Was nursing care better in the 'old days'

sodapop

Nursing care is much more technical and things have moved on such a lot since I did my training. I do think some skills in bedside care have been lost along the way and it should not be down to volunteers to provide this. There is good reason I think to return to a two tier system with a qualification like the State Enrolled Nurse.

Absolutely! Getting shot of the SENS was the worst thing they could have done - they were the ones that WANTED to care, vocational nurses, although as a student nurse, so did I, but was almost not allowed to in some respects, hence I changed my specialty to do what was known then as Mental Handicap. This was in the late 1980's ....

Nowadays, as I am unfortunately a heavy user of the NHS (had 24 operations in the last 2 decades) I have literally seen it all!! There are some decent caring staff out there, but I honestly think the degree level nurses really do not want to do the actual care at all - too posh to wash, definitely! But some of the things I have seen have been just awful! Elderly patients who can't do anything for themselves, not given a drink, their food tray being left at the end of the bed by one member of staff, and then collected 30 mins later by another staff member saying 'oh * you not hungry today?' and taking it away!! This is just BASIC common sense - if you cannot reach your table or communicate you just get left! The last time I was in, and was supposed to be 2m away from other patients, I helped one old lady who was in this position, lying shivering as she wasn't covered up, gave her drinks, shut curtains as the sun was streaming into her eyes, etc, and she just smiled a beautiful smile, grateful that someone did something, it was awful and made me even more depressed for having to be there watching it. I now have home carers and they really are fabulous, paid a pittance with no sickness or holiday pay and 20p a mile for coming out to me, when fuel around here is almost at £1.50 a litre ..... it's just not fair.

This is the current position with Mental Health Care in the UK

www.bbc.co.uk/news/uk-politics-59336579?fbclid=IwAR1IOC-OdQP-7DyEH1Tv1_3vUP8k4-LPGqUVYlBC0AXpIsQE7LVOkYw5ZuY

- and these are the people that can ACTUALLY get some help, my daughter has been on a waiting list for years, moved t the next county and has been kicked off the list, her suicide attempts must be approaching 20 or more by now, can we get help, no!! Goes into A&E and is sent home, even tried to take her life in there twice on time.

A Department of Health and Social Care spokesperson said: ""There are now record numbers of doctors and nurses working in the NHS and we are on track to deliver 50,000 more nurses by the end of this Parliament." So where are they going to come from then??? Kenya I read somewhere .... I thought Brexit was about getting rid of 'foreigners who take our jobs'. Just ridiculous.

"We're also investing £2.3bn a year by 2023/24 to transform mental health care, and will bring forward our plans to reform the Mental Health Act shortly, to ensure anyone in a mental health crisis is treated with dignity and respect." When my daughter was in a 'crisis' she was told to have a bath and light some candles .... that is MH care in the UK.

Oh good to hear it’s not just me!
Thanks I’m over it now and nothing too sinister was revealed !

Lucca

Well yesterday I had a gastroscopy …yuck. I was so wound up about the procedure and also what it might reveal that when the admitting nurse was so very kind to I burst into tears and she was lovely.

... hope your 'oscopy' went well. Good to get it over with, eh? It's not a pleasant experience (I've had several - both ends , and the nurses have always been very kind and reassuring... and I've burst into tears a couple of times, too.

It's the tension - relieved by someone being understanding.

JaneJudge

I think there is a discussion to be had around do you have to have a degree to be a 'nurse' Of course old auxiliary nurses are now called health care assistants. Is a health care assistant really NOT of a nurse?

HCAs are extremely valued members of any team, but as they have no formal training in the competences of Nursing, anatomy, physiology, pharmacology, disease, and all that entails. That is why they are called Health care assistants, they are there to assist, they can’t make decisions re patient care. Of course if they want to they can obtain the necessary qualifications to commence a three year BA (Hons) degree , as a few of my former colleagues did. My SEN RGN FPC, Ret.,were all gained by hard work, left school no qualifications, hours of study, all that and working full time, so I took my title of Nurse as well earned, along with the ability to care and give my patients the very best I could. Wether people like it or not, Nursing is a degree level Profession, to give all the very best of evidence based treatment. Unfortunately you do get some who don’t seem to be able to give the best care they can do, Nurses and HCAs.

