Friday, July 19, 2024
HomeCulture WarWhat would Florence Nightingale think about our uncaring NHS doctors and nurses?

What would Florence Nightingale think about our uncaring NHS doctors and nurses?


IT’S clear that those running the NHS are utterly clueless about how to tackle their failing behemoth’s problems. Likewise, commentators limit their discussion of reform to berating the undoubtedly bloated, inefficient management. However the great NHS debate is always confined to challenging evil managers who are thwarting the noble efforts of heroic front-line staff. The inability to question the competence, attitude and accountability of doctors and nurses is near pathological. Of course trusting and admiring someone who heals the sick is a natural instinct. Surely it is compassion that motivates a person to take on such a job? 

Only a few days ago a story hit the papers of a GP who refused to go to a patient’s house to verify a death. Instead this ‘NHS hero’ asked a widow of but hours to hold up her smartphone to her husband’s corpse. She couldn’t bring herself to do so and her friend had to take over, moving it up and down the lifeless man as instructed. Later the distressed widow said: ‘You just assume that when somebody dies in your home that somebody’s going to come out and  . . . have a tiny bit of compassion in there.’ 

Such horrific episodes are surely a rarity? However although the report on the Shrewsbury and Telford maternity scandal strongly condemned management policies and understaffing it also specifically criticised a lack of compassion and dehumanising of patients. As pointed out in UnHerd, ‘One of the most disappointing and deeply worrying themes that has emerged is the reported lack of kindness and compassion from some members of the maternity team.’ Furthermore one has to ask what type of person stays quiet while knowing that people are suffering and dying due to medical error. This was the culture not only at Shrewsbury and Telford: the cover-up culture is endemic in every part of the NHS.

Yet even the admirably outspoken NHS critic and Talk TV commentator Dr Renée Hoenderkamp shies away from the idea that some doctors and nurses may not care about patients as much as she clearly does. In an article in June she ascribed the lack of compassion in treating patients to the pressures of a rotten system leading to overworked, stressed staff. I take the view that ‘stress’ can’t make a compassionate person uncaring. A perfect example is the glass of water or plate of food which is placed out of reach of the patient. As a campaigner against NHS malpractice, I commonly hear this basic complaint about nursing. It takes the same effort and time to place something accessibly as it does to put it down too far away. The only difference is genuine care for the patient.

What does ‘patient care’ even mean nowadays? The job of nursing has removed itself from any responsibility for basic patient care e.g. washing, turning immobile patients in bed, fetching a commode, feeding etc. The mother of nursing, Florence Nightingale, set out an approach in her Notes on Nursing that would be alien in any hospital today. Her whole focus was on what she called ‘momentous minutiae’ – basic, individual care which would now be seen by too many of today’s degree-garlanded nurses as beneath them. Indeed for Florence Nightingale and the generation of nurses that followed her their role was ‘care’ in the real sense of the word. They tended to the sick in the most intimate way and not from the end of the bed with a clipboard or an iPad:

 ‘Again, a nurse is ordered to give a patient a tea-cup full of some article of food every three hours. The patient’s stomach rejects it. If so, try a table-spoon full every hour: if this will not do, a tea-spoon full every quarter of an hour.’ 

If any NHS structural and managerial reform is to be successful, reform of the medical profession must go along with it. In other words if we truly want to ‘save the NHS’, and more importantly the nation’s health, we must redefine the job of being a doctor and a nurse, the type of work it entails and the attitude required. The practice of medicine isn’t a power career, it’s patient care. Degrees should not be an entry requirement for nurses, but psychological vetting and compassion must be. Doctors need to be assessed on that old-fashioned concept of ‘bedside manner’. Hopefully this redefinition will in itself attract people more suited to what should be a vocation to tend to the sick as unique humans, not ‘cases’ on a chart. Patient feedback must really make a difference and not just be filed away. There must be, as also for management, total accountability and whistleblowers must be protected.

During the recent court drama around the tragic case of Archie Battersbee, anyone supporting his family was liable to be bombarded by hostility and anecdotes of ‘wonderful’ doctors and nurses. Of course many such individuals exist. But those who insist that all doctors and nurses are ‘doing their best’ should remember those mothers in Shrewsbury and Telford who were treated without care and compassion, as well as being victims of bad NHS policy. They should talk to more NHS patients who suffer their own scandals that never hit the headlines. Florence Nightingale said: ‘I attribute my success to this, I never gave or took any excuse.’ I don’t believe she would look upon the medical profession of today with a sympathetic eye.

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Romy Cerratti
Romy Cerratti
Romy Cerratti is half German, a quarter Italian and a quarter Peruvian but is proud to be British. She has a masters degree in medieval history from Oxford and is a passionate campaigner on issues of mental health and NHS reform.

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