As a student nurse, Christie Watson was asked to give blood during an occupational health screening, in case of a needle-stick injury. After the phlebotomist tied a tourniquet around her arm, Christie soon found herself lying on the floor, with her legs up on the chair.
“You fainted dear,” said the phlebotomist. “Happens. Thought you might want to rethink your career.”
In the end, Watson enjoyed working for two decades in nursing, moving from mental health and paediatrics to neonatal, A&E and the intensive care unit. Amid it all, her queasiness around blood never left her.
“I find it really difficult to watch blood or gory scenes on TV, but if there’s a real life patient in front of you and suffering, your own concerns go out the window, bizarrely,” she says.
And in 21 years, Watson has seen suffering galore, but all prongs of humanity, too: compassion, hope, tenderness. She has laid bare her experiences in the startling memoir, The Language Of Kindness: A Nurse's Story. It's a highly emotional and eloquent retelling of different patients, staffers, experiences and departments, moving from Watson's first shocking moments on the wards to eventual compassion fatigue.
I do think it's about time we heard from a nurse
The book is the latest in a recent wave of compelling medical memoirs, among them Adam Key's This Is Going To Hurt, Rachel Clarke's Your Life In My Hands, Paul Kalanithi's When Breath Becomes Air, and Henry's Marsh's A Life In Brain Surgery.
“I’m really glad that so many of these books are out there, as I’ve loved this kind of narrative non-fiction for so long,” says Watson. “When I went to libraries though to do research, I couldn’t find a single book written by a nurse. That speaks volumes about gender, and speaks volumes about our value as nurses. I do think it’s about time we heard from a nurse.”
Rich seam to mine
Working at the coalface of the gossamer-fine line between life and death, Watson certainly has a rich seam to mine. At the behest of her mother, who worked with adults with disabilities, Watson started her career at 16 as a carer. She recounts that, as part of the job spec, she had to help elderly patients in very intimate situations, like urinating into bottles or putting a sheath-style bag on genitals: “I thought I had started at 17, but redrafting the book my mum told me that I was 16,” says Watson. “Looking back, it’s pretty shocking that I managed to deal with that. But at the time it just felt like someone needed help. Obviously, we’re living in different times; my daughter is 13, and I can’t even imagine her going to the post office on her own. Children are children for a lot longer.”
The moment where you're holding your breath, wondering if this baby will be okay – that's as close to death as you can get
On seeing her first dead body, and seeing a child born for the first time, Watson can still recall the visceral shocks she felt.
“Seeing a child born was very much the same as seeing a dead body for the first time,” admits Watson. “It was really shocking to me, especially seeing that the umbilical cord is blue. The moment where you’re holding your breath, wondering if this baby will be okay – that’s as close to death as you can get. To see the violence of it made me hold my breath.
"I never imagined what a dead body looked like, though in Ireland you have quite a cultural difference around seeing dead bodies," observes Watson. "Some of the best nurses I worked with were Irish. My mentor, who was Irish, was kind, matter-of-fact – a beautiful mix of all the things you need to be. I think there's a cultural difference between Irish and English nurses, but there's definitely a universality in the language of nursing."
Vivid detail
From her formative experiences, Watson evokes the topography of each arm of nursing in vivid detail.
“I started with mental health and while I know much has changed, it’s still a devastating thing as I don’t think mental health services have gone far enough to help people,” she observes. “I then worked in paediatric intensive care where the vast majority of children on the ward get better and go home. It’s devastating to see a child and help the family through that. You don’t ever recover from losing a child. It’s a hugely creative area of nursing. If a child dies, there are some things that aren’t uncommon, like getting a footprint done of the child, or having the child christened.
“Accident & Emergency always terrified me as it was so chaotic,” she adds. “The nurses there loved the unpredictability and the adrenaline, while the intensive care nurses are much more about controlling situations.”
As Watson moves from ward to ward in her book, she recalls a number of unforgettable patients. There’s Betty, recently bereaved, frail and admitted to A&E with chest pains. There’s baby Emmanuel, hovering near death and wrapped in a sandwich bag. There’s Gladys, elderly and vulnerable in a labyrinthine healthcare system. And there is Charlotte.
“Charlotte came in as a toddler and was suffering meningococcal sepsis, and was the sickest patient I ever looked after,” recalls Watson. “It took three of us to keep her alive for the night. She lost her legs to the infection, which is horrible but alas common. She came back in to visit us 18 months later, and was living a full life. I remember thinking in that moment, ‘this is a phenomenal job’. I found too that family never forgets the nurse.
“They don’t know the doctor who looked after their relative – and some of the doctors I’ve worked with have been truly brilliant, but they never forget the nurse who got them a glass of water, or displayed some small moment of kindness.”
Human voice
Above all, Watson offers a much-needed human voice to a story that the public knows all too well: an NHS that is stretched to its limits, and healthcare professionals who are worked to the bone.
“I think it’s harder now for a nurse than ever before,” says Watson. “The workload is harder than ever, there have been huge cuts, the population is ageing, so people are sicker and suffering more. I think there’s an existential fear today that leads some people to make different lifestyle choices. Nurses are working with fewer resources and their stress levels must be off the scale. When asked why they are leaving the profession, 44 per cent of respondents in a recent survey said it was because of the level of stress. That’s a ticking time bomb waiting to go off. And it’s not just about the NHS – this is happening internationally with all nurses. And it’s about to get so much worse.”
In the end, Watson succumbed to compassion fatigue and quit full-time nursing recently. A dream to be a full-time writer had long been in her peripheral vision. She gained her Masters' degree in creative writing from the University of East Anglia while working full-time (and being a mother to her toddler daughter). She published two novels, Tiny Sunbirds Far Away, which won the Costa First Novel Award in 2011, and Where Women are Kings in 2013. Now Watson writes full-time and teaches part-time at St Mary's University Hospital. She would like to get involved with policy-making, to "use this privileged platform to do some good in the world".
Juggling writing and nursing has been interesting to say the least: “I was doing a radio interview from the toilet, with a beeper in my pocket,” she recalls with a laugh. “I was praying that it wouldn’t go off, and no one else would flush.
You have to be prepared to give so much of yourself and have a great deal of empathy to be a good nurse – basically, to love people who are strangers
“I think the compassion fatigue had gone on for years,” she adds. “You have to be prepared to give so much of yourself and have a great deal of empathy to be a good nurse – basically, to love people who are strangers.
“I started to become emotionally numb to quite shocking events. There are some patients who break through that, and you realise that no, you’re not numb.
“A student nurse I’d worked with a couple of years ago got in touch recently, and she said, ‘I remember working with you. I was brand new, and crying a lot, and you were very kind to me.’ I think that’s a very common thing when you’re new to nursing, the crying. Maybe we should be crying ourselves, and alongside our patients, so much more.”
– Christie Watson’s The Language Of Kindness is out on May 3rd via Chatto & Windus (€14.99, paperback).
