IT was hard not to like the look of Henrietta Scott in the papers last week as she retired at 70 after 52 years as a nurse at Glasgow's Victoria infirmary. Ms Scott was an excellent nurse, judging by the accolades heaped upon her by colleagues. Described as a remarkable woman who everyone came to for advice because of her wealth of experience and knowledge, she also, importantly, was the life and soul of the operating theatre with "a smiley personality and cheer that lit up the hospital". She recalled the long-gone days of strict and scary matrons, adding: "It is much less formal now, which has its benefits and its downfalls, but the staff are still faithful to the patients and work extremely hard."
I'm sure she's right. But sadly, in the very same week as Ms Scott bowed out of a profession she had honoured with hard work and dedication, The Patients Association published a report revealing appalling abuses and neglect of elderly NHS patients in England. It catalogued vile, unthinkable things. Patients left in their own faeces, starved and dehydrated, unattended without pain relief, dying of bed sores. The findings are all the more shocking because few people in the UK are genuinely surprised at its revelations. In other words, it's nothing we didn't already know.
When this issue was discussed a few months ago I was overwhelmed with communications from people anxious to relate their own harrowing tales of how low nursing standards had fallen, including some truly ghastly anecdotes from nurses themselves. The consensual view was that unchecked, bad nursing is bringing down both the reputation and morale of good nurses, and that patients and their families are so numbed by experience that they regard complaining as utterly pointless; they fully expect to be maltreated in hospital, and so prepare themselves accordingly.
Seasoned hospital regulars know the score. They come prepared to feed, to bathe, to care and to intervene to ensure the most basic of assistance is not withheld through laziness or forgotten in the chaos of overwork and understaffing. But those new to the system, particularly those with elderly loved ones, will now understandably dread any hospitalisation, scared rigid by this latest evidence of what has up until now been largely anecdotal.
It was 150 years ago that Florence Nightingale said: "It may seem a strange principle to enunciate as the first requirement in a hospital that it should do the sick no harm." That might be a more meaningful reminder to pin on ward walls than the one telling us we'll be prosecuted for assaulting staff.
What an absolute tragedy. This report must be manna from heaven for the American Republicans trying to discredit the NHS in the face of President Obama's health care reforms. Hey guys! Those limeys don't even let old people have a glass of water before they die in their own mess. That's public health care! But is it? The reason we cherish the NHS - and the recent outpouring of affection for it in response to the American assault showed that we do - is that much is still wonderful about the service, and the things that are demonstrably wrong are all eminently fixable. That includes the declining standards in basic care.
We cannot let the incoming Conservative government use new Labour's box-ticking, target-meeting, form-filling, Kafkaesque insanity, which replaced traditional nursing and contributed to this disastrous dip in care, as an excuse to rip apart the NHS and replace it with something worse. The exposure of so many shared experiences of malpractice has, in some ways, been a relief. We can now discuss this pressing issue without the ridiculous tabloid beatification of nurses as "angels". We should make room to take a cold, pragmatic view of what we expect for the people we love when they are at their most vulnerable, and what nurses deserve, from management and government, to rebuild a sense of pride in their vocation and consequently be properly rewarded for hard work in the most challenging of jobs.
There are many solutions, and the ones put forward by concerned nursing staff should be attended to most keenly. They complain to deaf management ears that they are not a new "too posh to wash" brigade of heartless shirkers, but that time is eaten away by paperwork, and their roles are confused in the eyes of patients by the economically convenient, low-paid, part-time untrained care staff. There is not a high enough ratio of trained nurses to patients to nurse effectively, and the training itself has become separated from the messy realities of human suffering into the more comfortable exact science of dosages and high-tech machinery.
More than one nurse has complained that bedside manner coaching focuses mainly on dealing with "difficult" patients, and legal rights concerning verbal and physical abuse, than it ever does on the subtle philosophy of how to make someone sick and helpless feel less afraid, more comfortable, less alone.
It's partially this poorly weighted emphasis that has contributed to modern nursing being in turmoil. Let's destroy the myth that while the administration of drugs and dressings and the interpretation of an ECG can be taught, caring can't. It can. It's simply the intelligent anticipation of need. Bad nursing is reactive, late and consists of ineffective responses to situations that are already causing distress. Good nursing thinks ahead and plans to prevent discomfort. Even a person under enormous pressure can learn do this. Ask any 24-hour, 365-days-a-year carer. The Royal College of Nursing lists these as personal qualities you need to nurse effectively. "You need to be non-judgmental, and a good communicator, with the ability to listen, empathise and provide support." Not good enough. That could read the same for someone training to sell life insurance. We need to get not just more money but more humanity into nursing. What motivations made Henrietta Scott take it up 52 years ago? Here's an idea. Let's ask her and try and replicate them.
