“The Language of Kindness”: on being a nurse

Cushla McKinney

After twenty years as a nurse in the British National Health Service (NHS), Christie Watson is leaving medicine to pursue a literary career. But with the generosity that characterises the job to which she has devoted much of her life, she has taken the time to share what it has taught her.

In The Language of Kindness: A Nurse’s Story of Life, Death and Hope, which falls somewhere between memoir and manifesto, she offers readers insights into an essential but undervalued profession and provides a blunt assessment of the way in which decades of political decision-making have compromised the heath system in general, and nursing in particular.

Although she touches on nursing history and theories of practice, Watson relies primarily on her own experience to illustrate the values that define the profession: kindness, empathy, compassion, and the promotion of dignity in the face of illness that robs the patient of any and all privacy. What emerges is a picture of a vocation that falls somewhere between an art and a science, requiring skills that can only be learnt through doing.

A good nurse must be able to calculate complicated dosages on the fly and spot changes in a patient’s condition too subtle to be detected by mechanical monitors. She (and it is still primarily a female profession) must keep from her face the horror of cleaning an incontinent patient, spend time listening to or holding someone as they grieve despite a growing backlog of other tasks, know to keep a child still during a lumbar puncture, be able to translate scientific language into something a husband, parent or wife can understand, recognise when to dissuade doctors from unnecessary treatment and how to convince them intervention is necessary now. And do these things day after day regardless of whatever else is going on in her life.

It is a job that takes a heavy emotional and physical toll. Compassion fatigue, back injury, depression, PTSD and substance abuse are all too common side effects of days spent caring for others. The role can only be sustained by drawing on the altruistic impulse that draws nurses to the profession in the first place. Stresses are exacerbated by workforce and funding shortages that mean nurses are unable to provide properly for their patients. And although Watson does not say directly why she is leaving the profession, I suspect it is partly because she believes that changes such as the devolution of basic physical care to unqualified and lowly paid healthcare assistants, and the reliance on nurse-practitioners to fill the role of junior doctor (without the associated wage costs), have isolated  nursing from its nurturing core.

Despite its political messages, The Language of Kindness is also an intensely personal book, and one that celebrates compassion in all its forms. Watson shares the experience of observing her first birth and death, how treating hundreds of abused and neglected children spurred her to adopt her son, and what she learned from watching her own father being nursed through his final days of life. I was left with a deeper understanding of and appreciation for the work that nurses do. While New Zealand’s healthcare crisis is not yet at scale of that faced by the NHS, it is a timely reminder that society can be judged on how it treats its most vulnerable and those who care for them. It is a message we ignore at our own risk.

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Cushla McKinney is a research scientist at the University of Otago, Dunedin, New Zealand.

The Language of Kindness: A Nurse’s Story of Life, Death and Hope by Christie Watson is published by Penguin.

This review was first published in the Otago Daily Times.