There’s an interesting article on the Guardian’s Comment is Free site, discussing the suggestion that hospital visiting times be extended so that families can be more involved in their care.
The suggestion, previously made by Peter Carter of the Royal College of Nursing, had been the focus of a lot of criticism. Some suggesting it’s about too-posh-to-wash nurses, others that it’s an admission that the wards are too overwhelmed to provide basic care.
Peter Preston has a different take on it. He points to his experience of being in hospital in Spain, where the whole family tends to troop in along with the patient.
And the deeper point, revealed time and again, has absolutely nothing to do with cost-saving – or with graduate angels too proud to plump a pillow. The Spanish experience is instinctive and positive. It doesn’t make family involvement a passed parcel of sneaky budget savings. It says, simply, that this is what family life is all about. Hospitals aren’t carved up between them and us. Hospitals are more joint community centres in a society used to doing the right thing.
It’s a valid point, in my opinion. I remember when my father was terminally ill in hospital. I spent a lot of time sitting at his bedside, making sure he ate the food that was in front of him, giving him occasional sips of water…nursing my own Dad. It didn’t just mean that Dad didn’t get malnourished or dehydrated. It also gave me a bit of closure on the relationship with my father that was coming to an end, and it helped later on when I was going through the grief process.
Regarding the criticisms of Carter’s suggestion, I’ll start by saying that I don’t agree with the suggestion that nurses are “too clever to care” with hoighty-toighty degrees but too proud to wipe a bum. Admittedly I’m biased since I went down the degree route myself, and I’m currently in a role that doesn’t involve bum-wiping (I spend much of my time doing cognitive-behaviour therapy with self-harming teenagers. I think they’d be a bit unnerved if I offered to wipe their bum.) However, when I was a staff nurse on a ward I felt it was very important to show that I wasn’t too proud to get mucky with the basic care. As for the slogan, “too clever to care”, my experience is that clever people tend to make for outstanding nurses. If a staff nurse thinks something is beneath them, my experience is that those nurses are usually muppets.
Also, those who insist that nursing has been ruined by the British university system tend to forget that much of the care on our wards is done either by people who trained in the Phillipines, India or Africa, or by healthcare assistants who didn’t go to university at all.
As for the other criticism – that it’s a sign that the NHS isn’t coping. Well, that one’s a little harder to argue with. Just this week the Care Quality Commission reported that half of our hospitals are failing to ensure elderly patients are properly nourished. They give some pretty clear indicators of the reasons.
One nurse said: “Sometimes I am the only staff member to feed on the ward. How can I feed all these people?
“Sometimes by the time I get to the last bay, either the food is cold or it has been taken away.”
There’s the usual mouthwash from the health secretary Andrew Lansley about how he wants poor care “identified and stamped out”. Naturally he’s talking utter drivel. NHS trusts are freezing recruitment left, right and centre. The wards will get more understaffed, patient care will get worse and there’s not a damn thing that Lansley can do to stop that.
So, should families get more involved in patient care? I can see valid social reasons in favour of it – both from Preston’s article and from my own experience. But there’s also the brutal reality that we may have to just to make sure our sick relatives are getting enough food and water.