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?