You may have seen in the news this week that the Care Quality Commission published their "National report on dignity and nutrition review". It makes for quite distressing reading and some of it I read with sheer disbelief. Since when did we become a profession of uncaring, cruel and callous beings who are not worthy of calling ourselves “Nurses”. Florence Nightingale would turn in her grave!
I have been a Nurse since I left school and qualified as a Registered Nurse in 1986 so I have seen many changes over the years…. Some good but some not so good. When I was in training most of my time was spent on different wards learning from experience and from good role models. We spent alternate 6 weeks on a ward and 2 weeks in the school of Nursing over a period of three and a half years.
I have great memories of those days as a proud Student Nurse… I loved wearing my uniform which included a starched nurses hat, belt, fob watch and a thick woollen nurses cape. I remember, with more affection now than back then, Miss Moss who was the Nursing officer for all of the medical wards. She was the typical matronly type old school nurse who stood for no nonsense and was incredibly strict. I dreaded taking the day or night report to her because she always quizzed me on the meaning of some of the medical terms I was reading out to her and I couldn’t blag my way out of the situation; I simply had to know what I was talking about! She would gaze sternly at me over the top of her spectacles if I couldn’t tell her about each patient and she would watch me squirm if I tried to pretend! I remember that no one was on first name terms, it was always Nurse something! I remember how we had to position ALL wheels of the beds facing forwards, the overhang of the counterpanes equal both sides, the pillow case openings facing away from the door of the ward and so on; otherwise we would be in so much trouble. Our uniform conformity had to be 100% and we had to “look” like nurses. Our conduct had to be impeccable both inside and outside of work. This was all attention to detail and that was before any of the patients came into the equation. In those days I remember how bed bathing, feeding, toileting and maintaining the dignity of patients was absolute priority and considered to be an everyday part of our role. It was after all part of our Nursing Code of Conduct back then and it still is today!
As a Ward Sister at the age of 23, I expected and upheld the same standards that I had been taught. I wore my navy blue dress, silver belt buckle, frilly starched hat and cuffs with honour and pride. On my ward the elderly patients were helped to dress appropriately and always in co-ordinated colours. Countless times I would reprimand nurses for dressing patients in clashing colours that they themselves wouldn’t be seen dead in! I would forbid Radio 1 on the ward and anyone caught would be in big trouble. Since when do 80 plus year olds want to listen to music like that? I remember one nurse bed bathing a patient and she washed her with a soapy flannel but then proceeded to dry her without rinsing the soap off. Not rinsing off the soap is something no one would do to themselves but because this particular patient couldn’t talk or move she was at the mercy of the Nurse who thought she would not be caught out. I could tell you many stories but the point to me telling you these things is that I achieved good standards because I care! I care about vulnerable, sick patients! I care about the attention to detail! I care about fulfilling basic human need in nursing! I care that we are in a position of trust and should feel privileged to be there…. And all you nurses out there should care too!
When did things change so much I ask myself and result in the damning report that has been published. In all honesty I think many Nurses feel that they are not valued in the way that should be in the NHS. The morale is so low and they are over worked, paid little for the responsibility that they have and are expected to do more and more and thus become burnt out. My observation is that there is more emphasis on the technical and academic side of nursing than when I trained to be a nurse. When the style of nurse training changed and the schools of nursing became affiliated with Universities there was more of a shift towards academia and less towards experiential learning. No one can learn to be a nurse through spending the majority of their Nurse training reading books and writing dissertations! For example the student nurses now that I have come out with me tell me that they are not taught about exactly how to feed patients nowadays or how to bed bath in the way that I was. They seem to be taught more about “promoting independence” in those aspects of human need and thus encouraging patients to feed or wash themselves whether they are capable or not of achieving it. Maybe things have changed because of medical advancements that have affected the way we nurse nowadays. Post-operative patients would be cared for and nurtured gently back to health before they were sent home a few years ago. Now that some of the procedures are less invasive the recovery period is often quicker and patients are sent home much sooner nowadays to recover. However, anyone who has had even minor surgery will tell you that they go though a period of at least discomfort, if not pain and sickness and require some help until they recover.
I don’t have the answers in writing this blog. Generally today life is different and it is much more of a dog eat dog, selfish society which perhaps has led to the decline in nursing culture these days. Every nurse should read the book "Notes on Nursing” by Florence Nightingale. It was published in 1859 but is still very relevant to today and is very focussed on what basic human need is and how to achieve that. There have been numerous wonderful medical break through’s in the world of health care which is exactly what we want to hear, but the one thing that hasn’t changed is basic human need and my feeling is that we are not caring enough about that … I have Maslow’s Hierarchy of needs imprinted on my brain from my nurse training days and those needs remain the same whatever medical advances have taken place. It is not rocket science is it? Nursing the sick or infirm is simple if nurses keep one principle firmly in their minds……. 'Care for patients in the same way as you would expect your loved ones to be cared for' …. We can’t go wrong with that can we? It has worked for me for all these years!
I hope and pray that the Care Quality Commissions report brings about change for the better and that Nurses can take a pride in their role once again. But for now, I am grateful that I am the nurse that I am and that I work with others who work in the way that I do!
