Monday, October 13, 2003

Come Back Miss Nightingale

Mrs Tall is currently taking a 'back to nursing' course in the UK after 8 years as a full time mother. She trained at Barts under the ancien regime and is puzzled by the 'coursework' she's being given now.

She's currently looking at three set texts

"Nursing Rituals" by Mike Walsh and Pauline Ford

'... the unquestioning tradition of obedience ... Victorian legacy ... this involves obedience to hierarchy and also to men, who, according to Victorian values, are seen as inherently superior to women. It is no accident that most nurses are women and most doctors are men.'

A later work by the same pair 'New Rituals for Old'

'being powerless is synonymous with being oppressed (tough being a baby then - LT) and one of the principal tenets of feminism is that women are an oppressed group. About 85% of nurses happen to be women. It is hard to ignore making a linkage (sic) betwen these two statements, and, in addressing the issues of empowerment, feminist perspectives therefore deserve our immediate attention.'.

The theme of this book appears to be that 'we've thrown out all that stuffy old tradition and we're STILL oppressed'.

And 'Nursing Models and Nursing Practice' by Peter Aggleton and Helen Chalmers.

.. until relatively recently many nurses believed that nursing is best carried out when based on instinct, intuition and empathy, elements that make up 'the calling' ... such an approach ...has since come in for considerable criticism.

It was not until 1967 that Yura and Walsh argued that nursing care ... should be likened to a problem-solving process in which nurse and patient
1. together identify the causes of problems requiring intervention
2. make plans to remedy this problem
3. take the necessary steps to alleviate them, and then
4. reflect on what has happened '

Love that 'reflect on what has happened'. Presumably only if you're still alive. My mother was subjected to this last approach (known as "the nursing process") when she was dying of cancer a year ago - a charade of equality. It was a pity that during this dialogue her night nurses made plain to her their displeasure at having to take her to the toilet several times a night.

When I was studying sociology and annoying my tutors, my wife was learning nursing at the sharp end in London casualty units.

It looks as if the 'return to nursing' courses are not designed to update the returnees in clinical practice, new drugs or techniques, but to reprogram them into a new nursing ethos, one in which the nurse and her status are all-important. All for the patient's good, you understand.