Before the industrial age hospitals were built like cathedrals in order to lift the soul and ease the mind. Hospitals were decorated with carvings, works of art, flowers and perfumes. Modern hospitals are built with no regard for the spirit, eye or soul. They are bare, more like prisons than temples, designed to concentrate the mind on pain, fear and death. Where there are windows they are positioned in such a way that patients can’t see out of them (though even if they could they probably wouldn’t be able to see anything more enthralling than the refuse bins or the air conditioning units). If there are windows with good views then those windows will be on the sides of offices occupied by bureaucrats. The most highly paid bureaucrats get the best views.
But patients aren’t just in danger because hospitals are badly designed and badly run.
One of the reasons why hospitals are no longer suitable for sick people is the fact that ambitious, modern nurses want to administer rather than nurse.
In the dark old days nurses were hired and trained to nurse. Aspiring nurses (mostly but not exclusively female) were inspired by the desire to tend and to heal. Nursing was a noble profession. Caring was the key word. The most powerful jobs in the profession were occupied by ward sisters and matrons — all of whom still had close, daily contact with patients.
Sadly, today’s career structure means that nurses whose desire to nurse is accompanied by even the slightest ambition must quickly move up the ladder to a point where they spend very little time with patients. Many senior nurses now spend their days closeted in their offices, staring at computer screens and filling in assessment forms. Many seem to regard themselves as above what they see as the menial tasks of nursing. They leave the hands-on work to untrained staff. The introduction of degrees for nurses has made things even worse by turning a fundamentally practical profession into one with entirely spurious academic ambitions. The modern career structure for nurses has taken the best nurses away from patients. The drive for this career structure was driven by a patronising and entirely inaccurate concept: that nursing is demeaning.
Today, many nurses go into the profession attracted not by the desire to tend the sick but by the salaries, perks, authority and career structure which will, they know, take them away from practical work. The system is designed to attract exactly the wrong people into nursing.
The actual hands-on nursing is done, very largely, by junior staff.
This is, without a doubt, one of the reasons why modern hospitals are so bad and it is the reason why serious hospital infections are now endemic; it is why nurses are too often rude and uncaring to patients and why, in so many hospitals, clusters of nurses are more likely to be found having meetings (more appropriately called coffee-breaks) than actually helping patients. It is, for example, why thousands of elderly patients are left in pain, left to starve to death, left to die of dehydration, left in soiled bedclothes and left, ignored and without dignity, while nurses complete their paperwork.
Time and time again patients report that nurses won’t lift them up the bed (it has been reported that some hospitals have posters with the slogan ‘Nurses are not weightlifters’ on their walls), won’t help feed them, won’t bring bedpans, won’t change beds, won’t do anything for patients in pain or distress and won’t respond when the call button is pressed. They will not, in short, do any of the things that nurses are traditionally supposed to do. They are not interested in soothing or healing or helping because, even at quite junior levels, they have become career administrators with ambitions.
In many hospitals it is the patients who can get out of bed who end up doing all the nursing work.
Stop a nurse in a modern hospital and ask her where such and such a patient can be found, or how he or she is progressing, and you will probably be met with a glazed, disinterested look. They don’t know and they don’t much care. Private hospitals, where patients pay directly for their care, are a little better.
This article is taken from the book `101 Things I Have Learned’ by Vernon Coleman. The book is available on Amazon.
Copyright Vernon Coleman October 2022