Letters to the Editor section Irish Times 22nd February 2017

“A Nurse’s World”

Sir, – The sentence “the author’s identity is know to The Irish Times” at the end of the two articles in the “A Nurse’s World” series speaks volumes and not because of the content of the articles.
The writer, I guess, is fearful for the future if she or he criticises or questions the system. It was ever thus in may areas of Irish life, but particularly in healthcare.
The two-tier system of nursing in’ place now for some time has done little to get across the importance of the nurse in providing compassionate care/ It would be considered old fashioned and uncool to refer to Florence Nightingale, but we should never forget Florence fought a lone battle with parliamentarian, army personnel and so many other to set the strong foundations we are now working from.
In highlighting what is wrong it is important that nurses note the socio-economic determinants of health and the environment in which health policy is made.
The Nurse who is well informed and who can look outside the box has, to my mind, a huge contribution to make to health policy. This too can make the work of the nurse more interesting and help provide the culture of powerlessness and victimisation that is clearly creeping into the discussion around the role of the nurse. – Yours, etc
Director of Services,
Alice Leahy Trust,
Bridge Road
Dublin 8.

Healthcare Interdisciplinary Research Conference in TCD

Points from a Keynote Address by Alice Leahy, Director of Services Alice Leahy Trust at the 17 th Healthcare Interdisciplinary Research Conference in TCD on November 10 th 2016

On the theme: Contemplating the Past, Present & Future, Alice Leahy, Director of Services of Alice Leahy Trust in her presentation “Wasting Time with People?” said: “the theme of the conference “Contemplating the Past, Present & Future” was a hugely important one at a time when our country is struggling to cope with what seems to be a chaotic and sad health service. She said she wasn’t using PowerPoint because to her mind it prevents a real connection between the presenter, the topic and the audience……….. She said she was deeply honoured to receive an Honorary Fellowship from the faculty of Nursing & Midwifery, RCSI a number of years ago – that Faculty was the first of its kind in these islands and the founders in October 1974 were acutely aware of the need for post graduate nursing training. The first Dean Mary Frances Crowley said “we are fortunate in Ireland in having a surplus of applicants for the nursing profession; it is right that we should improve their academic standing and career prospects, but we must guard against some of the dangers of specialisation in this technical age, remembering that to the ill patient it is the nurse’s sympathy, kindness and understanding which are her most valuable assets”. Alice said she thought Florence Nightingale would agree with her and as she (Florence) once said “nursing is a progressive art, to stand still is to regress”………… Alice said we all need to look outside the box, particularly in the area of nursing and healthcare and look at healthcare in a wider context. Note the socio economics determinants of health and the environment in which health policy is made. She said the nurse who is well informed has a huge contribution to make to health policy and can make the work more interesting and help avoid the culture of powerlessness and victimisation, something she had noticed creeping into the discussion around the role of the nurse………… She said some of you have or will have a key role in nurse education, others of you will move up the ladder of promotion and she said she guessed some of you might find yourselves on the margins because you ask the awkward questions, others will emigrate and hopefully not too many of you will become disillusioned, because nursing, in spite of what appears to be happening, is a very special profession. In College Choice 2005 – an Irish Times supplement 11th January 2005 the following description of nursing was used to promote nursing as a career – “Nursing is inextricably linked with life. What other career permits practitioners to be present at birth, death and every life enhancing moment in between? Equally while few careers offer such opportunities to share in and care for the lives of others, nursing is about self-development too”. This perhaps captured what nursing is about and could be restated over and over again. We all know that nursing challenges us to look at our own humanity and vulnerability especially when working with vulnerable human beings and particularly in the current changing climate. No one group have all the answers but all of us together and aware of our own humanity can make an enormous contribution to making our health service one to be proud of – something we cannot say with any degree of confidence currently. But we can and must promote caring, hope, vision and positivity. We can only do this if we have confidence in our unique role………… She described the daily work dealing with people who are homeless from across the world, sometimes meeting people from 26 different counties in a given month….. She said today you are only too well aware of the housing shortage in our country and this has been allowed to develop over the years; it didn’t happen overnight. This crisis has been well publicised. Women and children are living in cramped hotel rooms, with all the negative consequences that these circumstances involve. It should be pointed out however that there is a difference between houselessness and homelessness and no matter how many units of accommodation we provide, there will always be people who feel excluded and don’t fit in. There are deeper problems which take time, patience and commitment to work through; the application of some simple solution from a distance will simply not work………. She said caring for others challenges us too to look at our own humanity and vulnerability especially when working with vulnerable human beings and suggested that so many people needing healthcare are vulnerable because others unknown to them so often make crucial decisions about their lives without their involvement – their personhood handed over to others. All contact with human beings moves us and when it doesn’t it is time to question why we are working in the field of healthcare………. She said conferences on Health Reform like many conferences can be academic with a lot of reference to research and figures and little reference to human beings. Of course good quality supervised research is crucial to good planning. Sometimes the only hearing the people we meet ever get is when they are being researched – an issue we have grave reservations about because of the amount and quality of research being undertaken today. Of course we know research is required but we all know reports are gathering dust all over the place. In that context nothing has changed in the last forty years as a quote from a report we wrote in 1976 which could be validly published in its entirety today: “If we are to push for fundamental change in the whole area of homelessness, then a certain amount of constructive research is necessary. We feel strongly however that it must be pursued with the greatest caution. It is clear to us that the ‘research industry’ uses that section of our society, which is the most vulnerable and the least able to battle for its rights as its’ source of material. We must never forget that we are working with human beings, who for the most part have been battered by our society and who for so long have been pushed about as just another number in a cold inhuman bureaucracy”. We all have an obligation to use knowledge based on hands-on experience to ensure a culture of compassion exists to ensure people are treated as people, not mere statistics…. She said we should never allow human contact and frontline care to be devalued, it is not easily measured as you know. A philosophy of caring is good for people but is also the most economic in the long-term…… She said sometimes we blame Florence Nightingale for the image of nursing presented as being a vocation – it’s not cool in the present day to suggest that nursing is a vocation. We should never forget that Florence fought a lone battle with parliamentarians, army personnel and so many others to set the strong foundations we are now working from…… She said its time to treat people properly and that it is the one thing that is increasingly difficult in the modern Ireland where we are all statistics reduced to a quantitative or monetary value and where caring is at times taken for granted. In a world, which is increasingly governed by performance indicators and benchmarks, is it even possible to preserve even the concept of a philosophy of caring and compassion? We should not allow ourselves to be distanced from people, aided by technology, voicemails, emails etc – all this seemingly designed to keep people at a distance while increasing numbers of expert groups and bureaucracy flourish….. She said we all need to consider where we stand and what kind of Health Service we want. The power to change things is in our hands. At times we can be overwhelmed by the amount of caring required of us, we can loose confidence, our compassion can be taken for granted, our energy sapped. While acknowledging she was speaking to some of the converted she said we can all get invaluable support from each other and must never give up. It was Maya Angelou who said “I’ve learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel”.