'Shame on us nurses'

 
Nurse with elderly patient

Following the Care Quality Commission's recent report on what it called "alarmingly" poor care for elderly hospital patients, leading nurse Prof Ian Peate says in this week's Scrubbing Up that the profession should look again at how it trains people to look after older people.

Once again we read about the disgraceful care of our elderly and frail population and once again I cringe with embarrassment as I read how we abuse the people who we have the privilege to care for.

Yes I know there are some excellent examples of high quality outstanding care provided to people. But there is something seriously wrong here.

Nursing is well on its way to setting minimum standards for a degree level nursing programme and justifiably so, given the complexities of care and the demands the public rightly make in insisting on high quality, safe and effective care.

The Nursing and Midwifery Council (NMC) regulates nurses and midwives in the UK.

It sets standards for education, attempting to ensure that nurses possess the right skills and qualities when they start work as a qualified nurse.

What the NMC does not do is stipulate any mandatory requirements for elderly care. They leave this up to the individual educational institutions, so each will approach the teaching of elderly care in a variety of ways.

The time has come for the NMC to compel those running courses to stipulate how much time should be dedicated to the care of the elderly, in practice and theory.

There is a need to ensure that students of nursing - our future staff nurses who will be looking after me when I am older - are able to care confidently and competently for older people - geriatrics.

'High touch' - not high-tech

The art and science of gerontology has all but gone and this is a pity.

As a nursing student I was privileged to take a course that instilled in me the skills required to care for geriatrics patients, responding to their unique needs as people who have a number of concurrent illnesses and take a variety of medications.

If nurses get the care of older people right by applying the theory to practice, paying attention to feeding them and providing them with fluids, washing and cleaning them when they are unable to wash themselves, communicating with them and encouraging them through caring, kindness and compassion then caring for other patients will come naturally.

Start Quote

We need to say sorry to our patients and to tell them what we are going to do to get it right”

End Quote Prof Ian Peate

These are high level skills that require the nurse to apply scientific principles to the art of caring.

As a student I was assessed, on the job - by an experienced nurse - in caring for geriatric patients. But that specific check is no longer required.

We should not be ashamed, embarrassed or made to feel politically incorrect when using the term geriatric.

It is a speciality, with care provided by skilled practitioners, on the geriatric ward as opposed to a busy acute medical ward where high-tech is favoured and preferred over "high-touch".

We have witnessed our medical colleagues embrace so-called "soft skills" (communication skills, a good bedside manner) through their improved undergraduate education.

NMC take heed.

Demand the curriculum you validate has explicit elements of geriatric care in them, in the classroom and on the ward; direct that no student will progress if they do not pass the an elderly care part of their course; continue to reinforce the need for all staff to speak out when they witness substandard or abusive care but also insist that those who speak out are supported.

Shame on us nurses.

We need to say sorry to our patients and to tell them what we are going to do to get it right, and we need to be brought to account each time we fail to provide care that is compassionate, kind and humane.

 

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  • rate this
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    Comment number 289.

    I don't agree about staffing levels or pay, it appears to be how they are taught. My lad had a large part of his intestines removed due to Crohn's disease. When I visited and asked a nurse for help to raise him in the bed I was told he could do this himself ?! Too much emphasis on degrees and not enough on care. My aunt was a matron for many years so I do know how hospitals used to be run.

  • rate this
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    Comment number 288.

    I thought all nurse were mother Theresa's.

    Then I had an op early this year and witnesses some shifts who were callous and uncaring, espciallly with dying people. Itsickened me, but like the others patients I was too weak and dependant after an op to do anything.

    I am sorry to say this was most evident amoungst older nurses; in fact the young ones were lovely and as shocked as me I thnk.

  • rate this
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    Comment number 287.

    It's a crime that people responsible for staffing are allowed to understaff wards as much as they do especially for the elderly. The elderly can take a huge amount more effort not to mention abuse often received from them. It's dead easy for a patient to cry abuse! but until you've nursed the elderly you don't realise how trying it can be. I've been bitten had my glasses broken but we struggle on

  • rate this
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    Comment number 286.

    @277.
    Tigerlily Bane
    21st October 2011 - 23:22

    273.adzcliff

    I'm disappointed in you. My wife's a student, having been a teacher of children with behavioural difficulties (and then dep-headmistress). Her course run 46wks of the year, with half that time in clinical placement. This is NOT a little bit - it's the same as my first wife did 23 years ago. Assessment is by nurses - in both settings!

  • rate this
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    Comment number 285.

    282.sarah
    I am currently a student nurse, having been a carer for 20 years. I truly believe that all students should have some care background, and not be allowed to apply until they do

    =>Back in the day this happened. Student nurses worked on the wards as well as classroom work. They were assessed by matrons, ward sisters and examiners. Lazy or uncaring people never made SRN

 

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