Saturday 10 August 2013

Nurses and the Health Service crisis

The Health Service has been much in the news recently; again. And I believe more than ever that many of its ills come down to the state of nursing.

Firstly, I can't stress enough that I know there are many good, caring nurses out there. But I also know that something is terribly wrong. Nurses used virtually to hold the health service together. They were the ongoing link between patient and doctor, between ward and kitchen/cleaning department./ dispensary. I know much of this is now impossible, with the subdivision of all the various responsibilites. But a time was when a good ward sister knew ALL her patients, and the other nurses knew about all patients on their ward. They had to. It was their job. During his recent hospital stay, my husband saw a different nurse every time, and never even met the sister, although he was in for well over a week. I know that part of this is due to the way the wards utilise their staff, but a good part lies in the way nurses are trained. In my last (shamefully long ago) post, I wrote that it would be a start to bring back the SENs, and never has that been more true than it is today. As for nursing degrees, I will never accept that you need a degree to be a good nurse. A good nurse is (in many ways) born, not made. You have to be a certain kind of person to look after the sick, and to do all those less savoury jobs with willingness and a sense of privilege. No amount of clasroom teaching can change the kind of person a nurse is.

But the current training would have it otherwise, and seems to assume that characteristics such as compassion and empathy can be taught. They can't. I've seen it failing to work, as have many unhappy patients.

But to the modern degree training: here is an exerpt from the information about a nursing degree at an English university:

You will be able to design strategies for the collection and analysis of scholarly material relating to nursing care, as well as be able to identify nursing issues from a wide perspective. You will be able to identify and lead changes in practice, improving the quality of delivery of care.

Obviously I have slected a passage that illustrates my argument, but there are many more like it. It costs £20,000 to train a nurse (unlike other undergraduates, they don't have to pay tuition fees), and when student nurses work on the wards, they work with a 'mentor' and are not a regular member of the ward team (in the past, students were seconded to a ward to work as they learnt, and were  paid a salary, albeit a small one). Putting aside patient dissatisfaction, can we really afford this?

11 comments:

  1. Francis, it's sad but true fly to Spain or Portugal. The surgeons are better and not as pompous and the nurses are....Well Nurses...They make you feel better. I'm not bolshie well; I am a bit when in pain but caring treatment dispels it.
    Don't even think of going near our NHS.

    ReplyDelete
    Replies
    1. Adrian, that's all very well! But who has time to fly abroad for emergency treatment?

      Delete
  2. I don't know, Adrian, a friend of mine was taken ill in Portugal three years ago - he was nearly killed by being given antibiotics when they were completely wrong for his condition, he was there a month in intensive care without them being able to find out what was wrong - the diagnosis took four days in England (his notes were not sent with him so they started from scratch) - and he got bedsores because of the poor nursing. A doctor told his wife "the Portugese Health Service is broken."

    You are clearly right, Frances, I've seen excellent nursing care but also some very poor treatment of vulnerable people, particularly old ones.

    ReplyDelete
    Replies
    1. Thank you for replying, Z. I just want to get something done about it, before it really is too late!

      Delete
  3. I completely agree with you, Frances - there is absolutely no need for a nurse to have a degree and they are excluding a lot of potentially wonderful "born" nurses by insisting on it. Bring back SENs!

    ReplyDelete
    Replies
    1. Teresa, everyone has horror stories, but nothing gets done. In my more energetic moments, I really would like to get a campaign going. Would you be interested??

      Delete
    2. I wouldn't know where to start, Frances, but I'd be happy to help spread the word x

      Delete
  4. I could write a huge amount here Frances. At the age of 16 I worked on a ward (a very valuable and enjoyable experience in my life) and life was very much as you describe. Also at the age of 16 I had a partial lung removal so experienced care from that side of the bed too. Since then I have experienced 15 years of cancer care (including a major operation) and have after a heart attack and angioplasty in 2000 I've experienced 13 years of cardiac care. I am, thus, about as fit as a chap of my age can reasonably expect. I have nothing but the greatest of praise for our health service. That does not mean, of course, that I think it is perfect nor that the present way of working is not improvable.

    I agree that good nurses are born not made (and I met a few who were definitely not born to it and who were the despair of the Sister's life) but I also hear from nursing friends that a great deal of what goes on on the ward is no longer anywhere near as simple as it was even 30 years ago (when here in Scotland nursing degrees were in use).

    I could go on and on but I will spare you that - for now.

    ReplyDelete
    Replies
    1. I'm glad you had such positive experiences, GB, as I know many have (including me). But I think that so much more could be done to ensure more positive outcomes like yours. I think that, training apart, like everyone else, nurses are drowning in a sea of paperwork and red tape, and the whole system is falling part because of it. Like you, I could go on, but no room here! But - every single time I raise the topic in company, everyone has at least one horror story of things that would never have happened in the 'old days'.

      Delete
  5. Interesting article, best regard from Belgium

    ReplyDelete
  6. I salute nurses

    http://inthebothv.blogspot.ae/

    ReplyDelete