Authenticity in Nursing

By Pete Smith

The patient–clinician interface is the most sacrosanct space in healthcare.
How well we inhabit that space informs how well we deliver care.
A system is perfectly designed to deliver the results it does, so if those results include preventable errors – fatigue, burnout, bullying and ‘never’ events – then something is amiss.
In Authenticity, change becomes possible.
Nurses:
Awesome today;
Awesome tomorrow;
Awesome always.
But only ever human.
And only ever as good as the system allows us to be.
Increasing the technical skill of a health care clinician makes for incremental change.
Improve the culture within which we work and suddenly quantum change is possible.
Patient safety and clinician wellbeing are functional imperatives.
Authenticity is the key driver towards reducing healthcare delivery risk.
Choose to agree or disagree, but only the brave will seek to understand.

• Language: English
• Publisher: Tellwell Talent
• Release date: Jan 27, 2021
• ISBN: 9781922542212

Pete Smith

Pete Smith is a Technical Architect and data warehouse specialist with a wide range of expertise from application analysis, design and development through to database design, administration and tuning. This experience covers 19 years in the IT industry, 14 of which are specifically on Oracle platforms and demonstrates a high degree of longevity and familiarity with the Oracle database server and associated products. Qualified to degree level, Pete has worked for many years as an independent Oracle consultant and, more recently, in a senior position as a Principal consultant with Oracle UK; Pete now works for a specialist UK IT consultancy.

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Authentic, a Definition

According to Merriam-Webster, an acceptable definition of the word ‘Authentic’ is as follows:

Authentic:

· worthy of acceptance or belief as conforming to or based on fact

· conforming to an original so as to reproduce essential features

· made or done the same way as an original

· not false or imitation: REAL, ACTUAL.

Authenticity as a concept is of particular interest in psychology. It also arises as a topic for contemplation in existential philosophy and aesthetics.

Wikipedia states: In existentialism, Authenticity is the degree to which an individual’s actions are congruent with their beliefs and desires, despite external pressures.

Authenticity is a complex topic.

In a dynamic, ever-changing world, the contemporary evolves from the classic.

The pressure to conform to the rigours of society is culturally nuanced and in conflict with the pressure to conform to one’s own beliefs, values and desires.

Conflict therefore creates a dynamic tension arising from these internal and external, often combative, sources.

Authenticity has an aesthetic quality.

Integrity is the behavioural expression of that Authenticity.

Words can lie.

It is behaviour that tells the truth.

Samaritans, Each and Every One

The only question I remember in my hospital interview to become a nurse was pitched to me by the then Director of Nursing at Grafton Base Hospital, Matron Higham:

Why do you want to become a nurse?

I don’t know, was my naive reply, though I had done other things and failed at them all, and I thought nursing might be something I might be good at.

How I got an offer to commence Preliminary Training School I don’t know.

In retrospect, I can only thank Matron Higham for the trajectory she set me upon because, in part, of the simply incredibly amazing people I have had the good fortune to have been surrounded by all my nursing life.

A career in helping people should be the most noble, enabling and affirming life one could have.

A career in nursing should be a crown jewel in the spiritual journey of living of a well-lived life.

So it interests me as to why nursing, whilst uplifting to many, also has the potential to destroy uncere­moniously some whose only crime is to try their best to live up to their own, and society’s, expectations in the simple endeavour to care for those in need.

The Good Samaritan of biblical fame lost little in attending to the needs of the philistine.

Nurses, each and every one, on the other hand, are the epicentre of a maelstrom of collateral damage suffered, first by themselves and then, as second victims, their families and loved ones.

My belief is that the construct of the nursing identity is that of a healer. Through a long legacy of the artful application of rigorously tested science, the role of a nurse is simply to ease suffering.

It is a simple pretext which covers all aspects of physi­ology, psychology and existential fear:

To ease suffering, and, where possible, to heal.

To any nurse, the image of Florence Nightingale is burned into their brain.

It forms a permanent imprint upon our amygdala, whether we want it or not, like it or not, rail against it or not.

As usual, the cultural image of the lady with the lamp is different from the actual DNA- and emotion-clad personage.

The truth is different in a thousand little ways from the legend, but it is the ‘legend’ which has supplanted the ‘real’ in our minds.

As an aesthetic construct, the ‘idea’ of Florence is what we subscribe to. The rest becomes mere hearsay.

It is with this construct that we create the beliefs and values we ascertain as ‘Authentic’ in our field.

It is against this construct that we measure ourselves.

There is a Florence in every nurse.

You can tell a nurse by their smile: the all-knowing, all-understanding smile of the compassionate person who has seen humanity in all its vast vulnerable nakedness and still chooses to put it all aside, give of themselves, and care.

So imagine the shock when nurses discover that their greatest virtue is used against them by a clandestine, intemperate society with a monopoly on misplaced self-interest.

Imagine the shock when a caring person finds the duty of care goes only one way.

Imagine the shock when a nurse discovers that they are expected to break their back for people who won’t lift a finger to help themselves.

Imagine the shock when a nurse discovers that the culture of safety we so celebrate is in fact a crumbling ruin with little basis in fact.

What part of this is ‘the Authentic’?

Can belief and fact find in us a truth?

A Midwinter Morning Dream

It was not a bad dream, as far as dreams go.

At an old farm at my mother’s birthplace at Hernani, on a hairpin bend on a winding mountain road, stands the small old cottage of brown raw lumber flanked by the all-important frostbitten chimney.

I always imagine my mum as a small girl on this farm, standing stoic on the hill in the icy dawn, dress flapping in the wind, going about her traps to release the rabbits that would earn her the pittance that would fund her purchase of precious forever-loved books.

The cold mountain climate keeps the bracken fern thick and green down by the road where, almost obscured, first by the fact that it is so familiar, and second by the unkempt growth that surrounds it, stands a timeless old bus shelter with space for a huddle of just four small girls.

Beside it stands a memorial to Mary MacKillop, saint.

Just over the hill on former farming property, the roofs of industrial sheds have hastily grown at the first whiff of opportunity.

The sounds of timber mill saws can be heard drowning out the bellbirds, with their classic chime-like call.

It is familiar territory because I have dreamt of this place before.

What was strange for me was that the dream, so real, seemed so subconsciously linked to a problem I was grappling with, the problem of Authenticity.

In it there was a tribute to learning; the bus stop, quaint as it was, offering protection with the hope that know­ledge would keep me safe.

The little altar, covered with moss, showed a saint in her humility, with the words We are but trespassers here etched underneath.

On the kerb was a new addition to the topography of my dream, the fire bell, gleaming, polished but, until that moment, unobserved.

I remember being glad that the warning system was right outside this house.

A few cars rushed close past on their way to the industrial estate, becoming airborne as they topped the crest on the gravel road, and that was it.

I woke up to a grey cat sleeping on my feet, a winter dawn sun peeping through the east window of the Chateau du Bunyip and the yodel of a magpie reminding me of its desire for breakfast.

The warning bell was the part of the dream that puzzled me.

In my dream, it was so perfectly in focus.

I wondered what role it was meant to