Nursing nowadays – a response to our guest post

via Stuff

Guest Post

Your guest post by the Registered Nurse who has become a patient strikes so many chords for me.  Although I am a generation earlier, and did my training on the wards, not in the Polytechnic, much of what she says resonates with me.

We did twelve weeks on the ward, followed by six weeks in class learning the technical stuff.  Then another twelve weeks cycle. Our ward work was rigorously supervised to unbelievable timetables that I can still recite sixty years later.  Early morning shift on Women’s surgical with 30 or more patients we started at 6am, doing a pan round.  At 6.30 we finished the pan round (everyone needed one) and shoved the trolley with the pans into the sluice room.  The Junior nurse then stripped all the beds down one side, and gave every patient a bowel of water and washed those who couldn’t do it themselves.  A quick swipe of 15  bums to avoid bed sores, then hastily made their beds, often with clean linen.  At 7.15 we got rid of all the bowls and did a quick ward tidy of the bedside cabinets before serving a breakfast of porridge and bacon eggs or whatever at 7.30.  After breakfast was served we rushed over to the nurses home for our own and then back to take away the trays, empty the pans and bowls and wash the other 15 patients.   

The process was always a rush, but every patient was made clean and comfortable and fed and watered to a ritual timetable.  No-one got forgotten.  No one was ignored.  Each rank of nurses had strict duties laid out in a checklist style, and her work was checked by the ward sister.  Junior nurses did the bedmaking and bodily functioning things, while the Intermediate nurse did the dressings, and theatre preparation.  The senior nurse did the major dressings, the drips as they were called then, and the medicine round.  The ward sister was responsible for the managing of the ward, and keeping the Doctors at bay!  They were autocratic, arrogant, and careless of the patient’s well being.  But the nurses were wonderful

Because they were routinely and constantly assisting the patients, they became keen observers of the clients state of health, and had to write in tiny hand writing any observations they had made of problems on the patient report card.

Many of our patients did die.  I accept that if you judge nursing by todays standards, we probably lost far more patients than nowadays.  In fact I remember with some embarrassment at the grand age of 17 ¾ I was doing my first Senior afternoon duty, in charge of a whole ward with no back up from registered or even senior nurses.  I had five patients on death watch, and I would go round to each of them, hold their hand and ask them not to die until I went off duty!  Not because I was scared of death, but because if they died it took two nurses an hour to lay them out, and prepare them for burial – we did that, not the undertaker.  Not one of them ever died on my watch….I do wonder whether they were too scared of me to dare, or whether they were comforted somehow by the conversation about death.

The routine was brutal, both for the staff and patients.  But everyone was washed, panned, fed, had their beds made and was held when they needed a cuddle.

Some four years ago I had a coronary and finished up in CCU for eleven days.  The sophisticated care that I received kept me alive.  There is no doubt in my mind that in “my day” I would have died.  But no-one washed me, or gave my back and bum a rub.  My bed was not made or changed in six days, in spite of the fact I was sweating and sticky.  It was on the 6th day I asked for a wash and for clean sheets, and the nurse was somewhat surprised at my request!  And then asked a support worker, not a nurse to do that chore.  So the opportunity to talk with the patient, when undertaking the most personal of actions was not taken up.

I have had frequent visits to hospital since, and watch the nurses with an old fashioned eagle eye!  I note the things they do right and wrong.  The biggest deficit is, I think, that they spend almost no time in physical contact with their patients.  You can tell so much by the feel of the patient – are they sweating, or dehydrated, are they scared.  Do they smell “ill”?  My sense of the smell of illness is still extremely strong, and yet few nurses seem to be taught this very important diagnostic tool.  Physical contact can be a very healing thing, and has almost gone nowadays in this world of political correctness.

Some of the best nurses I have had are the Philippine trained nurses.  Many work incredibly hard, and are caring and supportive, as well as competent nurses with the mechanical components such as IV lines etc.  The older New Zealand women are pretty good – usually – but some of the younger ones leave a lot to be desired.

So I think you are less likely to die nowadays when you are admitted to hospital.  But your basic cares will be no where as good as they were fifty years ago.  Lift your game nurses!  There is nothing to say you cant do both brilliantly.  It is not a matter of resources.  That is a lousy excuse

What does surprise me though, is how overweight many nurses are!  I presume their excuse is that they are unhappy in their job, unloved and unwanted, and therefore over eat to comfort themselves.  I cannot imagine working the way we used to and carry all that weight.  If you are working at a hard physical job, the weight should fall off.  The obesity  sets a shocking example to the patients.


Frances Denz MNZM

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