Neglecting the basics of nursing.
Article Type: Report
Subject: Registered nurses (Services)
Registered nurses (Beliefs, opinions and attitudes)
Author: Ritchie, Lorraine
Pub Date: 10/01/2011
Publication: Name: Kai Tiaki: Nursing New Zealand Publisher: New Zealand Nurses' Organisation Audience: Trade Format: Magazine/Journal Subject: Health; Health care industry Copyright: COPYRIGHT 2011 New Zealand Nurses' Organisation ISSN: 1173-2032
Issue: Date: Oct, 2011 Source Volume: 17 Source Issue: 9
Topic: Event Code: 360 Services information
Product: Product Code: 8043110 Nurses, Registered NAICS Code: 621399 Offices of All Other Miscellaneous Health Practitioners
Geographic: Geographic Scope: New Zealand Geographic Code: 8NEWZ New Zealand
Accession Number: 271050298
Full Text: The two articles printed above, viewpoint pieces written by relatives about the care their family members received in hospital, do not reflect well on nurses and nursing practice. Both are written by nurses themselves about the unsatisfactory treatment their ageing parents received in two different public hospital in New Zealand. The nurse writers are also daughters who wish for, and expect the best level of care possible for their parents, the level of care they were taught should be delivered by a registered nurse.

Their stories cite examples of discourteousness, poor assessment, lack of co-ordination and communication, and lack of caring by nurses. As a third party reading their accounts, it is always difficult to know particular contexts and circumstances for the staff involved, but it is not difficult to see that underlying the actions is a culture of neglect. Neglect of the so-called "basics"--pain relief, comfort cares, management of elimination and nutrition.

These basics are not hi-tech but they are the mainstay of nursing. They make up the heart and sou[ of what it is to be a nurse; someone a patient can trust, talk to and feel respected by. The basics are what make a difference to patients in an already compromised condition. They make up the first rung of Maslow's Hierarchy of Needs which every nursing student in New Zealand learns about in year-one of their studies. They are what patients think a nurse provides, by very virtue of her name. In fact, the basics are not basic at all It is not easy to always be polite and courteous, understanding and observant and respectful to anxious older people in our care, but it is what nurses have been educated to do as health care professionals. And as some nurses in these scenarios thankfully showed, nurses do know how to do this.

It is hard not to read these viewpoint scenarios as evidence of ageism. Older people are not incontinent on purpose. They cannot help being in pain due to brittle bones and falls associated therewith. They are not deliberately sick and too weak to feed themselves. Assisting them in these situations is what nurses do. Warmth, food and freedom from pain are among the necessities of life.

There are many stories of nurses being too busy to have time to provide basic cares these days. The co-editors of Kai Tiold Nursing New Zealand have received a number of articles in a similar vein, including one published in August written by a nurse cataloguing her own poor nursing care. Nurses are most certainly often short-staffed and working in stressful conditions. But it is the nurses who take time to say hello and listen to their patients; the nurses who take time to stand by and assist an old lady off the commode and the nurses who find a blanket for an old man when he is feeling the cold, who will be remembered by patients as providing good care, "basic" care.

Commentary by NZNO professional nursing adviser Lorraine Ritchie
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