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Nursing

A&E Covid 19 Story Week 10

Covid-19 and BAME Inequality.

Previously, I have talked about the gender inequalities that wearing scrubs has exposed within the healthcare system. This weeks post there will be a wider focus on Covid-19 and BAME inequality. 

Recently, the murder of George Floyd, a 47 year old Black man, has been brought to the attention of the public eye. Footage has been shared of the (now charged) police officer kneeling on George’s neck. This happened for 9 minutes, whilst he begged for his life and can be heard saying “I can’t breathe”. This event lead to the murder of the 47 year old. This tragic death is an unforgivable casualty of police brutality and systematic racism.

A Subject People Find Difficult to Address

Firstly, it is undoubtably a difficult subject to address. It is extremely important to talk about, regardless of how uncomfortable it may be. Secondly, its important to address the leading voices on the matter Alicia Garza, Patrisse Cullors and Opal Tometi (Founders of the Black Lives Matter movement). Finally, I can only speak from my own expertise and experiences. Therefore, I wanted to make this next post about something I am very familiar with. Concluding this, this post will be (as you might have guessed) about Covid 19!

Covid-19 and BAME Britons

This week I would like to talk about how BAME Britons have a disproportionate mortality rate from this virus. This is twice the risk of death according to the ONS. This is a health inequality that needs addressing.

Whilst we are in the middle of the pandemic with a virus that has many victims (including young and usually health people) many people seem to think its unimportant to focus on specifics such as who is more affected. However, as the affects of the virus have unrolled across the UK, it has become ever more pressingly apparent that people from ethnic minority backgrounds are disproportionately dying from the Corona Virus. Out of the 200 health workers who have died in the UK from Covid 19, 60% of the people were BAME.

It has never been more important to collect, study and distribute the findings from a health crisis. To look into who is disproportionately affected by it and what we can do to minimise this public health inequality. In summary It is not ok to place unequal value on the lives that have been lost during this pandemic and its time we addressed it. 

On the 10th May there were calls for a public enquiry into this issue. 70 public figures (including London Mayor Sadiq Khan) signed a letter to the Prime Minister demanding transparency into this matter. Public Inquiry’s are important for safety, education and can lay foundations for future policy makers and research. An inquiry could help employers make appropriate allocation decisions based upon risk assessments increased safety for staff.

Risk assessment for BAME NHS staff

Gal-dem.com outlines excellently why there is a need for an independent public inquiry into this.

Moving on from the public inquiry, here are other recent and relevant pieces of news.

Firstly the first news story I will mention is, The tragic death of Belly Mujinga. A woman who lost her life 2 weeks after being spat on by a man claiming he had the Corona Virus whilst working her essential role at London Victoria station. 

Additionally, The tragic death of Trevor Belle a 61 year old taxi driver who died 3 weeks after being spat at by one of his passengers.

What you can do

Firstly, for people living in London who want to support communities in the capital.

Similarly, for people who want to volunteer:

Moreover, if you can donate money to support memorial services for BAME families, bereaved because of Covid-19

Additionally, if you can sign a petition supporting a public inquiry into BAME loss of life to Covid:

Categories
Nursing

Scrubs and Inequality: A&E Covid 19 Story Week 8

Week 8: Scrubs and the Inequality Beneath

Today I am going to address something that has come to light due to Covid 19 which I believe deserves addressing, scrubs and inequality.

If you ask people who work in healthcare if they enjoy wearing scrubs, the majority of nurses (myself included) would say they prefer scrubs to the usual uniform as they are far comfier. Historically people adopted scrubs as they began to realise the importance of a clean surgical environment. Since then, in England it is my understanding that most nurses wear a uniform. The exception to this would be surgical/recovery nurses and nurses in some emergency departments. However, due to the Covid 19 pandemic most staff members who work in hospitals are now wearing scrubs. This is for infection prevention and control reasons – to prevent staff members bringing the harmful virus particles home and on public transport on their clothes. 

Pre-Covid-19

In a time before Covid, nurses, physios, health care assistants, domestics and porters wore a uniform whilst doctors seemed to be the exception to this rule. It seems doctors had the choice between wearing their own (smart) clothes or scrubs. This means doctors wear suits/dresses or ‘professional’ clothes whilst working on a ward, despite having contact with bodily fluids.