I think we just have rose-tinted spectacles about how care used to be.

I had appendicitis 35 years ago and was admitted to a London hospital
- I had to spend hours in post-op recovery as women's surgical had no qualified staff that night - eventually night matron had to be called
- the junior doctor on call fell asleep on my bed because at that point he was 95+ hours into his 120 hour working week and had not been to bed for the last 60+ hours
- they had to borrow staff from the next ward to deal with my drip as none were qualified
- there were 28 beds crammed into an old Victorian 20 bed ward - 7 were men who couldn't be accommodated on male wards
- there was a structural ceiling crack above my bed with plaster falling on me while I slept
- there were 3 toilets and 1 bathroom for the 28 of us - just stalls that were shared with the men - one toilet was unusable because it was covered in poo and blood and the contract cleaners refused to do it - no it stayed like that the 4 days i was there
- I got a post op infection

So things really were not better

I trained as a nurse in the 1970s and retired at 60yrs. The NHS is very different from 50years ago with new treatments and technological advances that I could never have imagined years ago. Back then people would stay for 10 days for appendix removal, now it's out in 48hr with keyhole surgery. The age limit for an ITU bed was 70 and now there is no age limit to complicated procedures for patients in their old age.
Chemotherapy was in its infancy, the treatment for childhood leukaemia was pioneered in the hospital where I worked but still with a high mortality rate.
The pressures on staff I think are higher due to the rapid turnover of bed occupancy and the treatments now available.
Were nurse kinder ? There have always been a mixture of personalities in nursing as in any occupation. I worked with dragons and angels. My own personal experience with a chronic illness has been mixed but on the whole kind and compassionate.

It is about management and the basic structure of the system now. Farming tasks out to outside private providers has caused chaos. The chain of command and responsibility has been broken and the sense of commitment destroyed.

It is a pig's ear and needs radical change, based on patient and staff need and not political dogma.

A service is a service, not an opportunity to get snouts in the trough for profit. But this government does not understand what the word service means.

Well yesterday I had a gastroscopy …yuck. I was so wound up about the procedure and also what it might reveal that when the admitting nurse was so very kind to I burst into tears and she was lovely.

I think nursing staff were more 'involved' all those years ago- more friendly, now especially with covid, its more of "doing their job" than being emotionally friendly.

grannyactivist

No, I don’t think nursing ‘care’ was better. I had dreadful hospital experiences in the past, where the nurses were in thrall to the doctors, and and other experiences where nurses were wonderful.

Nowadays nurses are doing many of the procedures that used to be done by doctors and are also experts in their own fields. My nursing daughter is a teacher, manager, mentor, administrator, researcher - and this is all fitted in around her nursing shifts. She has split shifts so she is permanently exhausted, has several specialities that mean she is often called in if another specialist is off sick and has endless compassion for her patients and their families.

She has been assaulted by patients and their family members more times than I can bear to think of; patients have also spat at her, deliberately urinated on her and pulled her hair out by the roots. She has charge of machines that look as if they were birthed by NASA, understands some complex procedures that doctors are baffled by - and somehow manages to pin a smile on and deliver excellent nursing care when she’s on the unit.

What a wonderful person she must be ! And all that for a pathetic salary .

My personal experience has been that nurses are still very much as they were back in 'our' day. Most are caring and kind, others... not so much. I think it's down to personality rather than degrees...

What HAS changed, and IMO it's a change for the worse, is the way the NHS now operates more along the lines of the 'business model', since Margaret Thatcher's government introduced the 'internal market' system. Patients started to become 'service users', and more levels of admin had to be introduced to make it function accordingly. Cost became paramount and sometimes, doing things 'on the cheap' ended up costing more money in the longer run. Ticking boxes became the 'thing'.

