Shaun Watson

Shaun Watson has worked as a qualified nurse in England since 1989, mostly in terminal and palliative care and HIV. His passion is for death and dying, sex and sexuality – the taboo subjects that traditionally we find difficult to talk about. This is his story...

I trained in Hull and moved to London in 1997. I have managed wards in a generic hospice and a specialist HIV unit and taught general nurse and HIV modules at three London universities. I have been a community HIV specialist nurse since 2005, managing people with complex HIV in their homes.

My family lived in a village and I thought about joining the police. But at a “careers” event at school, I was told to look at nursing and I volunteered at a hospital. Although I had dull tasks, such as making tea, I enjoyed talking to patients about their lives. I did a pre-nursing course and then studied at Hull District School of Nursing. I had an interest in terminal care, having lost my grandparents and father within seven years.

I can pinpoint the start of my interest in HIV to a lecture in nursing school about AIDS. The lecturer did a session about safer sex, which bordered on homophobia. I became a volunteer at an HIV charity and joined its counselling team. At this time, I knew I was gay, and I devoured anything about being gay; most, unfortunately, was around HIV and AIDS, which was not the most positive coming-out experience.

For me, basic nursing hasn’t changed. We have more administration and pressures, but day-to-day care and support and our interaction with people who are ill and their families is the same. Systems have changed and seem to be less supportive. In the 1990s, you would never discharge a patient until services at their home were set up for a safe discharge. Now, there is pressure to move patients as soon as possible.

My proudest moment was becoming a ward manager in a hospice. It was my first management role: I liked to think that I could shape nursing by recognizing that caring for the same patient every day could be tiring, allowing nurses to choose who they cared for, giving them a break and focusing on the family and how we supported them.

My biggest challenge is fighting for nurses to be who they want to be as “nurses”. I don’t have a degree … I do have 30 years of experience, and this has been a battle to develop as I want to develop, not as my manager feels I should. The pressure to grow through academia is immense, but does not suit all nurses. Some of the best nurses are those who learned from their history, patients and work, those who can reflect and support nurses from their own experience, not through a textbook. I learned from observing good and bad managers; you cannot teach a nurse to be a “good” listener, empathetic, to comfort and support, to effectively break bad news.

I have been redeployed to the COVID-19 frontline. In my hospital, most redeployed nurses were from sexual health and HIV. One is working there full time, some flourished, and some despised every shift. I was in the middle: scared but skilled. I see a similarity to what we do now in HIV. We had to adapt the way we worked with HIV over the years.

The world is a strange, alien place. I have half an eye on making sure that my patients are supported and safe and the other on my emails, awaiting redeployment. It is quieter now, but there is still the fear that long days and nights in critical care are around the corner. I feel that I need more balance. My flat is on the market and I’m looking for a place nearer the coast to enjoy my days off more. I still feel unmotivated, distracted and anxious.

I hope that I will see nurses being the future of HIV care and the COVID-19 response. We are leading HIV clinics, prescribing medications and dealing with complex care coordination issues. We have proven our worth, flexibility, adaptability and resilience. I hope that nurses can see their power and remain strong.