Reflecting on the meaning of true nursing quality

Abstract

It is not uncommon to look back over our lives and recognise the important roles various people may have played. As part of my nurse education I had several work placements across the county to gain valuable nursing experience and a critical element to my learning. During that time I came into contact with nurses of varying levels of ability and grades. Two nurses have had a significant impact on me as I felt they demonstrated the polar opposites of what I perceived to be nursing qualities. Spouse (1996) argues that the most important feature of a work placement is the quality of the student–mentor relationship, a viewpoint with which I heartily agree. One of the first mentors during my nursing education quickly made me feel disillusioned and dissatisfied due to his poor attendance, unprofessional attitude and low application to work duties. His consistently vocal negativity towards mental health nursing had a depressing and demoralising effect upon me, particularly as I had only just taken my first steps into the world of nursing. Darling (1985) describes those mentors who abdicate their responsibility as ‘dumpers’. She referred to these mentors with whom we have negative relationships as ‘toxic mentors’ due to the detrimental effect they have on the mentee. I did not wish to be viewed negatively or to cause conflict with my mentor and therefore felt unable to voice my concerns either with the mentor or the team manager; unfortunately during this period my guidance tutor was absent on sick leave. With hindsight I managed the situation poorly by avoiding what I perceived as potential conflict rather than dealing with the issue proactively. Similarly to most nursing students I took action after completing the placement (Gray and Smith, 2000). Since this was not my first mentoring experience, I was left with a bitter after taste about the ethics and standards within mental health nursing and questioned whether I had made the right career choice. Pearcy and Elliott (2004) found that traumatic placement experiences have been cited as one of the reasons given by students for noncompletion of pre-registration courses. The second nurse was a team manager of a community mental health team. I had previous knowledge of the team and admired the strength of the team’s ethos of inclusiveness. I observed with interest the interaction between the team manager, his staff and service users. He was unstinting in his compassion, care and warmth towards others with an expert knowledge of his field. He showed a genuine interest in the person, whether it was a team member or service user. As a consequence he appeared to inspire the affection, admiration and respect of those around him. I reflected upon his qualities and skills with the aim of understanding what I could learn and take away from my observations to integrate into my own nursing practice. The team manager held a small caseload but due to the nature of the team remained familiar with all service users. He continually went beyond the call of duty, resulting in his nomination by service users for a local trust award. Daily morning meetings were held where open communication was encouraged with each member of staff, students included, able to voice an opinion without fear of criticism. This increased a feeling of being valued, where every person’s opinion counted. Being valued was further emphasised by the team manager giving praise, either publicly during a team meeting or privately on a one-to-one basis. I have observed the positive effect this had on staff. Doran et al (2004) contend the provision of support, encouragement and constructive feedback, taking a genuine and considerate interest in staff are instrumental in increasing cooperation and teamwork. Emotional intelligence demands selfawareness and an ability to be warm and empathetic within interpersonal relationships (Hurley, 2008). While admiring the team manager’s qualities and skills, human beings are unique and complex, and therefore individual. While I recognise the importance of how he manages situations, staff and service users, I need to ensure that I remain genuine and ‘true’ to myself, adapting my personal style rather than attempting to produce a carbon copy. Hurley (2008) outlines the importance of the use of ‘authentic self ’ within interpersonal relationships, necessitating congruence between actions, verbal and non-verbal communication. Taylor (2010) remarks on the ‘ordinariness’ of the nurse–patient relationship and the connectedness of being human. By ‘living authentically—of not living outside myself behind a veneer or a mask’ (Taylor, 2010) the connections of being human can enhance the quality of the providing and receiving of care, the holistic underpinnings to nursing practice. BJN