by being part of this great group of people and this conversation which has led me to my conclusions around unfairness.
Before we go further, a short tale from my first year of emergency nursing may help you understand where I’m coming from.
I was a young hardworking ED nurse. I had just finished a standard 9-hour shift in the ED. Being new to the ED, I had not yet realized why staff used the back exit to get to the carpark. Walking through the waiting room to the main exit was so much faster, but I was soon to learn this lesson. As I walked out into the waiting room with my backpack a lady stood up and spoke to me.
‘How dare you!?‘
I didn’t understand what she meant. ‘Excuse me?’
‘How dare you! This room is filled with people still waiting to get in. And you have got your bag and are leaving while we are all still waiting in here? I don’t know how you sleep at night.
She sat down. I was shocked. I had worked tirelessly through my shift and skipped my meal breaks. Her perception was that I should not be permitted to go home until there was no-one left to see? That time never comes. If I waited for the department to be empty, I would never be able to leave.
What could I say? I didn’t have much time to think before I spoke. Luckily it wasn’t an offensive retort.
I said ‘I sleep at night very quickly, because its eleven-thirty now and I need to be back here by seven in the morning. Don’t worry though, other people are working now‘. Her expression softened slightly and she didn’t say anything else. I trudged out. I have never left through the waiting room since.
On the way to the carpark I started to feel guilty whilst considering my options. Maybe I should have stayed back longer? I was already very tired and knew I had to start again in eight hours. At an inner level I knew it would be dangerous for patients and myself to work for too long without a break, or to have such a small amount of sleep before being expected to function at peak performance again.
For the safety of the public, I also needed to have sufficient sleep.
So why did I feel so bad?
Because Doctors and Nurses are unfair people. We don’t treat all people equally.
We want to serve. Our shifts and our lives revolve around the needs of the public. We stay awake all night to be there in case you need medical care at 3am. We are okay with that. We thrive on helping others. We want to be there for you, but this is why we are unfair.
If we were fair, we would recognize that ’every person’ includes us. Through our own eyes we see everyone in front of, behind and around us – except ourselves. We don’t realize that we are treating someone (ourselves) unfairly because we can only see through our eyes. We are part of that ‘every person’ deserving our care, respect, attention and fairness.
We expect more of ourselves than anyone else does and we give ourselves less. Less sleep, less time to eat dinner, less time to go to the bathroom. Internally, we talk to ourselves in ways that we would never speak to anyone else. The strangest thing is that we would never expect this of anyone else. If someone needed to eat dinner or use the bathroom, of course they should! We would have no problem with that. So why do we have different rules for ourselves – the definition of unfair? How can we expect to role model and embody health for our clients when we haven’t even had breakfast?
One solution is to recognize ourselves as people. We are part of the ‘everyone’.
We need you to remind us of that. We need to remind each other.
We are not machines that can function without food, water, sleep and the toilet.
We need other things too, but let’s start with those important areas first.
Let’s remind ourselves that we are equally deserving of our own care and attention as other people are. Let’s act and look after ourselves. In airplanes they advise us to apply our own oxygen masks before applying them to other people. This is the same principle – we can’t help others before we help ourselves. When we recognize that we are people too, we recognize that we have needs to meet to be healthy.
Forgetting to attend to, or denying ourselves leads to burnout. When we burnout, we help no-one.
Stop being unfair.
Next time you notice that one of your needs is not met, realize that you are a person and you are important too. If that seems difficult, pretend you are someone else and serve that person as you would any other. Fairly. The unhealthy and inequitable trend of being unfair needs to stop.
Until we realize we are all equal and that we need to value our health as much as the health of our clients, there cannot be equality in the delivery of healthcare.