the parable of the ED nurse

Bex Lawton tells a parable that may have some familiar echoes

Listen. One day, a nurse in the Emergency Department sees a number of children who have bumped their heads. Fallen off bikes and scooters or tripped over in the playground. All are brought into the hospital by their worried parents. But, after an initial assessment and observation, the nurse decides to send them home.

With each child, he tries to reassure the anxious parents that their children are safe. That they don’t need any further scans or treatment. They can have Calpol when they need it. And he has a ‘head injury’ advice leaflet he can give each of them, which includes a list of symptoms to look out for.

One mother was so fed up with waiting. Impatient to leave, she is halfway out the door muttering something about the cost of parking as the nurse tries to speak to her. The nurse waves the advice leaflet and shouts after her, but the mother ignores him. Later that night, when she sees the bruise on her son’s forehead developing, she takes her son back to hospital just as worried as she was before.

Another mother stayed to hear the nurse’s advice but was distracted by notifications on her phone. Reading a message from a WhatsApp group and then replying to a work email that just came through. So that later, when she sees her daughter’s bruise, she can’t remember what was said or where she put the leaflet. She stays up all night googling head injuries, panic-stricken.

Another hears the nurse’s advice and asks questions. But questions the authority of the nurse. What qualifies him to make these decisions? So what if he can quantify the number of hairs on her child’s head? She insists on seeing a neurosurgeon before discharge. And when she doesn’t get what she wants, books a private appointment, only to waste her money to hear the same thing. She can’t find peace.

Still another listens to the advice. Asks questions to make sure she’s understood. And allows herself to be reassured. Full of peace, she takes her child home and explains everything to her husband. When she sees her child’s bruise develop, she calls to mind the advice from the nurse. She refers to the written advice and re-reads and re-reads it.

In fact, she values the nurse’s advice so much that she goes on to share it with other parents, seeking reassurance. She posts on Mums’ Facebook groups and online forums. She decides to go back to university to do some further study. She becomes a nurse herself and goes on to specialise in family health promotion and runs local parenting courses. Translating the original leaflet into multiple languages, some might say she was able to re-share the advice she received that day, maybe thirty, sixty, or even a hundred times.

Bex Lawton is Head of Nurses and Midwives at CMF and works clinically as a Paediatric nurse