Friday, 2 December 2011

What Ever Happened to Nurses Who Care?

Recently I had to go into hospital for an operation and I was scared both of the op and how incapacitated I might feel. It didn’t bode well when the standard  doll sized paper knickers squeezed over  one buttock before tearing, accompanied by a one size fits all theatre gown with two tapes, one at the neck and the other at the waist. Nice! Fortunately I had a dressing gown but one poor man had to walk about the ward clutching his theatre gown together at the back saving the rest of us from having to bare witness to a white bum.
Generally I look after my own physical needs, except when lying flat and confined to bed for four hours.   Being restricted postoperatively meant I had not been to the loo for six hours, a record for me. I didn’t ask for a bedpan and it wasn’t offered, indeed the nurses seemed to avoid the whole issue. It’s so frustrating to feel helpless especially when no one came to remove the blood soaked sheets or change the very uncomfortable theatre gown. I was glad to see my husband at visiting so that he could help me scramble into my pyjamas and move the disgustingly uncomfortable bed linen.
After the op , I requested a drink from one of the nurses’ who appeared to glide backward and forward on rail tracks with no detour. A weakly raised arm brought some rushed intervention and some tea. They were friendly enough but the time given seemed hurried and scanty, inviting guilt on my part for being a bother. It’s been said once your in hospital you cease to be a human being –as a patient you become a no-body. It’s as if you don’t exist.  Nurses seem to look ahead like marching soldiers focused on some invisible goal.
Patients are vulnerable, dependant upon others for our safety, well being and general care but these days we cannot rely upon it being consistent.  What is the problem with today’s health service? Why do we have to listen to all the bad news, complaints and poor management of our hospitals, spouted by the media? Indeed, why has nothing been done about it yet? We have a right to expect high standards of nursing and medical care don’t we? Sadly in part that is not happening. Training appears puny in the basics of practical and emotional care. There seems to be no system in place for TLC and definitely a grave reluctance to deal with feeding and toileting where needs must in many hospitals. How can we blame nurses for this, surely it is structure that is at fault?
Now it’s time to say, In my day As a qualified nurse I worked on the wards and in the community for over twenty years. How things have changed, we must make way for progress but is it always good? For instants, is it necessary to have so many staff nurses on the wards, where are the hands-on nurses, those who are trained in basic nursing care? Perhaps today’s nurses have not served a sufficient apprenticeship on the wards. Limited training in the practicalities, insufficient time doing the daily grind in ward work, these things cannot be learned in the classroom, feeding the elderly and incapacitated, taking them to the toilet, anticipating needs. What happened to daily bed baths for poorly patients? My mother of ninety four was in for six weeks and did not have a bed bath or hair wash in that time unless I did it, the family spent time feeding and pushing fluids because the nurses did not.
I completed my nurse training in the late seventies, first a State Enrolled Nurse then a State Registered followed by Health Visiting. There was a code of conduct. ‘Never see a patient as a condition or bed number, always as an individual. Each person must be treated with dignity and respect. Put yourself into the shoes of the patient and treat them as you would want to be treated’. This philosophy was drummed into us like a mantra and it wasn’t always easy.
Student nurses served an apprenticeship by helping and observing, mentored by more senior nurses, learning on the wards about the medical and surgical conditions and treatment. With weekly nurse training school throughout, we moved from department to department. Trained to anticipate patients needs not wait for them to be crying out in pain, or in need of a toilet, or desperate for a drink of water or food.
There is certain kudos in the idea of being a degree nurse. Perhaps modern medicine requires more academic training? I can see that today our young nurses seek degrees like we strived for our staff nurse’s belt. But has the plot been lost, do we need four or more staff nurses on each ward? It’s like having four bosses and no workmen in a factory. What happened to the basic nursing care aspect? Where has the anticipation of a patients needs gone? As nurses in the 80’s we would snigger at the idea of a so called degree nurse, we couldn’t see how it would work.
Many of the older generation have tales to tell about either being a patient or having a relative or friend as a patient. They relate that they are afraid, because they are getting on in years and do not want to be helpless. Many fear being dependant upon others, they fear making a complaint in case there are repercussions. How awful is that?
Is the NHS for the general public who are ill, including the elderly? Is the NHS up to the job or should there be another facet where the poorly elderly receive respectful medical and nursing care? Shouldn’t we older members of society feel safe in the hands of the health service, because right now many do not.

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