The NHS Then and Now
The NHS has been looking after us for 75 years and I have been part of it since the tender age of 18 when I commenced training at The London in Set 424. I still feel part of it as I receive an NHS pension for which I am extremely grateful.
So how have things changed since 1971? I can only relate my recent experiences as a patient since I had to give up hands-on nursing 25 years ago after being involved in a very serious car accident and although I managed to keep my registration until 11 years ago whilst working for NHS Direct and the local GP Out-of-Hours service I never set foot as a nurse on the wards again.
My personal experiences are varied and there has most definitely been a difference in the quality of care and organisation of the NHS over the past 10 years or so. I was so fortunate to train at The London as we were taught how to care for our patients holistically and our staffing levels were good compared with how they are today. The ward sisters were true role models and as we rose through the years of our training we learned how to run the ward supported by the trained staff and nurse tutors. When nursing moved into the degree level at University the length of time students spent working on the wards reduced dramatically as the academic content of the courses increased. When I qualified I had already been in charge of several wards at night as a student nurse so this valuable experience made the transition to Staff Nurse much easier. Newly qualified nurses now need much more supervision and a year in preceptorship to gain confidence.
In terms of the care I have observed as a patient, I have watched nurses who trained before degree level was introduced exhibit much more ‘hands-on’ nursing skill and they seemed frustrated with the over-use of computer-led drug rounds and the prominence of form filling away from the bedside. The role of the HCA has largely taken over that of the qualified nurse and most bedside care is now dependent on these stalwarts and the role of the ward sister has been relegated to being office-based and now even domestic ward staff wear the coveted blue uniforms! Nurses wear their uniforms into supermarkets and shops whereas we were strictly forbidden to wear them outside the hospital, even removing our starched aprons before going off the wards.
The NHS still cares for us within the strict confines of the budgetary limits imposed by the government but the infrastructure has become more bureaucratic and the huge cost of modern medicines and diagnostic machinery has seemingly left the ‘human’ cost of care behind together with the care of those who are trying their best to practice the art of nursing. Yes, being able to critically analyse and compare theory and practice is very useful but no substitute for a hand to hold or a clean sheet when a patient is desperate for comfort.
Happy Anniversary NHS but don’t forget you are looking after human beings, not computers and electronic gadgets. Maybe time to look back and remember the words of Florence Nightingale: “Nursing is an art: And if it is to be made an art, it requires an exclusive devotion as hard a preparation as any painter’s or sculptor’s work; for what is the having to do with dead canvas or dead marble, compared with having to do with the living body, the temple of God’s spirit? It is one of the Fine Arts: I had almost said, the finest of Fine Arts.”
Jane Harvey
