2023 is marching on; pardon the pun. We’re already in March and in Cornwall the daffodils are out and the first signs of spring are with us. Magnolia trees are in full bloom and are looking beautiful in the glorious sunshine, although I have to say, a deceptive chill still appears to cover the UK and I haven’t put away the jumpers and thermals yet.
As we look forward to a time where we can start to think about shedding the winter coats and gloves, we can start to look forward to venturing outdoors and being surrounded by the warmth of the sun and nature in all its glory. It is all too easy to become absorbed in doom and gloom, especially in winter, when all around us appears so dark. The gravity of what we are witnessing around us can sometimes be too much to process, so it is all the more important that we look after ourselves and those we love.
I am getting many e-mails from our wonderful viewers telling me they are losing faith in humanity and they are despairing. Losing faith is, of course, the goal for those in charge, the globalists and those who try to control us. Faith is the antidote to fear, like a silver bullet to a vampire. It is imperative that however grave things get, we stay positive and remain calm.
Nursing
One of the first people many of us encounter when we are born is a nurse or a midwife. One of the last people we encounter when we die is often a nurse. The work of a nurse is to nourish and nurture the sick, unwaveringly, and to hold their hands and give comfort to those in their final days and hours. Indulging myself in a walk down memory lane, on a subject close to my heart, I was delighted to be joined by Jenna Platt RGN RMN this week to chat about nursing now as opposed to nursing in my day, when I trained as a State Registered Nurse in the NHS back in the 1970s. The differences were stark. Comparing my nursing world with her nursing world was a revelation, I think, to both of us. However, it was an uplifting and passionate conversation, and gave us a glimpse into what we as nurses could do to fix what appears to have become so utterly broken. We show nurses how they can use their Nursing and Midwifery Council Professional Code of Conduct to help them to speak up. Many of the medical professionals who are overwhelmed, exhausted and tired may feel, through no fault of their own, that they have drifted away from all that they stand for. Perhaps they feel coerced but too scared to speak out. What is a ‘nurse’ in 2023? No one wears a name badge these days and everyone looks different, so how do you know? I am proud to have had what I believe to be one of the finest trainings in the world. But that was back in 1976, dinosaur years ago, and a lot has changed. My training could almost be likened to an apprenticeship, as the majority of our three-year intensive training was spent at the bedside. Basic nursing care, making beds, observing vital signs of patients, bed baths, bedpans and brushing false teeth were where we all started. Imagine my surprise when I was asked what ‘basic nursing care’ was; who would want to do that? There is a protection for the title ‘nurse’: it is to be used only by those registered by the Nursing and Midwifery Council (NMC). As I am no longer officially registered with a unique registration number, I refer to myself as a retired nurse. Our unique registration number was engraved on the backs of our shiny silver-coloured badges; however, today, badges are no longer issued on qualifying. I find that sad; we all aimed for that precious status of becoming a nurse. Today’s prize is a Personal Index Number (PIN): without it, a registered nurse is not allowed to practice. Guard it with your might. The PIN number is a unique number that will identify each nurse to the Nursing and Midwifery Council, nursing’s regulatory body. You can enter a PIN number here to check whether a nurse is registered to practice. Today, in 2023, a nurse wanting to be promoted to ward sister or charge nurse will need a university degree. No-one needed a degree in my training days: most hospitals would accept a student on the results of what were then known as O Levels, taken by sixteen-year-old school leavers. A pass in English and Maths was considered worthy enough. Perhaps the way we train nurses today is where we appear to have lost our way? With an ageing population, a shortage in healthcare staff and increasing waiting lists, Artificial Intelligence (AI) is ready to jump in and fill the gap, but AI can never replace good old-fashioned human contact, holding a hand and giving a smile. If I could take a 2023 trained nurse and time travel my way back to the 1970s, the scene would be unrecognisable to them and they would feel lost and confused in the NHS that I was trained in. Likewise, I feel lost and confused in the newly transformed ‘innovative’ NHS. Without our even noticing, technology and knowledge has seeped into all of our lives, not least to those within the NHS. While there have been marked social and cultural changes affecting the way we treat and care for patients, the basics must never be forgotten, for the basics are the essentials. Back in the day, pride didn’t mean a parade promoting ‘gay rights’; it meant immense loyalty, satisfaction and pleasure to be part of a ‘hospital family’—and, for the record, ‘gay’ didn’t mean homosexual, it meant cheerful and carefree. There were no NHS ‘trusts’ because each hospital was run in a slightly different way, with different policies, uniforms and services according to the population and needs of the community. Nurses wore their uniforms with