Tuesday 1 March 2011

The current state of nursing


The recent publicity around the care of the elderly in care homes and hospitals has highlighted a growing problem in the health service: quite simply, nurses are no longer nurses.

I have had a bee in my bonnet about this for years as I have watched nursing move from a practical, hands-on profession to an all-graduate one, with disastrous results. Who hasn't heard tales of nurses chatting round the nurses' station while patients lie in their own excrement, or can't reach a glass of water? I have seen this for myself. It is not a lack of funds, or even a lack of staff (when I nursed back in the dark ages, we were often short of staff, but no patient ever went hungry or dirty) that is at the root of the problem. It is the lack of the right training and the right candidates. People who would make excellent nurses are deterred by lack of qualifications or the willingness to take a degree, and thus we are losing many caring young people who would make excellent nurses.

Once, I was proud to say that I was a nurse. Now, I feel a deep sense of shame that a profession which was once so great has fallen to such depths.

Ask yourself this. If you were in an aeroplane, would you rather be flown by a pilot who had a degree, or one who had learnt his skills in the cockpit? Flying aeroplanes is also a profession. A practical profession. I know which I'd choose.

12 comments:

  1. I couldn't agree with you more, Frances.
    I've seen it first hand. It is a terrible state of affairs.

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  2. An interesting point you make, Frances. Here, it is also lack of adequate staffing due to....what? For-Profit hospitals? Greed? Maybe there are not enough empathetic people attracted to the profession for the reasons you state.

    My sister is a retired nurse (bad back and varicose veins from too many hours in the operating room standing motionless, hearts-in-hand) and my sister-in-law is an unretired nurse who often works 12 hour shifts. I wouldn't want to be in dire straits in her 12th hour.

    It is a serious problem. Thanks for your insight.

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  3. I know there are some good nurses out there still, but my interactions with them and observations of them as an EMT have been horrifying at times.

    Every profession has people with bad attitudes, petty interests, their mind elsewhere... But as the primary mediator between patients and care, every little thing seems so much more critical in nursing.

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  4. Oh, Frances, this is a pet subject of mine too - as you can imagine, having also worked in the NHS! I hasten to say that the nurses in my own Unit were mostly excellent, caring, and lovely. Some of them had worked for us for decades and their loyalty was second only to their compassion for their patients. BUT I've seen the other type too, and it horrifies me. My worst experience was when one of my daughters was in hospital at the town where she went to uni. She was only 22 and had had to have major emergency abdominal surgery. She was frightened and in pain and the two staff nurses on her ward couldn't have cared less, in fact they behaved as if she, and I, were being a nuisance if we even asked about her pain relief - and they weren't even busy. I believe so passionately in the NHS that it hurts me to see these people giving it a bad name ... these people who should never be doing a job they're so unsuited for. Sorry. Rant over! Kick the soapbox away from me!

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  5. I'm so glad others agree (and don't kick the soapbox away, Olivia - it might come in useful again!). This has been a pet rant of mine for years - I even tried to start a Real Nurse Campaign, and had a good following, but in those days, sadly, I didn't have the skills to run a website. I might still do it. Someone has to do something before it really is too late.

    Nevets - I'm sorry you have a similar situation across the pond. I thought things might be better in the US.

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  6. You're quite right , of course .The job has become much more difficult in recent years , given the development of new treatments and drugs , but sheer kindness and decency are possible , surely?

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  7. A valid point - along the lines of the sayiing 'teachers are born, not made'. It also applies to 'carers', or those with a the caring attitiude, which some people have by nature. It doesn't take great brains, so much a common sense and a wish to help one's fellow beings.

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  8. Hi SmitoniusAndSonata. Yes - things have certianly changed, but as you say, that is no excuse for the absence of care and compassion. And there is much more machinery to help nowadays. I remember in my student nurse days spending all night counting the number of drips per minute, every fifteen minutes, (two infusions per patient, different speeds, all set by hand) on patients after major surgery. Nowadays, nurses ony have to set a little dial, and it's done. Likewise, blood pressure and temperature can be recorded in a matter of seconds.

    As a ward sister (very busy ward, with among other specialities, patients awaiting kidney transplants, on daily dialysis), I managed to speak to every patient every day to ensure there were no outstanding problems, teach the student nurses, and ensure that food and hygiene were up to standard. We worked very hard, and often went home late (the night before my final exams, I was working until 10pm because we were short-staffed). But I loved it. I could no more have left a patient in a dirty bed or in pain than flown to the moon.

    In mitigation, paperwork was minimal, and targets non-existent (the last, in my opinion, unnecessary), but still...

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  9. Hi, Jinksy - I absolutely agree. Those who may have the vocation may well not have the academic qulifications needed to be accepted for a degree. And yet much of that training seems to me irrelevant (for instance, student nurses spend several weeks in day nurseries studying "the well child". If you don't know what a well child looks like, then you're most certainly in the wrong job!).

    PS Sorry about all those puns - I couldn't resist!

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  10. The profession could never be the same after graduating courses were introduced. Young men and women with University degrees won't take kindly to being asked to make toast for patients and empty bedpans.

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  11. Doctor FTSE - you are absolutley right. But what's the solution? The modern nurse is too posh to wash (or feed, or clean up). In the old days, we did EVERYTHING. I have heard of faeces being left on the floor because it wasn't the nurses' job to clear it up. And of course the degree courses are costing a fortune (as are the agency nurses, who take the place of the student nurses of old, who used be the backbone of the workforce). Putting student nurses bck on the wards would save millions. Literally. Pounds (and possibly lives, as well).

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  12. I am an RN and have heard all the stories of the "old days" for years from both of my grandmothers who are nurses. Can we PLEASE stop this comparing ANYTHING today to the "good old days"??? While I agree that in my baccalaureate program, there was very little physical work asked of me...(which left me grossly underprepared for the realities of floor nursing) it starts with instructors and college professors/administration being honest about the realities of hands-on, bedside, clinical nursing. Had I been exposed more as a student nurse, I, and others could have not only been better prepared, but we could have then better decided if nursing was something we wanted to continue to pursue. I did have clinical days at the hospital, but was given no more than 2 patients. The reality is more like 10-12 patients per nurse. (I'm speaking of an intermediate step-down unit). I could go on and on and on....but the simple facts are this: Nursing education is in serious need of an overhaul...and older nurses need to get through their heads that the old days are gone, for better or worse they are. Today nurses simply do not have time to do "aide" work. Its not that most of us with a degree DON'T want to help, we just don't have the time with all the patients and paperwork that has been loaded on this. Older nurses need to understand this and realize that it is not our fault. Its the insurance companies, lawyers, and politicians fault. Further, if the older nurses would stop bashing the "younger" or newer nurses, and instead come together to demand safe nurse:patient ratios, maybe the administrations would listen! Instead, they say ....Oh...these nurses are willing to work like dogs for pay not even close to being sufficient....so lets keep pushing them. If a major mishap occurs, we'll deal with it then. The idea is, its much more cost effective to pay off a settlement now and again, than to staff properly so these mistakes don't happen in the first place.

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