Forget about targets, we must return to the caring basics of being a nurse

If I had one wish, it would be for every nurse and doctor to experience being an in-patient for at least a week as a compulsory part of their training. I am utterly convinced it would guarantee a more attentive and sympathetic medical and nursing profession.

Going into hospital as a patient can be an extremely traumatic experience; people are often afraid and vulnerable, needing care and compassion from every member of staff they meet, regardless of stature.

When I began my nursing career in 1966, my one and only aim in life was to nurse the sick and dying. I wasn’t academic in any way and, fortunately for me, I didn’t need to have a diploma or a degree to be able to achieve my ambition. It was a particularly strict regime and although it sometimes put me on edge in case I made a mistake, the old-fashioned matron system was one that I became increasingly proud of. I realise now how lucky I was to have been trained in the era when a nurse’s main concern was for their patient.

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When I worked on the wards, excellent nursing standards were the accepted norm, but sadly in more recent years I have witnessed some dreadful situations. One concerned my elderly next-door neighbour Lillian.

One morning, her daughter Margaret, whom she lived with, came to tell me her mother had been taken ill and had been admitted to hospital. Later that day, I went to visit her in the geriatric ward. The sister in charge and several nurses were sitting around their station drinking tea and sharing a joke. One or two were writing reports, the others were just chatting.

I asked where Lillian was and Sister pointed to a four-bedded bay directly opposite the nurses’ station. The only occupant was an old lady who was sitting slumped over her table, face down in her congealing meal, both slippered feet surrounded by a puddle of urine.

The Lillian I knew was a sprightly 80-something, who having been a skilled seamstress for nearly 70 years was always extremely particular about her dress and appearance. For a moment, I thought I had been directed to the wrong bed. I hadn’t.

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As I approached, the stench of faeces was nauseating. It was simply awful to see my elderly neighbour and friend left in such an awful situation. Tears welled in my eyes and I had to hang back for a moment until I regained control. When I got to her bedside, Lillian didn’t even have the strength to raise her head so I helped her sit up, her face and hair covered in gravy.

She whispered: “Is that you Joan?”

I assured her that it was and asked whether she would mind if I cleaned her up. She smiled, nodded and said: “Yes please. I’ve told that lot over there you would look after me.”

I was seething with rage. None of the staff knew me and I wasn’t in uniform, yet they all just sat and watched me take a trolley from the sluice and pull the curtains around the bed. Lillian had been doubly incontinent. Her nightdress, dressing gown and slippers were stinking so I bagged them all up, washed her from head to toe and changed her clothes.

She whispered her thanks over and over again, but was so weak that she could barely move.

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Without a second thought, I lifted her into bed and could immediately see the relief spread through her weary body. She just lay there, all her energy gone and it seemed to me quite clearly that she was dying. I pulled back the curtains and saw that the staff were still sitting there, not one of them having offered to help.

I dumped the dirty trolley with a bang and presented myself to Sister. Trying to remain calm, I asked: “Have you let Lillian’s daughter know how poorly she is?” She dismissed my concerns, adding Lillian was just tired and sulking because she didn’t want to get up. There was a total absence of empathy, care and professionalism. As I left the hospital, Margaret was just coming in. I made her aware of what had happened, then when home at sobbed my heart out.

Lillian died that night, thankfully surrounded by her loved ones, but I still find it difficult to express my emotions about the incident as they veer from disgust to despair. How any nurse could possibly sit there doing paperwork when a vulnerable, elderly patient needed assistance is beyond my comprehension, although the real blame must lie with the sister in charge.

It beggars belief that staff with such low standards themselves could ever be appointed to train and supervise junior staff, and it raises serious questions as to where any future improvement in nursing standards will come from. In the 41 years that I worked as a nurse, I witnessed some amazing examples of good, old fashioned nursing, which is perhaps why I’m even more shocked by how things have changed.

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My friend Bernie was a fearlessly determined advocate for the patients in her care. She was a sister on a ward linked to the main hospital by a long, draughty corridor. The plastic swing doors were old, they didn’t close properly and it was notoriously difficult to keep the ward heated. During a particularly cold spell, the patients began to complain, but despite repeated requests to replace the doors, no action had been taken.

Late one night, Bernie produced a screwdriver and the faulty doors found their way into the skip. Administration staff were purple with rage, but she didn’t care. New doors were fitted soon afterwards and Bernie was applauded by the staff and patients. In today’s politically correct and budget conscious climate I have little doubt that Bernie would have been suspended, if not dismissed for such behaviour.

Targets and financial controls are, of course, important, but so much time and effort today is spent on administration and paperwork, that management and senior nursing staff have lost sight of the real purpose of nursing – looking after sick people. Caring for patients and saving lives is the primary reason for the existence of hospitals and patients are people not commodities in a supermarket. From 2013, all student nurses must possess a degree level qualification in order to be allowed to train and yet I have never seen any evidence that graduates make better nurses.

The new recruits may be much more intellectually gifted and educationally accomplished than a person like me, but a good nurse also needs to be a caring, compassionate individual who has an awareness of their patients’ needs at all times. No task should be too basic or unpalatable whether it be cleaning up an incontinent patient or simply taking the time to observe whether a patient is cold, hungry or in pain and acting upon it.

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Society has changed and people’s expectations have quite rightly grown along with that change. Miracles are regularly performed by life-saving operations and wonderful new machines are installed at enormous expense to us all, because it’s mainly public money which pays for it. Somewhere among all these soaring costs patients still require good nursing. Sadly it seems this fundamental compassion which should be at the heart of the nursing profession seems to have been forgotten.

Adapted from Matron Knows Best: The True Story Of A 1960s NHS Nurse by Joan Woodcock, published by Headline Review on February 10, priced £12.99. To order from the Yorkshire Post Bookshop call 0800 0153232 or online at www.yorkshirepost.co.uk.