Curtain raiser
The truth about being a nurse in Britain
After some generic training, Christie Watson chose mental health as her route into nursing. On her first day in the wards, aged 17, she reported to Sue, a small woman carrying a large set of keys, who was to be her mentor. Sue showed her around – the staff room, the medicine cupboard, the craft room – and introduced her to some of the patients, warning her to watch out for the anorexics who would hide razor blades. It was only when Sue mentioned “the patients don’t know that the medication is full of arsenic” and cackled, that Watson realised she’d been had, and that “Sue” was actually a patient.
It was an unsettling introduction to what would become 20 years of life on wards in various London hospitals, all vividly chronicled in her book The Language of Kindness: A Nurse’s Story. On the eve of publication, Watson, 41, is at her publisher’s office in London, blonde and composed, her conventional appearance offset by electric blue fingernails.
She is in the midst of a publicity storm – the book has been serialised in national newspapers here and sold to 20 different territories. Yesterday she was in Holland, tomorrow she is going to Canada; she is still involved with nursing, “but in a policymaking sense” – and she has just been asked by Lord Crisp to become a champion for Nursing Now, an international campaign to raise the profile of the profession.
Watson became a paediatric nurse. Two weeks into her first placement, she had scabies, impetigo and nits. “I’ve been bitten by a child and had to have a hepatitis booster,” she writes in her book, “and I have had an ‘eye wash out’ after a baby who was having a nappy change had explosive diarrhoea all over my face.” She looked after children who had rickets due to lack of vitamin D and toddlers who had had all their teeth taken out after years of drinking Coca Cola from a baby bottle, and a profoundly depressed 13-year-old who had been paralysed from the neck down in a car accident. Paediatric nurses, she says, have to be “child whisperers” – experts at communicating with those who are frightened and in pain.
It was her own father’s death from lung cancer six years ago that enabled her to wholly appreciate the importance of kindness and humanity; how deeply his nurse cared for him in every detail and how important that was to her family as well as to him. For there is great reward in nursing too, and moments of lightness in the book: the joy when the severely ill recover; the embarrassment when she mistakes the man delivering fried chicken for a doctor because of his white coat; the doctor she disapproved of because he was eating a Viennetta during ward rounds, who ended up becoming her partner for 12 years and the father of her two children (they have now split up); the nurse friend who confessed to her in a crowded operating theatre that she had slept with everyone in the room – except the patient.
Watson writes so well, movingly but sparingly, that the result is a profoundly vivid impression of working in a busy hospital – what the doctors and nurses and patients and porters go through – in all its horror, glory and banality. But after 20 years on the wards (the last 12 years parttime) Watson is hanging up her hat and focusing her energy on the political side of nursing – passionate about drawing people’s attention to the impending disaster in public health.
Because there is a crisis in nursing, and Watson believes it is about to become a full-blown catastrophe. “Nurses are leaving the NHS faster than they are joining – they are unable to cope with the pressure. At the moment the country is 40,000 nurses short and it’s getting worse.”
There are a number of reasons for this. Nurses are underpaid, undervalued and overworked, in
‘Nurses are leaving the NHS faster than they are joining – they are unable to cope’
hospitals that are underfunded. Watson writes about colleagues who were so busy tending to patients that they would faint from exhaustion, or get chronic cystitis because they had no time to go to the lavatory or drink water. Then there is the welldocumented bed shortage: “Quite often there are physical beds empty, but there are no nurses, so they can’t open the beds to patients.”
Lack of social care in the community means that hospitals have to take up the slack: “Bed-blocking is a real problem; people who are well enough to leave hospital but can’t return home to an empty house with no carers available to look after them. The NHS spends £820million a year on keeping older patients in hospital.
“And attitudes to the elderly have changed; they are a burden, they are not looked up to and revered as they are in some other countries,” says Watson.
Times have changed. Watson writes about an inner-city school nurse she knows who longs for the days when her job was about asthma pumps and twisted ankles, when now it is about gang rape and self-harm.
And not just in schools. “People are suffering – not necessarily with disease you can cure, but from social isolation, depression, loneliness, fear and anxiety – we’re more lonely than we’ve ever been and yet more connected than we’ve ever been, and nursing has never been more important.”
If she were Jeremy Hunt, she says, “I would immediately reinstate the bursary”. Since its withdrawal last year, applications for nursing courses have dropped by a third.
As Watson points out, “Unlike other students, when you’re a student nurse you’re part of the NHS workforce from the beginning and you’re paying £9,000 a year for it.
“When I started nursing the cost of living was so much cheaper. It’s a very different landscape now.”
The bursary was also useful for attracting mature nurses with life experience, “the people we really want looking after our older people – so that’s a big loss to the workforce.”
The book was written fast, in five months; Watson realised that although there’s a very popular genre of books written by doctors – Henry Marsh, Gabriel Weston, Paul Kalanithi – there was nothing by nurses. The idea became more prescient because there was an imperative. But the hectic pace suits the book – she wanted it to feel like you are rushing through a hospital. And it does.
There was fierce bidding amongst publishers for the book, and equally intense competition to obtain television rights, a contest won by production company Mammoth Screen, which is turning it into a drama with a script by Rachel Bennette (who adapted Zadie Smith’s NW), and a fictional character based on Watson, who is also the co-creator.
Her writing didn’t come out of nowhere. While still nursing part-time and looking after her daughter, she applied to do a masters in creative writing at UEA – she had no degree nor even an A-level – but got a place on the strength of a short story she had written.
That story became Tiny Sunbirds Far Away, which won the Costa First Book Award in 2011, a vivacious, elegiac tale of a girl called Blessing, growing up with her family in Warri, Nigeria.
It was followed in 2013 by Where Women Are Kings, also widely praised. She now lives in south-east London with her children (13 and 10) and teaches creative writing at St Mary’s University, but will not give up her real passion, which is to raise the profile of nursing.
“I fear for nursing but I’d still recommend it so highly to young people – you couldn’t have a more varied career.”
The Language of Kindness by Christie Watson is published by Vintage (£14.99) on May 3. To order your copy for £12.99 plus p&p call 0844 871 1514 or visit books.telegraph.co.uk