I was interested to read in the issue of The Times dated Thursday 21st April 2011 a letter from Frances Garrood, entitled “Too Posh to Wash” offering a perspective of the problems besetting nursing and the nursing profession at the present time from one who qualified when health care delivery and care in hospital were very different from what they are now. Being of an equivalent generation I can certainly see where she is coming from. In today’s issue of the same publication there are some interesting, if predictable, responses – some generally supportive of her opinion, others not.
Certainly, today’s nurse is a very different professional to the one she or he once was. Whether she is a “better” or “worse” nurse really depends on your expectations and understanding of just what it is that a nurse does. It may be that the changes have come about as medicine and surgery have become vastly more technical – more science than art. Procedures that are not judged to be “evidence based” are frowned upon and have very largely been displaced. Measurable outcomes are favoured over those, such as simple kindness and courtesy, which are not readily amenable to quantifying on this scale or that. Results pertaining to populations are judged more important than those in individuals.
I would agree with Frances Garrood that past striving towards an all graduate profession is not really what matters. Indeed, it is not so very long since it was perfectly legal to practise as a doctor without having a university degree. My understanding is that there were two routes enabling aspiring medical practitioners to do so. One was through obtaining the Licentiate in Medicine and Surgery of the Society of Apothecaries (LMSSA) and the other through obtaining membership of the Royal College of Surgeons and a Licentiate of the Royal College of Physicians (MRCS LRCP) and several of my peers at medical school in the 1960 qualified as doctors in exactly that way. Only last year I met a general practitioner whom I judged to be perfectly sound in his work whose only medical qualification was with the Society of Apothecaries.
The fact that nurses today are more health technicians than people whose first priority was in promoting the comfort, cleanliness and dignity of bedridden patients might not necessarily be a bad thing. What is bad is the lack of compassion, respect and basic good manners that is displayed in all areas of the National Health Service today. Most of what goes on is, of course, exemplary. But I would agree entirely with Ms Garrood on one premise: like her, I have never met anyone who doesn’t have a horror story of a stay in hospital. The respondent in today’s Times who informs her that “now she has met one” is either deaf or severely blinkered. Or otherwise motivated into making such a very surprising statement.
Thank you for drawing attention to my letter. The most indignant respondent today rather missed my point. I never said that having a degree meant that you necesarily lacked compassion; rather that many who would be good, compassionate candidates are not motivated (or qulified) to take degrees.
ReplyDeleteIn fact, in my day, nursing could be pretty technical, and without all the labour-saving devices avaible now. I remember being in charge of a cardio-thoracic surgical ward at night as a student nurse, where each patient had two IV infusions, each going at a different rate, and each having to have the drips counted and adjusted every 15 minutes. Now there are machines to do this. As a sister in the seventies, I had patients on my medical ward who were on peritoneal dyalisis every night, and their care had to be fitted in with the care of less sick patients. But we managed.
Only this week, my handicapped, wheelchair-bound sister was admitted for observation with a broken ankle. Because she was "only" under obervation and not officially an in-patient, she wasn't given proper meals - just sandwiches - and no top sheet; just a blanket to cover her. When she had an accident trying to get on to the commode, the nurse picked up her wet knickers and left them on the bed.
That nurse probably had a degree. Not much consolation, really.
PS In case you wonder, I may not have a degree but I can spell dialysis. I just can't type! Oh - and I forgot to mention that my sister was in hospital for two days (without the sheet and the meals).
ReplyDeleteSo glad you have posted again Author Doc!
ReplyDeleteUnable to view Frances's letter I can only offer a view based on my own experiences. As a patient myself some years ago - the burning memory is of a nurse who promised he would come back (after seeing me seriously distressed) and didn't do so. I did see him look (as a passing glance) through my side room window as he went of shift.
I saw my mother's needs being ignored (a dementia sufferer) while hospitalised and the horror I felt when her primary nurse told me pressure damage could only occur on the heel of a foot - I had informed her that my mother was prone to pressure damage on the side of her feet.
In both instances and for purely other reasons I laid an official complaint - this included doctors - and was just fobbed off.
Although I agree with Frances that the heart has disappeared form nursing to some degree and I would certainly include impersonal doctors - the nurses were 'too old' to be degree nurses.
I would direct you to Http://pyjamasinbananas.blogspot.com - a doctors blog - which really says it all. Go through his/her posts and find that he is excluded from wandering the corridors of admin.
Of course low staff moral does not excuse bad practice - but it certainly contributes towards it.
Anna :o]