great pride and always cheered on their own hospital football or rugby teams. Friendly rivalry was healthy and always well-meaning: we all knew by the uniforms where nurses were working. Today, hospitals have lost their unique identities and have become a blended mush of management and bureaucracy. There is no one-size-fits-all when it comes to medicine. In my day, we all knew who Matron was and we all knew our place. We would know all the names of staff, doctors, nurses, porters and domestics—and, more importantly, we knew the names of the patients in our care. Today, no-one appears to know anyone. My first day as a student nurse was one shared by 69 others. Most of us were eighteen years old, and it was our first time away from home; exciting independence and the thrill of being surrounded by like-minded others. We were all expected to ‘live in’, to ensure we were all behaving ourselves. My nursing home was in beautiful Hampstead in London. We were given a small room and had to share two showers per floor, with one tiny kitchen for all of us. Our home warden, Mrs Penfold, a motherly, kind but strict woman, was always there to lend an ear. She would ensure that we were well, but also kept an eye on any mischief we might be up to! A hospital minibus would pull up at the start and end of every shift to make sure we got to work safely and in the right attire (outdoor uniforms only). There was a sense of camaraderie, friendship and care surrounding all of us at every moment. Sure, some of us felt homesick and some got very tired, but we all muddled through together, in good times and bad. We were there for each other. Who is there for our nurses now? The nurses’ homes have been sold off to private developers, and student nurses have to navigate their own way through their training, often without support. Worse still, they are charged high prices for the privilege. For example, parking charges should never have been levied on nurses or doctors; that was a great mistake. It appears that the nurses of today have become isolated and alone. The care, compassion and tender loving care we protected so fiercely appears to be snuffed out like a candle. In my day, the ambition for student nurses was to qualify as registered nurses; the ambition for registered nurses was to run their own wards or to attain the level of working in specialised areas such as community, operating theatres or intensive care. Today, nurses appear hungry to reach the dizzy heights of ‘senior manager’, running whole wards with little experience or knowledge of patient-centred care. Tucked away in their offices, these bigshots often don’t even know their patients by name. Health innovation is moving so fast that it can be difficult to keep up with it all. ‘Innovation’ is a bit of an ambiguous word that can mean a lot of different things to different people. That being said, for most, innovation is merely looking at a problem and understanding it to make it better. If you manage to make it better, bingo: that is innovation. Innovation can apply to something completely new or to something which has been modified to improve it. However, innovation is only helpful if it benefits and improves the lives of those using it. Hospitals which were once full of flowers and kind professionals appear to have been replaced with machines, robots and gadgets. As I am of advancing years, I accept that I may be a bit resistant to change and want to maintain that the good old days were the best. Is that an ‘oldie thing’, or will I be accused of being ‘ageist’—even though, at nearly 65 years, I consider myself old? Making changes to any system, however small, can be met with resistance and teething problems—but this is to be expected. However, making changes to healthcare systems to cut corners, save money or save time is not being innovative; it is being dangerously irresponsible and putting patient safety at risk. Why are we losing so many staff in our health system? Where are they all going? There are no armies of reserves in starched aprons and frilly hats about to ride in and save us. As ‘innovation’ appears to be the only way to plug the gaps that human staff have left behind, who will operate this new technology? Yes, you guessed it: nurses, of course. In fact, nurses are currently being used to test out many novelties in the NHS. Only nurses can understand what aspects of our jobs could be replaced by new technologies, but nurses are not being asked; they are being told. How do we solve this multidimensional issue? Do nurses working in the NHS today even understand what ‘nursing’ was or is all about? Or have we strayed so far from basics that we have come too far to repair the damage? I think not. Perhaps we should start with repairing nursing education? In my day, as I have mentioned above, degrees were not required in order to be considered for nurse training. You just needed common sense, a basic school education and lots of enthusiasm and passion. If you were workshy or wanted to become rich and famous, then nursing was not the job for you. Back in the 1970s, it was not a given that anyone who applied to become a nurse would be accepted. You were considered very privileged if you even got accepted to start nurse training, and the process, which included two or three long and thorough interviews, could be quite grueling and definitely not for the faint-hearted. If you had the stamina to get through the interviews with some fairly stern-faced senior nurse tutors, you probably had the stamina to endure the hard but rewarding three-year training. Nurse education