RCN Bulletin January 2012: letters page extra

No time to care - full letter

Nursing just isn’t what it used to be. I qualified in 1977. In those days nurses had time to care for their patients. We washed them (every patient had a bed bath, immersion bath or shower, every day). We washed patients' hair, cut their nails, shaved the men. We fed them, and if they couldn’t eat we whipped up an egg and milk and stayed with the patient until it was finished.

We did their observations, administered medicines, helped patients to use a toilet, bedpan or commode, talked to their relatives and wrote briefly about each patient at the end of each shift. We did not have more staff than today, although student nurses spent more time on the wards and expected to learn all the practical aspects of the role.

We did work longer hours but we always had two breaks in a shift unlike today where some staff don’t take a break at all. Care assistants were called auxiliary nurses and I don’t remember there ever being more than two on any ward. We did “back rounds” on every ward, every two hours. Patients rarely fell. Relatives rarely complained. Patients stayed in hospital until they were fit enough to cope at home or occasionally went to a convalescence home.

People were not admitted to hospital because of drug problems or alcohol dependency or because they couldn’t manage at home. On most wards, some patients were always well enough to make tea and help other patients. We didn’t do audits or have “link nurse roles”. We didn’t do IV medicines, take blood or cannulate. We didn’t have specialist nurses because all the nurses were specialists in the area they worked in and new staff learnt from them.

We didn’t spend hours writing care plans, discharge plans or risk assessments. Surgical wards had “dressing books” and some wards had “bath books”. We took long-stay patients outside to sit in the sun, or sometimes wheeled the whole bed outside on orthopaedic wards.

We cleaned trolleys, drip stands, medicine and linen cupboards every week. Cleaners and domestics worked for the ward sister and were part of the team. Ward sisters stayed on their ward, had the authority to maintain high standards and made it their own, usually until they retired. Some were terrifying but you do learn how to make a bed properly if you have to make 28 beds three times until you get sister's approval. Most nurses retired at 55 although some did stay until 60, usually if they were senior and single, and nursing was their whole life.

Nowadays it seems that targets, audits and tick-box forms are so important that there is not enough time for the basic essentials of care. Discharge seems to be the most important aspect of any patient's hospital stay and throughput is so fast that all the patients are usually acutely ill and need more nursing care while staff have less time to deliver it.

On some wards trained staff administer medicines and complete documentation and have no time for anything else. Many are frustrated and demoralised because they want to be able to do more for their patients.

I suspect that if the Government’s pension proposals go ahead, many will leave the NHS as the hope of a decent pension is one of the things that has kept staff going.

I don’t know what the future holds but I do know that for very many nursing is no longer the rewarding job it once was and I for one would not recommend it to anyone considering a career today.

Cathie Blackwell
By email

Looking back on 2011

2011 was pretty dynamic for the All Pakistan Nurses Association (APNA-UK). In addition to working closely with the RCN and supporting British Pakistani nurses in a variety of situations across all four countries, it is also involved in promoting nurses and nursing in Pakistan.

Throughout the year General Secretary Muhammad Asghar, ICU Charge Nurse at the Royal Free Hospital in North London, travelled to Pakistan several times. He successfully set up a primary health centre in Rahim Yar Khan in Punjab and also provided an ambulance for use in remote areas. He also organised workshops to update nurses in their practice. APNA-UK also shipped two containers full of relief goods for people affected by floods and other disasters in Pakistan.

2012 promises to be equally lively and productive. APNA has identified three workstreams that should prove beneficial for both UK and Pakistani nurses. These are further education, public health and raising awareness and empowering women around health problems, particularly Thalessemia and other chronic diseases. Faith healers are a major concern - 'it was Allah's will that the patient died' - is stoically accepted. APNA has also been approached by a UK NGO, called Save Your Rights, to work together on mental health issues around forced marriage and child abduction.

This is indeed a superb opportunity for the Pakistani nursing diaspora as well as other interested nurses to get involved in a venture that would aim at raising the morale of Pakistani nurses, and improve the care patients currently receive in Pakistan. It is a project that asks for a small commitment but has the potential deliver significant rewards. Please contact for further information - zeba_arif@yahoo.com