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A resolution at the annual congress of the Royal College of Nursing (RCN) will propose that nurses are now “too clever to care”; it will suggest the compassionate part of their job should be delegated to “healthcare assistants”.
“When Florence Nightingale invented modern nursing, life was more straightforward than it is today,” said Tom Murray of the RCN’s Exeter branch, which put the resolution.
“People knew what doctors and nurses were there to do. Since these far-off days events have moved on.”
The traditional style of nursing — with time to take a patient a cup of tea, hold their hand or give them a bed bath — has grown unfashionable.
Some nurses are now increasingly carrying out other work, such as performing minor surgery, previously done by doctors.
Critics of the changes say the core role of their profession — the devotion and humanity personified in Nightingale — is being lost as nurses try to become “mini doctors”.
According to their more traditional colleagues, these nurses believe basic care, such as feeding and cleaning patients, is beneath them.
In a bid to force a debate on the subject, Exeter members of the RCN have proposed a resolution stating: “That this meeting of the RCN congress believes that the caring component of nursing should be devolved to healthcare assistants to enable registered nurses to concentrate on treatment and technical nursing.”
“Nursing must decide whether educated and well-qualified nurses should carry out the complex aspects of nursing and delegate the ‘touchy-feely’ bits to others,” Murray said.
“We are moving towards a situation where, if you are interested in providing basic nursing care, you would be better becoming a healthcare assistant rather than a nurse.”
Jeremy Bore, Exeter branch chairman, hopes the provocatively worded resolution will lead to a rethink.
“A student nurse recently said to me, ‘I will not wash patients’ bottoms, there are other people to do that.’ This reflects a groundswell that has built up over the past few years. Some members of the profession should be reminded of where their responsibilities lie.”
The modern “uncaring” nurse has been reflected in the Channel 4 drama No Angels, which portrays them as being more interested in visible panty lines and sex with junior doctors than looking after patients.
But the changes are causing genuine concern in the real world of nursing. One nursing school, dismayed that nurses have forgotten how to care, has even made a teaching video called The Art of Caring Exists. May McCreaddie, senior lecturer at the school of health, nursing and midwifery at Paisley University, who made the video, said: “Some people have lost sight of what caring is and how central it is to nursing.”
Claire Rayner, president of the Patients Association and former agony aunt and nurse, has had personal experience of the change. She was in intensive care for four weeks last year when she suffered complications during a routine operation on her Achilles tendon.
“It was so difficult to get a nurse’s attention,” she said. “I had trouble speaking at one point, so I was trying to catch a nurse’s eye, but I found that impossible. I was also very sick and when I was vomiting I found it difficult enough to get a nurse to give me a dish, never mind to help me.”
Rayner says that while student nurses now write essays on the theory of dignity, they do not know how to put it into practice. “I don’t object to nurses being academic, but they are not learning what is the core of nursing, and that is love and care.
“We have got to try to make nurses understand that holding someone’s hand is caring and much more important than pretending to be a doctor. When I was a nurse, if a patient couldn’t sleep, we would make them a cup of Horlicks or Ovaltine then sit down and reassure them.”
Another patient, a 64-year-old woman from Doncaster who preferred not to be named, had similar complaints. She was admitted to hospital recently suffering from angina and found a total lack of kindness from nurses.
“There were at least half a dozen nurses on the ward during afternoon nap and there was shrieking and noisy laughter coming from their station,” she said last week.
“I missed tea in the afternoon because I could not sit up and at about 7pm I asked if I could please have a cup of tea. The nurse in charge snapped at me that there would be another tea round at 10pm. On another occasion I was left lying on a plastic mattress with no sheet.
“Some nurses didn’t tell me who they were or ask how I was that day.”
The RCN insists that caring is still at the core of nursing, but Alison Kitson, its executive director, admitted “workforce design” was “unintentionally squeezing out” caring.
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