Friday, 14 October 2011

What has happened to nursing?

Come back Florence, all is forgiven
There has been quite a lot of fuss in the news this week about terrible care taking place in hospitals. I was listening to the Health Secretary on the radio and he was saying that poor care from nurses was down to bad leadership. I'm not sure this is the whole of the answer.

When they had a vox pop on the programme a little earlier, the daughter of a badly-cared-for patient was saying that she repeatedly asked for help from nurses to do basic things, but 'they didn't care - they seemed to feel it was beneath them'. And I'd suggest that this is a contributory factor.

Once upon a time, nurses did basic medical checks - but their primary role was nursing. Caring for people. In the last 30 years, their training has become increasingly medicalized (if there is such a word). They are trained to be and to think of themselves more as doctors lite. The inevitable result is that some nurses feel that it really isn't their problem to worry about a patient's basic physical state, they are there to deal with the medical side.

Don't get me wrong. Many, many nurses do a wonderful job. But I would suggest that those who do are managing to do this despite their training, rather than as a result of it, and there should be just as much focus on this as on failings in leadership.

Picture from Wikipedia


  1. "At the beginning of the 20th century, it was asserted that Nightingale reduced the death rate from 42% to 2% either by making improvements in hygiene herself or by calling for the Sanitary Commission. The 1911 first edition of the Dictionary of National Biography made this claim, but the second edition in 2001 did not. However, death rates did not drop: they began to rise. The death count was the highest of all hospitals in the region. During her first winter at Scutari, 4,077 soldiers died there. Ten times more soldiers died from illnesses such as typhus, typhoid, cholera and dysentery than from battle wounds. Conditions at the temporary barracks hospital were so fatal to the patients because of overcrowding and the hospital's defective sewers and lack of ventilation. A Sanitary Commission had to be sent out by the British government to Scutari in March 1855, almost six months after Florence Nightingale had arrived, and effected flushing out the sewers and improvements to ventilation. Death rates were sharply reduced. During the war she did not recognise hygiene as the predominant cause of death, and she never claimed credit for helping to reduce the death rate."

  2. I was a med-surg nurse from the 1960's until the early 1990's, who voluntarily and reluctantly left the profession I loved to enter a more "lucrative" field. For many years, I rarely graced a hospital door until the past four years, at which time a some family members have required hospitalization. What has come to my attention about changes in nursing is threefold. First, the nurses with whom I have come into contact recently appear very competent "medically" speaking, but basic nursing measures such as turning and ambulating patients and basic hygiene seems to be relegated to family members or overlooked. Secondly, most nurses appear to be relatively humorless. Everything is strictly business. It appears that most of them only know a patient as a diagnosis, not as a human being. Technology also seems to have replaced personal contact. Most nurses rarely smile. Thirdly, when a physician tells a patient he or she will visit, it usually means a physician's assistant or nurse practitioner will visit. It is often impossible to speak directly to the medical doctor or surgeon. I have observed these factors to be prevalent in several hospitals, in different states. I had considered returning to school and re-entering the medical/nursing field, but I did not think I would be happy in this seemingly impersonal, high-tech setting.

  3. Thanks for that interesting insight. I am sure a lot of nurses still remember the 'human' side of nursing, but your observation sadly doesn't seem to be unique.