I am on a journey of unlearning, learning, and forming educated opinions rather than simply repeating what I have heard.
—Jenna Pratt RGN RMN
The UK column welcomes back Jenna Pratt, a nurse whose practice matches her words.
Has nursing become too complicated? Over the past 50 years, the nursing profession has changed so much that it's almost unrecognizable. In this candid and honest interview, Debi Evans, Class of 1976, a retired state licensed nurse, and Jenna, who qualified in 2006, take nursing back to basics to explore where we may have lost our way, perhaps without realizing it, over the course of the same 30 years. Jenna and Debi discover that while nominally the same, their professional worlds are quite different. While Debi takes us back to fond memories, Jenna brings us back to the present. In this interview, both women look with trepidation to an uncertain future.
Starting with this question, Debi and Jenna explain what the PIN number is in modern UK nursing and how important it is for nurses to have and keep their PIN number. What is basic nursing care? Nursing and Midwifery Council The National Medical Commission (NMC) is the independent regulator for nurses and midwives in the UK and nursing assistants in England. The NMC Code of Professional Conduct The NMC Code of Conduct was established to protect patients and nurses. How can the NMC Code of Conduct help nurses today, including those who feel uncomfortable with what they have witnessed or are being asked to do? Speaking up is about being courageous and professional. Jenna has proven herself to have both qualities in abundance. Speaking up does not have to be confrontational or antagonistic. Jenna proved that with her calm, measured, evidence-based questioning.
How can you be angry at someone for simply following a code of conduct? You can't. In a chaotic and unprecedented world, many nurses are overwhelmed with information, data, and instructions, and some may have inadvertently walked away from everything they believe in and stand for. Many nurses feel coerced, silenced, or threatened if they dare to speak up, and some feel isolated and alone. Jenna has already walked a path few others have taken. From her experience, she can offer some light and advice on what nurses need to do to be heard, listened to, and noticed.
Jenna takes us into the world of modern nursing, a world very different to the one in which Debi was trained. The camaraderie and support that nurses enjoyed in the 1960s and 1970s seems to no longer exist. There are no nurse dormitories or subsidised accommodation, no hospital nurse transport, no peer group support or head nurses. The love, friendship and sense of belonging that Debi once experienced within the NHS seems to have disappeared. Nurses today feel isolated and unsupported in large, impersonal organisations. Most nurses don't even know the name of their direct manager, let alone where to go for help.
Nurses today need a degree to call themselves a “registered nurse.” In Debi's time, most nursing students were accepted into nursing training at as young as 18 years old. Nursing students were the heart of the hospital and received just six to eight weeks of intensive basic nursing care before being thrown onto the wards. Today, nurses require a university-based qualification to be qualified, few People are spending more time at patients' bedsides than they did half a century ago, and both Jenna and Debi agree that this isn't in everyone's best interest.
Selling the nursing home was undoubtedly a big mistake. Hospitals are often located in town or city centres and nearby transport and accommodation are very expensive. Unsociable shifts and long working hours mean long, often lonely trips to and from work. Making nurses pay exorbitant fees to park their cars during their shifts would have been unthinkable in Debi's time. In those days the nursing home had a nursing home manager who was like a mother to them, making sure all the nurses were well behaved and, above all, that they were well, not homesick and slept well during the night shift. Those were the good old days when a hospital minibus was provided to take nurses safely and punctually to the hospital.
Who runs the ward in 2023? Does anyone know or care? Who looks after the nurses? Debi explains that in the 1970s there was never a question of who was in charge of the ward; it was always the Ward Sister or Charge Nurse (the male version). However, Jenna explains that times have changed and there is often confusion about who is in charge, or if there is anyone in charge at all.
Patients are no longer called patients, client, Service users Or countless other names. Just as patients seem to have lost their identity, so too have nurses. Nurses of Devi's generation proudly wore their starched, laundered hospital uniforms, strived to earn precious badges from professional associations, and, once qualified, felt a fierce loyalty to their hospitals and their patients.
Uniforms were the perfect way to identify staff. First year nursing students wore different coloured belts or just one stripe on their caps. Qualified nurses wore belts and buckles, badges and different coloured uniforms and everyone knew each other. In Debi's time there were no NHS trusts and each hospital had its own identity, matching uniforms and training. In fact there was a friendly rivalry between the London hospitals where Debi trained which was healthy and fun.
Jenna reveals that for her generation of nurses, “rewards” and praise for successfully completing the day's designated tasks seem to outweigh patient-centered care, whereas in 1976, rewards were seeing a patient get better, receiving a hug from a grateful relative, and often personal, implicit rewards carried a lot of weight. As Jenna points out, being kind or smiling today rarely elicits praise or attention.
In 2023, nurses' eyes never seem to rise above the iPad screen. Basic nursing care seems to have been replaced by a checklist of “jobs to be done.” Washing patients, changing their beds, brushing their teeth (even dentures) are no longer considered “glamorous” jobs. And why would a nurse want to do those things anyway? With all the gadgets and contraptions on the ward, what motivates a modern nurse to sign up to learn to feed people?
Jenna explains that it seems like the fundamental principles of nursing have almost quietly disappeared. Why has this happened? And why are nurses so busy now? Busy with what? No one is too busy to remember a patient's name, to smile and reassure them, to help them take something to drink or eat nutritious food, to hold their hand or sit at their bedside for a quick tea and chat. Yet these small but very important tasks seem to be overshadowed by the technology gurus.
In 2023, with modern medicine, medical equipment, and cutting-edge facilities flooding hospitals, Jenna and Debi agree that nursing may have become too complicated and that we need to get back to basics. What happened to the “tender loving care” (TLC) that was always available and never went away? While many argue that we should move with the times and not go back, others, although from a very different generation, agree with Jenna and Debi. Going back and getting back to basic nursing care is the way to go, fast. In other words, bring back the Matron.
Jenna Pratt continues to travel the country asking questions, so if you see her out and about, give her a smile and a cheer. Check out Jenna's podcast here here.
The message Debi and Jenna want to get across to all nurses is to do your part, no matter how small. Smile and follow what your heart and soul tell you is right. When you put your head on the pillow tonight, know that you will sleep soundly knowing that you did the best you could and followed the code of professional conduct and ethics.
