Christie Watson is a nurse, author, Professor of Medical and Health Humanities at the University of East Anglia, Patron of the Royal College of Nursing Foundation and holds an Honorary Doctor of Letters
Interview by Rowan Pelling
We’re used to acclaimed books from doctors. Why have nurses’ voices not been heard until recent years?
Nursing has long been seen as female (89 per cent of nurses are women), lesser and not as academic as other disciplines. This prejudice seeps into politics and helps explain why there’s no nurse on SAGE [Scientific Advisory Group for Emergencies.] Saying you’re a registered nurse doesn’t hold academic weight the way it should, as a safety-critical profession that deserves a seat at the political table.
Nurses are caring and compassionate. They’re also safety critical, rigorously trained academic professionals, who have been at the forefront of saving lives during this pandemic. The lack of critical care nurses has been one of the crisis’s most significant challenges. Had there been a care home nurse on SAGE I’ve no doubt many more lives would have been saved.
I feel the public now has fresh respect for nurses, while the government is lagging behind.
What inspired ‘The Courage to Care’?
I wanted to weave a memoir into a book about the kinds of nurses you rarely hear about, who are an integral part of our care and expertise in this country. I really wanted to write about their diverse backgrounds and the wide range of people they care for: criminals, victims, premature babies, the elderly, the homeless, school kids, those with serious mental illness, learning disabilities, and prisoners. And the way nursing involves looking after patients’ families. You can easily find yourself spending 12 hours with a relative.
Nursing doesn’t happen in isolation – we’re all part of a wider family. Which led me to think of my own closest people. I started a story about nursing and it became a story about family.
The book reads like a portrait of modern Britain. Was that your intention?
I wanted The Courage to Care to be punchy and to talk about the fact patients aren’t always likeable, or good people; to highlight the fact every one of us could end up in an unimaginable situation if we’d had a totally different sort of life from the outset.
Was there anyone who stood out?
You’ll probably remember the parish nurse Rachel, AKA ‘the kindest nurse in Britain,’ who cares for the homeless and helps others see they didn’t start out this way. And there’s Jess, the forensic nurse, who looks after people accused of serious crimes, even rapists and murderers. She shows respect to every one of her patients and says her job is to ensure her patients are in the best shape to face a court, ‘So the accused and the complainant can get truth and justice.’
How has Covid-19 affected nursing?
This year has been the worst one imaginable. We might not be able to be with loved ones when they die, which has led to talk of people ‘dying alone’. But that isn’t true. A nurse will sit and hold the hands or our relatives; a nurse will play their songs, read their prayers and put photographs behind their bed. They will be with that person, one hundred per cent, if we cannot. There’s something spiritual at work here. It’s about grace as much as nursing.
What might have been done differently if a nurse had been appointed to the Covid-19 SAGE advisory group?
There’s so many issues that would have been addressed. The treatment of our elderly has been horrific and and to many nurses went to work without adequate PPE. At this very moment we’re going into what will probably be the worst winter in living memory and there are nurses sitting at home who can’t get Covid tests, who are desperate to get back to work. They’re desperate to resume cancer services and mental health care and all other services that have suffered during this time. Patients’ lives are being put at risk.
What do you think of the NHS response to Covid?
Nursing and the NHS has been agile and responsive to the whole crisis and change has been rapid. Colleagues built a hospital in nine days [the Nightingale]. I’ve seen cabin crew, school nurses and orthopaedic surgeons having to learn new skills overnight and helping critical care nurses. In Germany there are 29.2 intensive care unit beds per 100,000 members of the population; in the UK there are 6.6.
This rapid response has not been reflected in government policy. The NHS is not failing. It’s been failed. A third of nurses are considering leaving the profession. We’re already 38,000 nurses short, according to NHS England.
You say you saw nursing in a different way after writing this book. What were those key reflections?
How you deliver the treatment is often more important than the treatment itself. People aren’t always sick with medically explicable symptoms. Tablets and technology don’t always work. I listened to a GP, who has many homeless patients, talking on a panel. She said she always writes them an extra prescription that says something like, ‘This is not your fault,’ or, ‘I’m so sorry you’re going through such a hard time.’ Compassion, to her patients, is just as important as the medication she’s giving.
How did you weave in the story of your son’s adoption?
My family stories are weighted pretty evenly: my daughter’s birth, my son’s adoption, my nan’s wisdom, chats with my dad. But readers seize on the adoption, because it isn’t a tale we hear so often. I wanted the structure of my book to embrace my experience of nursing as one part of my story, while also writing about my experience as a family member and patient – because it’s informed my nursing.
I’m a single mother with two mixed-race children, who’s got a very strong sense of what close-knit family means: it’s mixed up, chaotic, with beauty in the differences. I’m proud of my kids and family.
Why do you say in the book fighting racism is – or should be – the vital job of all healthcare workers?
I feel like social justice and human rights have always been an integral part of nursing and midwifery. We’ve seen massive inequalities in our country, yet we’re still talking about systemic racism. I’m really happy the BLM movement has started. It’s given me hope for my children. There’s now an opportunity for change.
There are many moving stories in the book. Are there any you think are central to the message/to our understanding of society?
One story that really resonated was the 61-year-old patient, Gwen, in intensive care with ARDS [Acute Respiratory Distress Syndrome], whose husband couldn’t get to her bedside. Finally, against the odds, he made it. He kissed her like he might never get the chance to kiss her again. In a world of uncertainty we must kiss all our loved ones as if we might never kiss them again.
Christie Watson’s book “The Language of Kindness” is available from major book stores and online