I remember once waking up in intensive care being asked by an obviously stressed and overworked nurse to identify EXACTLY where my pain was. I couldn't, because it was diffuse. She insisted and told me she only had half an hour to complete her form, and that "you are not giving me the answer I need". I repeated that I could only give her the honest answer that I didn't know where the pain stemmed from. There was no box to tick for that. I didn't blame the nurse, who was plainly at the end of her tether - but the stupid one-size-fits-all 'questionnaire'.

I was later told by my surgeon/consultant that these forms were introduced by someone in Management as part of a time-saving 'efficiency' drive... he bent down and whispered in my ear, "he's never worked in any healthcare setting before" and then put his finger to his lips and said "shush", shrugged, smiled, and walked off.

... that's what's changed. Not the nurses.

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hair

Bring back matron I say! I have always had good care in hospitals but what I have noticed is the lowering of standards as far as the uniform is concerned (and tying hare back).

When my mother was in hospital one of the nurses we encountered was very fierce (we christened her The Dragon). She could be very abrupt and seemed dismissive of relatives, but when my mum became very ill she was the one who cared for her very gently and who discussed her future and a DNR with me. I think sometimes we forget what nurses deal with, and that when you are constantly providing care for very ill people, when you encounter other people you may have very few reserves left.

The pressures are far more acute as the population ages and that population has more medical treatments to survive illnesses that would have killed them not many decades ago.

And nursing bursaries were taken away in 2015 when I believe they came in at around £16000 a year. The bursaries are now back at £5000 min per year. The numbers applying have gone up.

Someone does need to overhaul the box ticking which takes up so much time - though an audit trail and up to date records are neccessary. More HCAs to check patients can eat and drink.

One of my children is a nurse. I hadn't seen them since last summer. They have worked long shifts, caught covid and had to deal with that. This weekend they managed to get long enough off work to visit me, part of the weekend was taken up with calls to and from the ward about issues they were dealing with. Nurses have had one hell of a year.

That poor nurse was probably exhausted, busy with a full ward. Where is the compassion for her?

JaneJudge

I think there is a discussion to be had around do you have to have a degree to be a 'nurse' Of course old auxiliary nurses are now called health care assistants. Is a health care assistant really NOT of a nurse?

Nowadays yes, you do have to have a degree to be able to call yourself a Nurse, who is by definition, a Registered Health care Professional who practices independently, provides a specified service and follows a code of Practice, and has autonomy in decision making and practice. A health care assistant, an extremely valuable member of the team, is under the direction of a qualified professional. Some I worked with eventually trained and became Registered Nurses.

Beswitched, how is your Mum? have they managed to ring you/ I know how difficult it is on the weekends

Had it occurred to you that she might have had her hands full with the patients who were actually in her care?

theworriedwell

If there were no beds what was she supposed to do?

I remember my grandmother when she was terminally ill in the 60s. A nurse called 3 times a day to give her a morphine injection. One particular nurse was regularly late, poor gran was in agony. When she dared to complain the nurse replied, "You're a Catholic aren't you? You should accept suffering for Jesus." I don't think she was very caring.

Obviously I didn't expect her to conjure up a bed. But when this has previously happened the nurse would ask questions eg has your mother been able to drink anything, does she have a temperature, try giving her xxx.
This nurse just kept saying we have no bed ring tomorrow, without displaying any interest or saying any reassuring words.

Anyhow I seem to be getting attacked on this thread for supposedly dissing nursing qualifications, nó matter how many times I've tried to clarify what I meant, so am going to leave it at that.

Apologies that was in answer to Jane Judges enquiry.

She's in good form but we're hoping the cancer hasn't suddenly progressed. She wouldn't be strong enough to cope with any more chemo if it has. We should know tomorrow so obviously are very worried.

Perhaps it would help if I explained that I'm Irish and over there the term 3rd level degree is used to describe any degree from a University. When people say it they mean an actual degree not a diploma or certificate. It would never be seen to mean anything insulting over there.
I'm genuinely confused as to how it means anything different over here.
To me '3rd level degree' means 'University degree'.

Beswitched
You can’t justify yourself by saying you are well educated with multiple degrees of your own.
You have insulted every nurse I have ever worked with with your throwaway derogatory comment about 3rd level degrees.