Thursday, April 7, 2011

Lamenting about the lost art of nursing care:


This is a plastic slipper-pan....mine was papermache...even more lightweight...

I have recently been in hospital, nothing serious but none the less needing/requiring some nursing care: There is nothing like a bit of firsthand experience to relay to nursing and midwifery students the importance of a caring attitude..... I also say that people generally complain about staff that are rude and give the impression of not caring ...that is a distinct difference to the nurse who just doesn’t give a shit.

I do have to say that I find being a patient extremely difficult because I do not want to relinquish any sort of control of my life.....to someone else particularly someone who really doesn’t care. On the whole my care was good..... However it is always the little things that make life all the more difficult..... like your tray being placed out of reach and you can’t move....emmm a little difficult.... and ringing the call bell to use...yes the dreaded bedpan... and it takes 20mins for the nurse to appear....then a further 15mins before you get the slipper pan.... oh no..... you can just feel your bladder is about to burst...and then you have this ridiculous looking slipper pan and you know it’s just not going to happen....at this point I wished I had a penis...it would be so much easier....but alas no we take a deep breath and ask to be left alone to contemplate emptying your bladder lying flat on your back and trying not to be in any pain.... it seems a fate worse than death...trying to pee in these conditions.... remembering you have done this all about 4hours ago and wet the bed in the process...then you have to go through the embarrassment and the changing of the bottom sheet.......anyway about half an hour later I think yes... I’m done.... ring the bell... by now the slipper pan is well and truly stuck to my buttocks... the nurse comes in “are you finished” yes thank you... Ok let’s get it out then.... lift up.... tummy muscles work frantically and lift.... as the nurse manoeuvres the pan out .... oops yes you guessed it.... a spillage...but of course... how can this flimsy product hold several litres of fluid without having a mishap......oh did I mention it is the middle of the night....the nurse says “oh that’s good....it didn’t spill did it?” emm... I lament and say...” I think that the bed is wet”....no says the nurse it’s your perspiration... it will dry very quickly....and slips out the room very quickly carrying her overladen slipper pan.... and me... well she doesn’t know that I am a nurse / midwife educator and am totally blown away by this blatant lack of insight into poor care....now here I am the patient....at this stage a not well patient who has pain, now lying in a wet bed and wondering is it worth the trouble to ring the bell wait another 20mins and complain about my care , have the sheet changed creating more pain or shall I just lay here and hope that I fall asleep as I am still affected from the anaesthetic... to which I do just that (I have to say this only happened once, not all the staff were like this).

I should think it is equally as difficult for a man to pee lying down.....

In the next bed was an elderly frail lady whom I had not met but could hear through the curtains that she had some sort of facial surgery and could only swallow. I came to this conclusion because I could hear her trying to swallow her drinks and her meals came in a bowl, she had hardly any visitors and was very quiet. It is interesting trying to assess someone you have not seen by the care she received from the nursing staff. Some nurses would come in very chirpy “Good morning, I have some pills for you, oh your poor darling, that looks uncomfortable let me crush your pills”....to, hello here are you pills.... Patient “oh I find it hard to swallow can you crush them” nurse – just try; patient; ok..... Cough; splutter; splutter; tears........oh Ok I will be back...... surprisingly it was the younger nurses that showed less caring....this occurred at least 4 times a day all with differing responses.... On the second day when the nurse came in and said “here are your pills and asked her to swallow them after the patient had asked for them to be crushed...... I could not bear to hear the patient again try to swallow....that I yelled through the curtains..if I could have got up without causing myself pain I would off.... why don’t you just crush or give her dissolvable paracetamol......the nurse scurried out the room and came back with dissolvable pills.... I know there is nothing worse than a busy body not minding their own business..... but it just had to be done...later when I got up ...the elderly lady said thank you to me for asking the nurse to crush her pills...and explained she had two sons lived away and it was difficult for them to visit...but they would say something if they knew.... and said I don’t know why some of the nurses won’t crush my pills.....she became teary and wondered whether it was all worthwhile.... I sat with her talking about life and I was saddened that none of the nurses found time to spend any time with this frail lonely woman who has had some remarkable facial surgery and how any nurse could possibly ask someone to attempt to swallow when visibly it was obvious that this was an onerous task for the elderly woman....

