WHAT HAS HAPPENED TO OUR HOSPITALS? CAN CARING HOLISTICALLY FOR PATIENTS HELP?

I trained as a nurse many years ago and there was something to be said for the system of training then. We were paid a salary as we trained and we started at the bottom and worked up. Training was on the wards under the tutelage of experienced nurses and we spent sometime generally a couple of weeks at a time in college on theory. We learnt people skills and became adept at practical skills and there was a strict hierarchy amongst the staff that instilled discipline within us and basic hygiene and good communication featured in this.

Now I know things have changed over the years and with the advance of new developments and technology over the years nurses have to be highly trained and skilled but something I have noticed nursing training today is more theoretic and the onus on students is more of an observer than a hands on, mucking in, type of nurse as was the case in the past, with all the practical what I call real nursing caring for the patients dealing with their basic needs and comfort.

A few years ago I worked in the palliative care department of a large teaching hospital and to be honest I was shocked. My job, which I did on a voluntary basis, involved me having access to patients that didn't have long left on this earth, so I had access to different types of wards within the hospital. I would use either Reflexology or Aromatherapy to comfort these patients in their last days. However I observed most of the REAL nursing, the grass roots type of nursing, dealing with making patients comfortable, feeding, washing, adjusting pillows, recording observations was being done by the hard worked auxillary staff, whilst the nurses were gaggled around the nurses station. When I was a student nurse and I completed my set jobs we would be put to work cleaning and tidying there was no time to be spent huddled in little groups

Now I'd like to think there was a good reason for seeing all these nurses hanging out together and give them the benefit of the doubt but I had access to a number of wards at anytime and this was my observations. When I trained as a nurse it meant three years on the wards, when you completed the training you were capable of being in charge of auxillary staff and student nurses and being left in charge of wards for a time. This does not happen now, student nurses spend three years at university and  some weeks of that time in placement more as observers, so when they qualify and gain their degree they are not capable of the responsibilites of the old system of trained nurses and often have to do apprentice schemes to make them fit for the job, something is not right here. Meanwhile we have Clinical Assistants who have six weeks training, taking temperatures, blood pressures and observations and even taking blood. To me this is all wrong and this is where all the basic disciplines are lost, therefore care, basic hygiene deteriorate and we have a system where the elderly who go into hospital for something routine come back out worse than when they went in, as no one has made sure they have been fed and kept clean, basic nursing.

Coming back to holistic remedies and care. Contented patients heal faster and that means dealing with patients in a holistic fashion i.e. mind, body and spirit and not just pidgeon-holing  them and dealing with their ailment. We need to think was makes a patient content and I feel that starts that knowing there is someone who will listen to their needs and making them feel cared for. That does not mean they expect their ailment to go away but to know someone will be there to assist them with the basic ablutions, making sure they are eating nourishing meals, so they get all the nutrients their body needs to repair itself. I know staffing makes it difficult to spend time talking to patients, but the odd kind word and smile achieves a lot to lift a patient's spirit.

It's taken a long time but the value of holistic remedies is at last been noticed, for what holistic  remedies and therapies do is they work on the whole patient. A contented patient fights infection better and heals quicker and even when the patient is terminally ill holistic therapies can make the easing into the next world more peaceful for them. 

Holistic care however does not mean that you have to have additional staff trained in various therapies, that would be lovely if possible, what it does mean though as to see patients as people, people who have feelings, who are anxious and worried what is going to happen to them. Remember Holistic means caring for the whole patient and not their ailment. They deserve to have their dignity preserved and they deserve basic cleanliness, these needs can be addressed by better nurse education and being put into practice. A stressed patient will not recover as quickly as a contented patient and if you have read my articles on here under stress you will know exactly what stress does to health by raising blood pressure and deminishing the immune system. Hospitals are frightening enough for most patients they deserve to be treated as those who treat them would wish themselves. I feel when hospitals take account of looking at care in a holistic way the standards of care and cleanliness would rise.

One in four patients say their local hospital is not up to standard

• Report also finds patients admitted to A&E at evenings and weekends are 10 per cent more likely to die

A quarter of patients would not recommend their local hospital, a survey revealed yesterday.
Their complaints included ant-infested floors, wards stinking of sewage and uncollected rubbish.
Others objected to doctors and nurses who made them feel as if they were on a  factory production line.
Some claimed nursing staff spent much of their time clock-watching or failed to wash their hands properly.

High risk: Patients taken to hospital over the weekend for emergency treatment have a higher chance of dying, according to statistics (Posed by models)

The Dr Foster research firm looked at the responses of 8,864 patients on the NHS Choices website and found that 26 per cent of them would not recommend their local hospital to a friend.
However, 58 per cent would do so however, while the remainder had no opinion either way.
Lack of cleanliness was one of the main reasons for the complaints to the website. One patient, who was treated at Whipps Cross University Hospital in North-East London, said ants had the run of the ward he was treated on. He also claimed food was not cleared from his bedside table for four days.
A patient admitted to Queen’s Hospital in Romford, East London, said bloodied dressings covered the floor and another said the ward stank of sewage.
At Queen’s Medical Centre, Nottingham, a patient said black rubbish bags were left along the corridor. Another complained that the same hospital was so dirty he ‘feared getting an infection’.
Some 72 per cent of patients who complained were upset at being ‘left in the dark’ by doctors and nurses who refused to speak to them about their illness or treatment.
One patient who had been brought in to the A&E department at Newham General Hospital in East London described doctors and nurses as ‘robotic’ and said they felt like they were on ‘some sort of mass production line’. A mother who gave birth at Queen’s Hospital said she had been ‘made to feel like an animal’.
The report also found that patients who are admitted to A&E during the evenings or weekends are 10 per cent more likely to die.
It warned that in many trusts too few senior consultants work outside of office hours meaning that patients are left in the hands of junior doctors.
In nearly a third of hospitals no senior staff were on site all weekend. Overall mortality rates, however, were found to have fallen by 20 per cent over the past decade.

The lengthy report also disclosed that some health trusts put just one nurse in charge of more than 20 elderly patients at any one time.
At South Tyneside NHS trust in Tyne and Wear the average is one nurse to 29.5 patients while at Frimley Park in Surrey the ratio is one to 20.
Dr Peter Carter of the Royal College of Nursing said: ‘Trusts now need to look at their staffing levels as a matter of urgency. Due to the complex needs of many older people, having staff with the right mixture of skills and experience on the ward is vital.’
Sir Bruce Keogh, medical director of the NHS in England, said: ‘Mortality rates are going down, but hospitals with high rates and poor outcomes in the evenings and at weekends must investigate to see where performance may be falling short and look to those with the best rates to see how they can improve.’
Professor Keogh added: ‘I will be asking the NHS medical directors to look closely at weekend services to ensure patients admitted at weekends receive the same standards of care as those during the week.’

WOULD YOU RECOMMEND YOUR HOSPITAL?

The Dr Foster report includes an analysis of patient comments made online about their hospital stay.

It revealed that disrespect and not being kept informed are the two main reasons why patients would not recommend their hospital. This was found to matter far more than single-sex wards or cleanliness.

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