Whilst there is the argument there to say that doctors are involved in less direct patient contact than the nurses; it does not explain why it is suitable for a doctor to do a rectal exam in a suit with a thin plastic apron on whilst the nurses who hold clinics or research studies are still required to wear a uniform.

Guidelines

The Department of Health published guidelines known as the ‘bare below the elbow’ guidance. It also outlines the three objectives when it comes to what health care professionals should wear. To summarise these are: Patient safety (ie infection prevention and control), Public confidence (clean/professional workwear) and Staff comfort (I.e., cultural practises). Reviewing this guidance, I cannot see any reason there should be differences between what doctors and nurses should wear whilst at work. 

Now I may be mistaken here, but I believe the contradictions present in these rules date back to a time, pre Florence Nightingale. A time when doctors were the Professional staff members who held a degree and nursing was an uneducated profession. Hippocrates who is widely regarded as the father of western medicine, claimed doctors should be “clean in person [and] well dressed”.

I believe that due to nursing being a ‘pink collar’ job i.e. a profession held mostly by females (89% in the UK) there is a long withstanding lack of respect and recognition for the level of education and professionalism required nowadays in the nursing profession. 

Hierarchy

Sadly, there is a very intense hierarchy present in healthcare. Anyone who doesn’t work in healthcare probably couldn’t grasp just how tangible that hierarchy feels sometimes. I have seen some people disregard people in job positions such as health care assistants, domestics and student nurses. I was actively terrified of doctors when I was a student nurse which I now realise was ridiculous. Obviously, most organised workforces involve a hierarchical structure. However, this is a problem when it means people feel that they are less important than others. I find uniforms to be an important reflection of hierarchy. 

What about now?

Nowadays, an RN requires a Bachelors degree. Additionally, nurses register to a professional body, the NMC. The discipline of nursing also encompasses many advanced roles such as Advanced Nurse Practitioner’s and specialities i.e. Heart Failure Nurse. Many of these professionals take an active roles in the Medical team. They often prescribe, advise and consult – skills attributed historically solely to doctors. Many nurses also take on a senior roles in the hospital and community settings as matrons, managers and coordinators etc. So, yes it did raise a bone of contention when I saw an Advanced Nurse Practitioner wearing a uniform whilst the doctor holding the same clinic in the room next door did not. This prompted me to write this post – scrubs and inequality.

Going back to the present day, everyone, despite their role is wearing scrubs. Whilst this is more confusing and this practice will not last, I think we can all learn a lesson from this. Nurses and Doctors deserve equality in their uniform or non uniform policies. 

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Nursing Self Care

Mental Health Support for Healthcare Workers

Mental health support for healthcare workers:

As always, follow the NHS advice on where to find urgent support if you are experiencing a mental health crisis.

If you work for the NHS and are currently, understandably experiencing more stress, struggling and feel like you need support, here is a list of resources for mental health support for healthcare workers I have compiled in an easy-to-access format. This list is by no means exhaustive and can be used by anyone. As health care workers, it is really important to look after yourself first in these challenging times, as I’m sure we’ve all heard the phrase: ‘you won’t be able to look after others if you don’t look after yourself first’. I hope this list helps.

Mental health support for healthcare workers: Resources and Contacts

If you prefer to phone

0300 131 7000 is a confidential staff support line from Samaritans for NHS staff. (Open between 07:00-23:00 everyday).

If you prefer to text

Text FRONTLINE to 85258 for 24/7 text support

If you prefer to read

Similarly, there is a selection of NHS guides to be found here covering useful topics such as an ABC guide to Resilience, Personal Resilience and creating a ten minute pause space (a place to reset and recharge).

Websites

Able Futures is a useful signposting website if you feel anxiety relating to work or think anxiety is affecting your work. It offers free support to employees (in Great Britain) on behalf of the department for work and pensions.

Their free number to call is 0800 321 3137

They also have a number of helpful pages on their website dealing specifically with topics such as Stress, Anxiety, Depression, Mental Wellbeing and Sleep.

Coping Methods

Mental health charity Mind has specific strategies you can follow to help you manage difficult symptoms you might be experiencing.

Mental health support for healthcare workers