Nurses & Midwives thoughts on the NMC diversity update

[Al1Langdownthecleghole]

From this mornings email update.
The Code
[The NMC Code requires nurses, midwives and nursing associates to prioritise people, to treat them fairly and without discrimination and to challenge any discriminatory attitudes and behaviours towards those receiving care. Those responsibilities endure beyond this emergency and can have a positive impact to help turn the tide on the inequalities highlighted so starkly by the impact of Covid-19.^

The Code states clearly the principles of treating people with kindness, fairness and without discrimination, bullying or harassment. These principles are exactly how we expect those on our register to be treated by others. No one should suffer discrimination as part of their job.

It seems to have been prompted by Black Lives Matters, but the wording “ to prioritise people, to treat them fairly and without discrimination and to challenge any discriminatory attitudes and behaviours towards those receiving care” seems to me to be open to interpretation. I hope treating people fairly applies to women who want single sex wards & facilities and who wish to be confident that when they request a female health professional it will be a biological woman and not a self-identifying one.

One to watch.

What does 'prioritise people' even mean?

Prioritise people over what? Cats?

It's been part of the code for ages to 'prioritise people'. It just means that we need to put people in our care at the forefront of our minds when we treat them, rather than simply doing what we've always done.

That makes sense. Unclear wording, though.

We often talk about how obstetrics and midwifery should be women centered. It often isn't. I wonder how long it will be before we can't say women centered.

I wouldn’t hold your breath, they also say:

These issues are not political, they are about humanity and they are about human rights. The Black Lives Matter movement reminds us all how urgently change is needed, making us acutely aware of how long these inequalities have existed with little change. We all have the right to live our lives without fear of discrimination based on the colour of our skin, who we love, our religion or faith, whether we have a disability, our age, gender or any aspect of our background or who we are.

They mention gender but not sex.

I'm a midwife in Canada but likely returning to the UK soon. Midwifery here is ultra-woke and has been completely overtaken by gender identity ideology. We don't speak about women at all here. I find it laughable and sad.

I now see the UK maternity services going the same direction to an extent. There is more focus on inclusion in some of the more "progressive" midwifery journals. There was a big article on trans inclusive care recently in one of them. I also see a lot of wokeism amongst younger student midwives on Instagram. However even when I have seen references to birthing people it's always been "women and birthing people", which is a bit silly but doesn't bother me as long as the primary language remains woman centred. I am concerned, but I suspect the UK is not going to go full-blown barmy on this topic. In North America midwifery is more niche and populated by SJW types, while in the UK it is mainstream. That changes the dynamic within the profession. Lesley Page is a very prominent UK midwife who did a presentation in Canada a few years ago. They asked her to change the language to remove references to women and she refused. The presentation went ahead

This worries me. When I qualified back in the dark ages there was a greater emphasis on advocacy in the shorter code. Yet we can't advocate for women if we can't name them.

I'm also concerned that the wording could be used to prevent nurses and midwives from speaking out, which doesn't bode well for anyone's care.

A further issue is when Nurses are not in agreement with a treatment regime for say a teen with ROGD, are they going end able to speak up - as would have been mandatory under previous COCs - or will that be classed as "discriminatory" too?

I'm very worried.

Nurses here. It doesn't seem particularly inflammatory to me ... prioritise your patients, ensure that good patient care is at the forefront of everything you do. That's what I do all day long in work.

I don't care what sex/gender you are or identify as. You're a person who requires some form of medical assistance from me - which I will provide to the best of my ability. That's my job 🤷‍♀️

It's going to be difficult to manage to prioritise patients though Shop when their placement on a ward causes conflict.

For example, If a man (who thinks he is/feels like a woman) wants to be placed on an all-female ward you will need to respect that request but by doing so you will be 'de-prioritising' that same respect you have for the women who are already there receiving treatment who don't want him there. Some might not mind but even if one does you have two patients, both are a priority, both need treatment and should be treated equally and fairly.

Wouldn't this situation force you to care about someone's sexuality and gender identity?

I'm not saying you wouldn't provide excellent care to both and not having a go, I'm just giving an example of where it is going to be a conflict and your job will be to manage it somehow.

