I’m officially ‘off sick’ at the moment, recovering from an operation. I found it absolutely fascinating, being a patient in a British hospital, as – apart from having my appendix out in Switzerland – all my hospital experience previously has been on the other side, as a nurse.
Probably with this tugging at my sub-conscious, I’m re-reading some Lucilla Andrews novels. She invented the ‘medical romance’ genre, but her books also have very evocative descriptions of nursing in ‘the good old days’ of the early NHS. Some recall her wartime and 1950s nursing work, but most are set in the 1960s. I started my training after that, but was also in a major London hospital, and there were still a lot of similarities. At the little country annexe where I did my first two wards, we still scrubbed instruments and re-packed them for the steriliser; scrubbed and dried red waterproofs in the sluice; and walked down windy corridors to the little nurses’ home – just like in her books.
It was undoubtedly a very different era. In those days there wasn’t much money around, and nurses were all ‘dedicated’. You had to be, since the pay was appalling, the shifts anti-social, and if you got married you had to stop nursing. It was also extremely hard physical work, and quite regimented, with Sister and Matron authority figures to fear. Much of this was still the case when I started, although we did have one extremely modern touch – our mercury thermometers registered fevers in Centigrade.
Now we have fancy machines that record everything, and although nurses are still busy, there is far less physical strength or stamina required. They are professionals, with better working conditions, and do not ‘lift’ patients. Neither do they expect them to give up their independence for the duration. Just as medicine and nursing have changed, so has the role of the patient. And, on the whole, I think this is a good thing.
In Lucilla’s days, sick people entered a ward and adopted the role of ‘patient’. They conformed, just as the nurses did, to the regime. Their position was a passive one, they did as they were told, and mature adults obeyed instructions – even those given by 18 year old student nurses – and reverted to dependency. A week or two after the operation, they were discharged, possibly to a convalescent home, to regain their full health and re-learn their independence, before resuming their previous ‘fit’ role in society.
How different it is today! If my op had gone according to plan, I would have been discharged the next day; as it was, I was kept in for two nights. But at no time was I ‘talked down to’ or not kept in the picture about what was happening and why. I was expected to move when I was able, be independent as much as possible, and carry on life as normally as I could. So I enjoyed the rest and continued being ‘me’. The nurses were there, but ‘available’ rather than obvious. I certainly had the appropriate amount of attention on my first night, but as I had no post-op problems, I don’t know from personal experience what it would have been like if I had ‘needed nursing’.
My instinct tells me that I would have got just as good care, but it would have been differently delivered than in Lucilla’s time. I was actually impressed – and reassured – by my time in hospital. The NHS gets such a verbal battering sometimes that one wonders. As it is, I think maybe some of the problem lies with us – our expectations haven’t caught up with modern reality, and sometimes we would quite like to revert to a dependent position for a while!
Modern hospitals eat money – they are technically efficient places, and staff get proper salaries. The NHS we have today has needs so different from 1948’s (and so does society) that it is obvious we need to get away from a sentimental image of it. On Question Time last Thursday it was referred to almost as a religion; but actually the S stands for Service, and that is how we ought to be looking at it when we make decisions about its future.
…Because its future is going to be different from the way it is now, just as my experience was different from Lucilla’s, and both were vastly different from that of the young nurses who looked after me. So I’m watching what is happening in Parliament with great interest, and hoping that sensible, practical (and affordable) changes to the NHS structure will be enacted.