I know we all use the excuse that we as nurses and midwives are overworked, but please, caring and compassion is what we are about... it is a basic human need.....everyone is so busy with the task that there was absolutely no caring or compassion ......

My dilemma as an academic is how we teach our students to be caring and compassionate in a world that demands tasks to be completed in unrealistic timeframes.... and why are we producing young nurses that do not have a caring philosophy.....

Tip to nurses.... you never really know who the person you are looking after.... therefore be kind, caring and professional to all.... treat your patients like you would like to be treated yourself... and if you are having a bad day stay home..... don't inflict it on your patients.....

6 comments:

Sue said...

I have always thought it should be compulsory for all nurses and doctors to spend some time as a patient. There have always been the 'off hand' nurses and then the ones who just go that little extra bit which makes all the difference. I would hope we all try to be the second type.
Someone (client) recently commented that I was very patient, and I replied that if I wasn't I would have no business doing the job. Let's all remember that nursing care is what it is really all about

Pam said...

I have also been the receiver of modern nursing 'care' as both a patient after a major operation and as a relative. I have also blogged about both experiences.
It does sadden me that there seems to have been a loss of 'vocation' in nursing. I especially still hold true to Maslow's hierarchy of needs (even though I recently read someone who was very critical of those still holding on to this as a model).
I too remember and am most touched by the nurse who helped me to the shower, showered me down, maintained my dignity, came into me after my painkillers were given to ask how things were and who took the time to explain what was happening.
I am a poor patient, I hate being out of control, I fear for my dignity and this one nurse very experienced nurse took care of me. This was in stark contrast to others on the ward who made me cry because they belittled the fact I couldn't get my bed to work, when I was so uncomfortable and so tired I wanted to lie down and couldn't manage without their help. The young nurse who dismissed my concerns that I wasn't passing urine properly, had pitting oedema from my toes to my mid thigh and that I seemed to have gained 8kg's despite being nil by mouth and the one night nurse who came into the room dressed in a bedraggled brightly coloured cardigan, hair everywhere and who tutted at me because I needed pain relief.

I've been at a research conference and a number of masters/phD nurses are centring their thesis around the fact that 'caring' isn't valued in nursing anymore.

This doesn't just make me incredibly sad but it makes me bloody angry.

Carolyn Hastie said...

So sad Pauline! Timeframes are horrible in hospitals these days. Everyone is rushed off their feet. Not enough staff for the complexity of the people. I hope the 1:4 roster in NSW and Victorian public hospitals has/is making a difference there! I'm sorry you had such a difficult time too, as well as that poor old woman. So fortunate that you were there to help her process her feelings. I do think empathy and kindness can be learned. We need group work, stories and role play. We need them over and over again to get those neural networks of compassion hooked up. Thanks for sharing your experiences. Your descriptions have given me some good ideas for when I teach students next

InfoMidwife said...

Thanks Sue for you comments and yes maybe a dose of being in hospital as a patient should be compulsory but sadly it is not....lets hope for better things to come.

InfoMidwife said...

Thanks Carolyn for your comments, as usual you are an inspiration for me...what a good idea stories and role play I will give it a go next semester and see if it makes a difference to attitudes. 1:4 ratio that's good, don't think that has hit WA...

Anonymous said...

Thank you for sharing. Brought a tear to my eye. I am a first year registered nursing student at Murdoch University in western australia.. I have motivated and supportive educators that have been instilling the importance of care and compassion. This is igniting a passion for nursing within me, and as a budding nurse to be, I hope to be able to enrich the lives of people who are ever in my care. Saddens me that not everyone is a passionate and caring.
Lisa

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