Nursing care quality on the decline

YOGIN DEVAN

IF ONLY hospitals awarded frequent patient points like airlines do for their regular flyers, then I would easily qualify for a free round trip to New York - in first class and with my wife, nogal.

I have lost count of the number of times I have occupied hospital beds in the past three years to be scanned, scoped, sliced, radiated, prodded and poked. I have given more blood than Dracula swigs when he is in a voracious mood.

With all the puncture marks, my arms resemble that of a heroin junkie. I am not fazed by surgical theatres anymore. I have endured much pain – being allergic to pain killers - all only so I can thwart the grim reaper.

And between all the medical interventions I have undergone in hospitals, I have personally found convincing proof of the general decline in the standard of nursing care.

Almost five decades ago when I was admitted to the RK Khan Hospital in Chatsworth for a broken pelvis sustained while boasting behind the wheel at high speed in wet weather, I recall that despite being a provincial township hospital, RK Khan was a haven of healthcare.

You could brush your hair by using the shiny floors as a mirror. Crisp, clean bed linen, uncluttered wards and beautiful gardens were the order of the day. The mutton breyani could have been prepared by the epicurean Solly Manjra himself.

The nursing staff at RK Khan, mostly drawn from Chatsworth, were veritable angels who lived up to the credo of the “Lady of the Lamp”, Florence Nightingale. who is credited as being the Mother of Nursing. Nightingale’s tireless work during war times laid down the template for what nursing practice must be all about and the role of the clinical nurse specialist.

Even after working a full day, these humble nurses at RK Khan managed to smile when taking a bed pan to a patient. They had to be strong to lift and adjust the manual beds, unlike the multi-function electric beds of today.

In those days during my maiden hospital stay, nurses could wear any colour of uniform, so long as it was white. The starched dresses with maroon epaulettes on the shoulders, small white caps, scissors in the top pocket and a fob watch, made them very recognisable, but it was not a very practical uniform.

Today nursing uniforms often take the form of professional looking tunic and pants combinations in a range of colours and styles, with soothing blues and greens being favourite colours.

But despite nurses having well-designed, comfortable uniforms nowadays, many make a patient’s stay in hospital anything but comfortable and pleasant.

Like most government hospitals, RK Khan has today fallen into a state of neglect. Patients must carry their own bed linen. The stench of urine hangs heavy in many wards. A shortage of qualified nursing and medical staff and the lack of up-to-date medical equipment, leads to huge backlogs. Many nurses are rude and arrogant.

There is a private hospital that I have stayed at regularly in recent years that is virtually paperless. All patient information is recorded by doctors and nurses on laptops. This is great for retrieving medical history without having to create a new patient profile on each visit. While the digital element of administration is commendable, the humanness of the nursing personnel is missing.

At this technology-driven hospital I have been in the hands of nursing staff who display an attitude that oozes “count yourself lucky ol’ chap, ‘cos I’m only doing you a favour”. That they are under-trained and not committed in a critical job comes through clearly.

I have had a blood pressure cuff put on me for a reading and the nurse went away, never to return to remove the cuff even 30 minutes later. Requests I made to nurses - for an extra pillow, a blanket, or some water - were never fulfilled. I am sure I read their minds correctly when they mentally said: “Go fetch it yourself.”

One entire floor of an “A” grade hospital where I have been a patient several times, has a bad habit of not answering the bell that you are so compellingly told when being admitted that you must press if you want a nurse to come to you. During one stay, I needed a nurse urgently late at night. I pressed the bell intermittently for more than one hour and no nurse came.

Yet from my bed I could clearly hear the bell ringing at the nurses station, amidst all the laughing, talking and singing around what could have only been a KFC 22-piece barrel. Finally, out of sheer desperation, I used my phone to call the main reception at the hospital, asked to be put through to the medical ward in question, and then asked the nurse who answered to come to my bed.

That same hospital has received numerous complaints from my fellow patients about meals, tea and coffee that are often served cold. No proper handover of patients is done at the start of a new nursing shift.

I have personal experience of doctors’ orders often not being properly followed. An infusion that had been ordered by the doctor to be started immediately only happened 12 hours later, after I had complained several times. More than three junior nurses could not get the drip machine working properly because the batteries were dead and they did not think of linking up the machine to electricity. It took a senior nurse just two minutes to resolve the issue.

There was a time when young women became nurses because of a calling. They had a desire to help people who were sick. Many student nurses graduated to become great nurses and they would not be able to hide their humanity, caring spirit and compassion, even if they tried.

Today, for many young women, nursing is just another job, much like that of a call centre operator, credit controller or secretary who does not have to share her humanity with those she serves.

Nurses are being churned out in their hundreds from fly-by-night nursing schools like a sausage factory. Other than providing a paper qualification in exchange for vast sums of money, truly little training would appear to be taking place at these dubious institutions with regard to instilling values such as empathy, compassion, understanding and responsiveness.

Fortunately, there are small pockets of nursing excellence that still exist. But it is a juggling game into which hospital to get yourself admitted. The hospital where your specialist is based may have a reputation for poor quality of nursing. You may have to seek a new doctor at another hospital where Florence Nightingale’s devoted disciples are in the majority. The problem is that by the time you find the right mix, your health condition would have been compromised - and your medical insurance funds depleted.

I am writing this column from my bed in a hospital where the nurses come running less than a minute after you press the bell. The food is of near restaurant standard. At sleep time the nurses station does not create a din. Your every request to a nurse is fulfilled without delay.

It all boils down to the efficiency of the HR department that is supposed to oversee the upholding of nursing standards. I have filled patient experience surveys many times, complaining of poor nursing at certain hospitals. And nobody has followed up with me to ask why I scored nursing care no more than three out of 10. Worse still, admitting doctors who have rooms at the same hospital are loath to complain on behalf of patients

No prizes for guessing why there are no nursing staff “thank you” cards on the bulletin board at the hospital where the slogan “It's Finger Lickin' Good” takes precedence over “Caring Hands, Healing Hearts”.

Devan is a media consultant and social commentator. Share your comments with him on: yogind@meropa.co.za

** The views expressed do not necessarily reflect the views of IOL or Independent Media.

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