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medpundit |
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Wednesday, February 11, 2004This trend away from old-fashioned caring started with theSalmon report of 1966. Ostensibly, it wanted to improve the status of nurses by regarding them as market professionals. So the hierarchical and disciplined Nightingale ward system was abolished in favour of a "modernised" approach; overnight sisters were transformed into ward managers. The RCN, forty years on, is Salmon supercharged. It uses the management babble of service providers and care users with a big twist of political correctness and status obsession. However, devotion to caring for patients is crowded out by the new verities of nursing. Hence Malone's odd contention that choosing one's working hours is a "basic human right". But then, this is the same institution that defined harassment to me a few months ago as "being made to feel inferior, or not being invited to meetings". Then there's Project 2000, which has done a great deal to poison nursing's culture. Conceived in 1988 by the Department of Health again to improve the standing of the nurse, Project 2000 meant that by 1995 all the traditional, hospital-based nursing schools were closed. Instead training for nurses was moved from the bedside, and taught in higher education colleges and universities. The teaching is founded on bogus sociology, which emphasises racism, sexism and inequality ? as if social reform would cure disease, and anti-discrimination practice were more important than caring for the ill soul in the bed in front of you. A young person who wants to nurse must now endure courses such as "ethnographic differences in first-time mothers in East London" or "ageism and the NHS" at King's College, London. I don't know how much political correctness like this goes on in American nursing education, but we, too, have seen a move from hospital based nursing education to university-based. I have to think that the move the university has had a significant impact on the career decisions of the nursing school graduates - many of whom go into research or teaching or for advanced practice degrees than true nursing (i.e. caring for the sick.) Hospitals end up having to rely more and more on nurses aides for the care duties while the few RN's they have serve as floor managers and medication passers. It's a pity, because good nursing care is essential to good hospital care. (Hat tip to Iain Murray.) UPDATE: From a nurse: Although I don't know much about nursing education in Britain, I can give you my perspective on nursing education in the US. I went to an associate's degree program to get my RN, then a few years later got my bachelor's and then master's (nurse practitioner) degrees in nursing. The associate's degree program was the only one I liked, because it was clinically focused and practical. I was not entirely surprised to find that I learned almost nothing valuable in the process of getting my bachelor's degree, and the faculty of my nurse practitioner program had no qualms about wasting our time with endless 'soft' classes' like nursing theory, while the students were literally begging for more clinically relevant content. Most nurse practitioners I have spoken to have the same complaint about their educational programs. It seems to me that the higher you progress in nursing education, the higher the proportion of baloney. There is an attitude in nursing academia which is frankly anti-scientific, putting a higher emphasis on spirituality, intuition, "lived experience", Rogerian theory (don't even get me started on this pseudoscience) etc. This can really be seen in nursing theory and nursing research. Although there are a lot of people with phDs in nursing, you may have noticed that they don't produce much clinically useful research. I suppose the good news is that nursing academia is almost completely out of touch with working nurses, who, in my experience, have no interest in the academic world. What's "Rogerian theory?" Oh, it's this. Here's a lengthy skeptical look at it. (It's worse than PC) posted by Sydney on 2/11/2004 08:03:00 AM 0 comments 0 Comments: |
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