today is university-oriented. Often, nurses of today don’t even get to care for a patient until they have studied for a year and a half. When I recently remarked to a young nurse that it doesn’t take eighteen months to make a bed or brush someone’s teeth, she looked shocked and replied, “We don’t do menial stuff like that; we are far too busy.” Perhaps my face spoke a thousand words as I struggled to get my words out: “Busy doing what?” Nurses of today have targets to meet, sheets to check off and tasks to finish. Listening to nurses, it appears that these ‘tick lists’, if not completed satisfactorily, could risk them losing their precious PIN numbers, without which they cannot work. But do those tasks include saying ‘good morning’ to your patient by name, ensuring their fluid balance chart is up to date and making your patient as comfortable as possible? No, is the short answer. I am privileged to be able to talk to many nurses: some still working within the NHS and also some who have left for a myriad of reasons, including feeling uncomfortable doing what they were being asked to do. Every nurse I have spoken to has expressed concern over patient safety in the NHS. Every nurse I have spoken to, like me, didn’t go into nursing for pay or acclaim; they signed up because they care. Every nurse I have spoken to has a good heart and soul and wants the best for their patient. Every nurse I have spoken to who has trained in the last couple of decades wishes they had what I had in the 1970s. Many of them had no idea of what went before, so it’s up to my generation to inform them. If they had what we had, they wouldn’t be leaving in droves. Merging two worlds—my nursing world and the new world of nursing—is not impossible. No-one is suggesting we go back to the heady days of the Seventies, for many valid reasons. However, maybe some of us who experienced the good aspects of past decades could bring them to 2023 healthcare. Fixing the NHS means fixing nurse training and how we look after our nurses. Fixing the NHS requires dedication, love and kindness. Fixing the NHS means, in my opinion, going back to basics. And going back to basics essentially means going back to making time for the patient. Surely, nurses can’t be so busy that they have no time for the very people that they are charged with caring for. Let’s make time: time for patients and our nurses. Time spent chanting on picket lines could be better devoted to patients. Time is a great healer, after all.Pharmacists
Although I am not in any way pharmacy-trained, I have been keeping my eye on how the role of the pharmacist appears to be rapidly evolving de-facto into that of a medical professional, despite pharmacists’ lack of training for that role. The following are a couple of the stories doing the rounds in this branch of healthcare.Stay Well Pharmacy
A new campaign has just been launched from NHS England. As we featured on last Wednesday’s UK Column News, there is also a new video on the NHS YouTube channel that tells you all you need to know. For those of you who can’t bear to watch yet another infantile mini-movie, I will briefly explain. Parents are being encouraged to visit their pharmacist first for all ‘minor’ health concerns affecting their under-fives. Sore throats, coughs, colds (yes, we do still have those!), upset tummies and teething thus all come under the care of your local pharmacist. However, parents should be aware that pharmacists will not have access to your child’s medical records, so they may not be aware of any other conditions that they may have been diagnosed with. In order to provide reassurance to both pharmacists and parents, the NHS’ don’t-call-us sales pitch adds the caveat:What is more, if symptoms suggest it is something more serious, pharmacists have the right clinical training to ensure people get the help they need.That claim from the NHS website would appear to suggest that community pharmacists and pharmacy technicians are qualified healthcare professionals and therefore somehow are the right people for you to see if you need clinical advice or over the counter medicines to help you. Have you noticed a ‘consulting room’ in your local pharmacy? Most British community pharmacists are now providing private areas where clients are able to discuss their problems with pharmacists—whom they most likely have never met. Who are you talking to: a pharmacist or a pharmacy technician? The aim of the game, of course, is to help free up our busy GPs and reduce Accident & Emergency visits. Pharmacists clearly are the way forward, but at what cost? The availability of our family doctors?
Pharmacists warn they will struggle to cope
Dovetailing nicely with the previous story, it seems that it is not only patients who have not been consulted over these changes to primary care, it is the pharmacists too. The i newspaper reports:Leyla Hannbeck, CEO of the Association of Independent Multiple Pharmacies, supports the aim of the campaign but is worried about the additional pressure it could bring.Pharmacists are also experiencing a shortage of trained staff, with big shortfalls in funding. Many are feeling overwhelmed and burnt out. Are NHS England’s expectations realistic, or is this simply an expectation too far? I suspect the latter. According to CD Pharmacy News, around 80% of pharmacists working at community pharmacist practices considered leaving their jobs in 2022. As wages decrease to 2020 levels, I can’t help but wonder how long it will be before pharmacists become the next British healthcare professionals to consider industrial action.
