Water, water nowhere and no-one who can think – Phillip Darbyshire, Professor of Nursing, Adelaide

Phillip Darbyshire 3Water, water nowhere and no-one who can think – Phillip Darbyshire, Professor of Nursing, Adelaide Australia

Every so often it happens, even at my age.  You think that you have seen and heard everything in nursing and then along comes something that completely upends you. I sat recently in a research conference in the UK hearing Janet Davies, head of the RCN say that she never thought she’d see the day when the RCN needed to run a campaign urging nurse to drink, eat and basically not collapse on duty from dehydration or hypoglycaemia.  I listened, but I also looked around, convinced that the ‘punk’d’ team were going to leap out at any second to heap scorn on the gullible who’d believed all of this.  They didn’t appear.  This was real. When the subject of water bottles and their ‘banning’ in some wards and units was raised, lots of nurses around me were nodding furiously.  Toto, I was truly not in Kansas anymore.

I had to ask colleagues about what I’d been hearing.  I asked educators, clinicians and students at various events across the UK.  Like any good researcher, I also asked twitter.  Could this proscribing of water bottles and drinking actually be ‘a thing’?  Was there an H2O version of the 1920’s and 30’s prohibition happening where nurses’ water bottles were confiscated and their illicit contents poured down the nearest drain?

It sounds like farce, but this is no laughing matter.  One 3rd year student in England told me of being loudly, angrily and publicly berated by a ‘Modern Matron’ (oh, the bitter irony of THAT) for having her water bottle at the nurses’ station and daring to actually drink from it.  She was excoriated for her “disgusting” and “unprofessional” behaviour.  No wonder that there were even motions proposed at RCN Congress this year to end such “draconian practices”!

Let me side-track slightly here.  At the same research conference, the same head of the RCN was cautioning everyone about how and why nursing cannot seem to hold on to its new graduates.  The RCN apparently used to work on exit interview data that suggested a 10-year career span for many new nurses before they decide that ‘enough is enough’ and head off elsewhere.  No longer.  It may now be as little as 3 years. We do know that for the first time in many years, more nurses are leaving the profession than are joining. You do not need to be the world’s greatest maths genius to see the Endgame here.

This should make every nurse in the UK, who cares about the future of our profession and the kind of legacy that we of a certain vintage are passing on, seethe with anger.  We are spending around £80,000 to educate a new RN and no doubt more on ‘new grad’ programmes together with preceptor and mentor empires.  The costs of replacing an RN are more than twice his/her salary (between $15-$105k here in Australia) and yet at the same time, we are allowing organisations and individual managers to drive out some of our brightest and our best with such crass, idiotic, malevolent and evidence-free bureaucracy.

Let’s be quite clear about what is happening here in nursing ‘Watergate land’.  This is about one comparatively powerful elite choosing to use their power to belittle, intimidate and control a less powerful group.  This has nothing whatsoever to do with ‘infection control’ or any other ‘elfinsafety’ issue.  I asked infection control nurses on Twitter if I was missing something important here about water bottles and infection.  Their response was unequivocal: this has nothing to do with infection so don’t blame us for such thuggery!  Unless there is a particular infection raging through the ward, (in which case there would be a whole raft of IC measures in place) having and drinking from a water bottle is as harmless as a patient having a water carafe on their locker.

Here’s the real rub though.  This has nothing to do with water or plastic bottles.  It has everything to do with power and who decides that they have the power to determine and enforce what counts as ‘untidy, ‘unprofessional’, ‘disgusting’ or whatever.  What gives a particular manager the right to define what is or is not ‘professional’ or ‘unprofessional’ I have literally no idea.  The last time I looked there was no NMC competence or standard that deemed that nurses should not drink water on duty or that said water must not be housed in a water bottle.

We are talking here about nurses whose daily work involves giving children chemotherapy, who are breaking the news to a young mum that her breast cancer has returned and spread, who are managing an A&E department on a Friday night, who are helping an ultra-fragile extreme prem baby take her first unaided breaths, who are supporting a husband who must now say goodbye to his dying wife of 60 years, who are gently enticing a long-term catatonic person back to speech and engagement.  They are working at the very limits of human existence and in intense human relationships that society entrusts very few professionals to do. And yet, someone, somewhere is telling them that they cannot be trusted to have a water bottle in the ward because it makes the place ‘look untidy’ or because someone thinks it is ‘unprofessional’.  It is beyond parody.

One day however, the worm will turn.  One day a new grad or other RN, or the entire staff will tell this manager in no uncertain terms, just where to go and that if they want their water bottle, they can come and try to prize it out of their cold, dead, hand.  Otherwise, go away because I am unbelievably busy with important work that needs to be done.

And at this point, the bully will crumble as they always do when confronted and their once-fearsome persona will seem as terrifying as the Wizard of OZ when the curtain is pulled aside.

We simply cannot allow the power obsessed to micromanage our new grads and other great staff out of nursing.  Regardless of the human costs, these ‘new nurses’ are probably £100,000.00 plus investments that society has created.  They AND we deserve far better than to have their careers curtailed because of the tragic actions of some senior nurses who probably promised fervently 20 years ago that when they qualified, THEY would never become one of ‘those nurses’.

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