Lance the Boil


Fear and trepidation rose within my teenage frame, and I quaked as I tried to smile a welcome at the most powerful person I knew. I eventually mustered the strength to smile and say: “Good morning!” as if I meant it.

Matron responded to my salutation graciously, and then wondered aloud if I could help her. Nothing seemed less likely – and I gestured to the empty space around me where so many staff had been just a few seconds ago.

“There are doctors and Sisters here!” I protested to no avail.

I felt very exposed – like a rabbit in the headlights, as she bore down on me – the last member of staff visible on this Tuesday morning. I was rooted to the spot. With the magical disappearance of all trained personnel, I stood in A&E with Matron, apparently alone. As a second year Nurse, my antennae had obviously not been fully in tune.

It had been a quiet start to the morning in A&E, and I had been ruminating on the pleasant events of the night before and daydreaming. This meant that I had been slightly distracted – and I was caught unawares.

And now she wanted me to deal with her problem.

Xxxxx

“I have a boil on my hand, Nurse,” she informed me, “And I would like you to lance it.”

Time stood still. I had never lanced a boil before – I had seen it done, and I understood the principle – but to attack my Matron with a scalpel was unthinkable.

Again, I remonstrated. “There are people around,” I said, stalling hopelessly, regarding the void of human activity with disbelief. Such was the effect of the power that a Matron wielded.

“I’m sure you would be better with someone more senior,” I tried again – not wanting to admit that I really had no idea what I was doing.

“You don’t understand, do you, Nurse?” She put the question kindly. “I am training you – I need to know that you are competent before I send you out into the world.”

Casting one last, despairing look at the vacant surroundings – realisation dawned: I would have to bite this bullet.

Quickly, I cleaned and set up the trolley with swabs, antiseptic, scalpel, and dressings.

I cleaned her skin, and then I said to her, almost unbelievably: “This will just hurt for a second…” as I had heard my seniors say.  The offending boil was pierced. Then I expressed the pus, cleaned the wound and dressed it.

She thanked me profoundly, congratulated me, and said it had been virtually painless.

Amazed at my achievement, I watched as she strode silently away. She carried with her all the confidence of rank. I wondered at her bravery.  To put herself in the care of someone so junior simply to evaluate the training was extremely courageous.

But no doubt she left with an impression of her student nurses. I hope it was of competence and caring. And it empowered me – it gave me confidence. If I could deal with a Matron, I could cope with anything.

And I wonder, as I see the managers of hospitals increase – both in number and remoteness – whether they would ever consider this. They could probably manage to do it incognito. But I don’t suppose competence or caring is among their vast array of targets. They don’t see that by tackling these two issues, the results would follow.

Maybe someone is needed to lance the “Target Boil” – and let the managers see that it is competent practice and practical caring, combined with dignity and respect, that will bring results that they seek.

No-one who trained in my time placed any credit in the notion that you could treat the Health Service as a business. We also believed that when it was shown not to work, that the mistake would be recognised and we could revert to tried and trusted standards.

We did not believe that a system which was so patently not fit for purpose would be pursued relentlessly, ad infinitum – and with a determination which is laughable.

The target boil was not lanced. Instead more targets were introduced. Now we have so many targets that they are conflicting.

The target boil has caused septicaemia – and the patient is now very ill.

With the root of the problem neglected, it is doubtful if the Health Service can fully recover.

© Linda Jane McLean

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One thought on “Lance the Boil

  1. Linda

    I like your story and analogy. It captures nicely some of the dilemas of the NHS. I think you were lucky to have a Matron with such good leadership skills. I too was fortunate to work for 3 or 4 really good leaders in my civil service career – and trie dto emmulate them in my own leadership roles.

    I have been a Non Executive Director with a large Primary Care Trust for a couple of years. Earlier this month I resigned to become a NED with a newly formed Community Health Trust to move closer to the real issues of patient / client care – and took a 30% pay cut in the process.

    Part of the problem is the one you identify of the remoteness of DH / SHA decision makers but that is far from the whole story. I would add the role of professional leaderships and of public expectations. I am sure you will have suffered at the hands of professional arrogance in different roles. The heart of the matter for me is about a mismatch between public expectations of the NHS and the resources actually available, Its not confined to the UK.

    Something I witnessed yesterday was relevant (though not in the NHS). I arrived at the supermarket just on opening time 8 am. They were a bit late opening about 8 minutes and several people wnet in demanding a “public apology” and financial compensation for being kept waiting. If this is characteristic of how society is developing then the NHS cannot win. But I know the reality is that most patients and clients greatly value and appreciate the care and support they get from front line staff.

    Many Regards

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