Are modern nurses uncaring and slovenly?
Nursing has always been a trusted profession, strongly associated with caring. Doctors also register high in dependability, topping Ipsos Mori’s ‘most trusted’ poll once again this year (funnily enough, journalists languish at the bottom, only beaten by politicians in the least trustworthy stakes); however it is nurses who tend to be considered most empathetic, most approachable and most likely to see the human side of a patient’s condition.
Doctors might argue that nurses have time on their side thanks to their longer consultations, but nurses feel that ‘caring’ is integral to their profession which embraces an holistic ethos of patient care and is all about treating the person and not the illness.
Working for several years on Independent Nurse has shown me first-hand how closely nurses identify with their patients: it can be harder to ascertain nurses’ views on their own pay and conditions than their concerns about patients. When they do consider their own needs, it is often in relation to the potential impact on the people for whom they care. For example, the knock on effects of insufficient training or understaffing on essential services or opportunities to innovate.
However, criticisms of nursing have been gathering momentum: in yesterday’s Daily Mail, an article appeared entitled ‘Uncaring. Slovenly. Some of our nurses are a disgrace.’ Written by lecturer in nursing Lorraine Morgan, this outlines Ms Morgan’s outraged account of the treatment of her elderly aunt at the hands of hospital nurses, between 2005 -2006.
She describes the ‘neglectful care’ experienced by her aunt due to inattentive staff who ‘consistently failed to wash her for months, feed her or give her anything to drink’. Lack of fluids and nutrition left her aunt frailer, weaker and suffering kidney failure and she contracted cellulitis, followed by MRSA. She also fractured an arm falling out of bed (no protective cot sides having been attached to her bed) and her condition generally deteriorated.
On one occasion, Ms Morgan found her aunt dressed in a gown four sizes too big for her; this had fallen off her right shoulder, exposing her naked chest to the elderly man in the nextdoor bed.
This is not just a one-off case of Daily Mail hyperbole; earlier this year, nurses were branded ‘grubby, drunken and promiscuous’ by Tory peer Lord Mancroft, during a debate in the House of Lords.
He insisted that it was ‘a miracle’ he was still alive after his experience of filthy wards and ‘slipshod and lazy’ nurses, when admitted to the Royal United Hospital in Bath.
Lord Mancroft particularly objected to nurses talking over his bed, as if he wasn’t there, so that he knew ‘exactly what they had got up to the night before, how much they drank, and exactly what they were planning to do the next night.’
In light of such experiences, patient representative organisation, Patient Concern, has accused nurses of losing touch with the job by ignoring patients’ basic needs as they take on more responsibility in their specialist roles.
The perception is that reductions in ‘care’ are directly proportional to medical advances, with the focus now being on new drugs and treatments rather than on the quality of care and attention provided to patients; nurses are becoming increasingly trusted as experienced professionals, taking on advanced roles and prescribing from the full formulary, but less trusted by their patients, who value the human touch they used to receive.
Not all nurses should be tarred with this brush (criticisms are generally aimed at the younger, less experienced nurses working in hospitals, and at agency staff); nor are pressures on time, money or hospital beds the fault of the nursing profession.
However, mud sticks.
Let’s hope that this shift of image can be swiftly nipped in the bud. After all, much lip-service is paid by ministers to the concepts of ‘patient-centred care’ and ‘patient choice’ and most nurses generally are attentive and caring.
Helpful initiatives include the RCN’s recently launched campaign to ‘put dignity at the heart of health and social care’. This provides a complete package of resources created by nurses, for nurses, to help put dignity at the heart of everything they do.
As RCN chief executive and general secretary Dr Peter Carter makes clear: ‘Dignity should not be an after thought or an optional extra. Each and every patient – whether they are in a hospital, a GP’s surgery, in the community or in a care home – deserves to be treated with dignity and respect. Dignity should be integral to nursing care and this campaign is a big step in the right direction.’