The lost art of nursing care

The profession of nursing, like teaching and religious ministry are fabled to be inspired by divine favour. Florence Nightingale, John Locke and Jesus being a few of thousands of people throughout history, to be touched on the shoulder into service. Other people are driven by the sound of generational footsteps and the desire to uphold the family name of loyal professional service. For many people, there is a genuine desire to assist others when personal vulnerability is at its greatest. My mother’s childhood equipped her with many moments of dark loneliness and bleak vulnerability, which she transformed into empathetic nurturing during her nursing years before and during the years of the Second World War.
I have been admitted into several hospitals in the last six months, both as a public and private patient. I have been nursed by approximately 20 or so people, mostly registered nurses, some senior in position, one noticeably only recently registered, and a few enrolled nurses. There has been a huge variance in my personal experience of nursing care as a health consumer. Some blame must lie with inadequate training,  poorly screened international graduates, a workplace culture of short term labour contracts, a struggling under resourced sector and poor career and personality alignment. Frankly for some nursing should not have been offered as a career suggestion.
What makes one nurse exceptional and another barely competent? Both nurses that provided exceptional nursing service, performed their job effortlessly with the subtle grace of knowing what was required and offering it in such a way that no awkwardness resulted. Both were undoubtably experienced and highly skilled in the practical delivery of basic nursing care such as inserting IV lines, dispensing medications and in the taking of blood pressure and temperature readings. These days greatly simplified by machinery. It is in the capacity to advocate appropriate care with other medical staff and to instinctively act in the patient’s interest, where evidence of empathy and excellence is demonstrated.
One nurse at The Mount Hospital, brought to the role a personality both light and engaging and a sense of maturity and reliability that was demonstrated in her responsive attendance to my post operative needs. Her mandate was simply to ensure that I was comfortable and pain free. She spent time adjusting pillows under my arms and behind my knees, and ensured that I was warm and securely tucked in for optimum sleep. She responded to the call button, with genuine warm regard and when I needed assistance with personal hygiene, she did so as if it was a common request. She was clearly embued with empathy and emotional intelligence. 
The list of behaviours that were not conducive to excellence included a reluctance to respond to the call bell, response provided in a manner with the objective of soliciting no further requests, persistent alarms on IV equipment, carelessness with equipment, clumsy manual handling at the site of the surgery and over medicating causing vomiting. 
We all accept that regular observations at hourly intervals are invasive when you are trying to sleep and heavens knows you need it when you have undergone major surgery. It is the lack of empathetic response and application of emotional intelligence   from many nurses, that I found most alarming. Hospitals are a foreign environment designed for maximum efficiency and quick turnover. The beds are evidence to this, hard and unforgiving. The pillows provided are coated in plastic, so it is essential to bring your own if sleep is to be achieved, with or without medication. Only one nurse offered pillows under my arms and knees to support my body and regularly checked and adjusted these to ensure that I was comfortable so that I could sleep and begin to heal.
Sharing a room means sharing the television tastes of other patient and where the concept of volume control has been lost. In the past, the nurse reminded you that it was not necessary to have the volume at a high level as the unit was designed to be kept at ear level for the patient in between visitors. Hospital etiquette has disappeared in the path of progress. The downside of a private room is that you can become ‘out of sight, out of mind’ once the door is closed and there is no opportunity to catch the nurse to attend to minor requests while nursing staff are still in the room.
The absence of personal commitment was evident in the absence of introduction between shift changes or any time engaging in polite discourse to create connectivity and trust. Given my role in the Health and Community sector, I will be providing this feedback to current trainees within the vocational education and training sector however as nursing is primarily delivered from university settings, it is this sector which must solicit feedback from its clientele, the general public. It is the responsibility of governments, state and federal to fund and oversee budgets which are often in deficient for an increasingly demanding need. It is imperative that as a society that we honour and value those roles in our culture that provide service to humanity at its base vulnerability and to reduce, like teachers through education and the police through, community safety, potential loss and grief. 
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One thought on “The lost art of nursing care”

  1. A grim picture and analysis, dear friend, so here’s hoping you don’t need to place your vulnerability in their hands again for a very long time…by which time we would hope that the health care world will have undergone a miraculous transformation, or at the very least, learned how to respect vulnerability in humans. Love you.

    Like

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