What would happen?

I've just looked up the Canadian Midwives website - 'birthing people' 'birthing parent' 'pregnant people' WTAAAAAAF! (scuse my language). At least they still use the word breastfeeding..... and the 'M' word (mother) does make a sneaky appearance in there - oops - I'm sure they will sort that out soon though. I can't imagine how miserable it must be working in midwifery with the thought police on your back all the time....

I used to be a nurse, and I find it utterly repugnant that any nurse would prioritise their desire for validation of their ‘gender identity’ over the care and respect their patients need and deserve.

Any trans woman who insisted on their right to perform intimate care or examinations on women, with no care for the potential distress they’d cause would have proved without a shadow of a doubt, that they were AGP and definitely male- because I cannot imagine a female healthcare professional putting their own feelings and validation above the needs of the patient.

@OhHolyJesus that's a fair enough point, don't think you're having a pop :)

I work in A&E so for me it's all cubicles where gender and age and actual problem is neither here nor there! I know that broadly our hospital's policy is that those who are actively transitioning are placed in side rooms. This seems practical and solves many problems for us :) Saying that we are a fairly new hospital and are fortunate enough to have (comparatively) a lot of side rooms around the hospital

Thanks for that Shop, A&E is different as it's mixed and quite rightly so. The hospital building is a key point though, for mixed sex toilets and side rooms are important in the issue of Self ID.

In older hospitals which were not designed with any flexibility in mind there are possible problems and I know several NHS trusts were/are still applying Self ID and not following the EA2010.

It's the staff dealing with this I feel sorry for as is ultimately being managed on a day-to-day basis with little or no support or guidance from govt. Maybe more will become clear at the end of this month.

gardenbird48 we are still allowed to talk about breastfeeding my some miracle, though in official written materials it is often followed by /chestfeeding. I came across a new word via a ridiculous woke doula on Instagram the other day. Bodyfeeding. The word makes me shudder.

It's kind of meaningless, at best though, isn't it? Prioritise patients - ok. But in this context what does that mean? How do they want patients prioritised in relation to gender or race? What's happening that seems to be a problem?

@PhoenixBuchanan What do you mean when you say midwifery is niche in North America? Is it common to give birth without professional help?

@BlackForestCake I think Phoenix probably means midwife-led care is sort of a fringe choice in USA - seen as less safe and less desirable than the very medicalised model of care from an ob/gyn (who would be a doctor by training). In the UK midwife-led care is the default for healthy mums having uncomplicated singleton pregnancies.

Yes, in much of the US and Canada midwives are only available privatly, and you have to pay out of pocket. In maternity hospitals you are cared for by nurses.

Even in my province, although there are a few midwives available through health services, there are only about 10 for the whole of the province! They care for women who specifically ask for a midwife birth, at home or in a special part of the hospital - no doctor unless an emergency crops up so you can't for example have an epidural. It tends to appeal to women who are interested in natural birth.

And the American OB organisation says midwives are dangerous.Mind you it tends not to be regulated well there.

@Lougle

It's been part of the code for ages to 'prioritise people'. It just means that we need to put people in our care at the forefront of our minds when we treat them, rather than simply doing what we've always done.

I still don't understand, what on earth have you always done that didn't have the patient at the forefront?

For example, If a man (who thinks he is/feels like a woman) wants to be placed on an all-female ward you will need to respect that request but by doing so you will be 'de-prioritising' that same respect you have for the women who are already there receiving treatment who don't want him there. Some might not mind but even if one does you have two patients, both are a priority, both need treatment and should be treated equally and fairly.

Wouldn't this situation force you to care about someone's sexuality and gender identity?
Why should it? Their identity is irrelevant on a single sex ward. Their sexuality (which is a completely different matter) is also irrelevant??

Apologies @Thisismytimetoshine

I've only just noticed that I wrote sexuality and not sex in my earlier post. Thanks for pointing that out!

Gender identity should be irrelevant but when hospitals apply self ID as their policy for placing patients in wards it's not sadly.

To clarify, I realise that sexual orientation is irrelevant and I will check my posts before posting !