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The nursing profession has lost its way, Dr. Vernon Coleman says.
He argues that modern nurses have changed and are no longer doing the traditional tasks they were entrusted with, such as caring, touching, feeding and comforting patients.
Matrons have become administrators who are more interested in career advancement than patient care, and often lack the skills and passion for nursing as an art. They have become too self-important and consider themselves above tasks like collecting bedpans, plumping up pillows and feeding patients.
Somehow, nurses have managed to acquire the right to make diagnoses, prescribe drugs, perform surgery and make life-or-death decisions.
Nurses should focus on their core responsibilities, such as bandaging wounds, making beds and soothing patients, rather than trying to acquire more powers and responsibilities traditionally reserved for doctors, Dr. Coleman writes.
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Traditionally, nurses are beyond criticism. They are “angels” and they have always received a “good press.” But nurses have changed. And they have changed a good deal. The result is that today’s nurses are nothing like their predecessors. If they are to be forced back into doing what they should be doing then they need to be criticised – and their shortcomings need to be identified.
The big problem is that today’s nurses are too self-important to carry out any of the traditional tasks entrusted to nurses. Modern nurses don’t like to bother much with caring, touching, feeding or comforting. They regard themselves as above collecting bedpans or plumping up pillows. Nurses are now too self-important to feed patients or to lift them and too protective of their past to let anyone else do these things either. It is a tragedy that as nurses have become too important to nurse, no other group has been allowed to take on the most essential caring tasks. Auxiliaries, for example, are not allowed to do anything with to or for patients and the result is that there is no one on the average hospital ward to wash, feed or care for patients.
In the bad old days, nurses would help their patients in a thousand tiny ways. They would make sure that their female patients wore clean nighties and had their hair brushed before visiting time. They don’t do these things any more. And it isn’t that they have other, more important things to do. Go into any hospital these days and you will see half a dozen nurses sitting around the nurses’ station chatting and eating chocolates. (It’s no wonder they’re all so fat. You’d think nurses would be more concerned with their health. If they got up and moved about a bit occasionally they would burn up some of the calories.)
Nurses should bandage wounds, make beds, empty bedpans and soothe sweaty brows. They should take temperatures and record pulse rates and give out prescribed medicines. That’s what they are there for and it’s what they are best at. It is also what patients need from them. These are important tasks. Sadly, most nurses consider themselves far too grand for such work. Nurses have become lazy. It is their responsibility to make sure that hospitals are kept spotlessly clean and that patients with dangerous infections are barrier nursed. But nurses consider themselves too important to deal with practical issues. They prefer to sit around having meetings with social workers. On many wards these days it is impossible to find a nurse. Patients who need one must wait until one appears and then try to catch her attention. Sympathy and comfort are not qualities required of nurses these days. Indeed, I suspect that they are regarded as unsuitable weaknesses. Today’s Mrs. Gamp is too busy attending meetings to attend her patients. Mrs. Gamp has acquired ideas well above her station.
In some hospitals these days the sheets aren’t changed when patients leave and patients arrive. Instead, to save money, the sheets are just turned over. Top to bottom. The sort of practice that is frowned upon in the sleaziest of seaside boarding houses. It is, of course, the administrators who decide that this will be done. But it is the nurses who supervise its doing. (It’s the auxiliaries who do the actual work, of course. Nurses don’t do physical stuff anymore.) And so, the nurses are responsible. Just as they are responsible for allowing men and women to be put onto the same ward, and forced to share the same bathrooms and lavatories. Why don’t nurses stand up against these despicable practices? Easy. They say nothing because they have been institutionalised. They work for the Government and they don’t have the guts or the intelligence to realise that if they say “no” the authorities won’t dare do anything to them.
Many of today’s nurses are graduates; awash with diplomas and certificates. But their patients lie in their own faeces and urine. They do not have their faces washed or their teeth brushed or their nails cut or their hair combed. These are things that are beneath the new graduate nurse. Today’s graduate nurses are too busy chatting and playing with their computers to check that there is soap in the bathroom or toilet paper in the lavatory. Graduate nurses are different from their predecessors in that they are never around when needed. They tut and look cross if they are disturbed and asked to do something practical. Nurses, like administrators, have acquired authority but shed responsibility. There is no sense of caring. There is no accountability, no discipline and no supervision. When things go wrong (as they often do) no one is blamed except, possibly, the patients. Nurses chase promotion, attend seminars and perform useless research. They demand to be given time to attend to their office duties and to attend meetings. They insist on personal project time, time for research work and study time. There are, in short, many chiefs but no Indians. The young people who go into nursing with great aims and ideals are quickly broken and destroyed.
They still have a sort of ward sister in hospitals but these days she is far too important to do anything practical. These superior nurses, full of qualifications but empty of compassion, sit in cubbyholes, with the door closed. They share their cubbyholes with a computer screen, a packet of biscuits, many grievances and much ambition. They spend their days plotting how to gain more power from the administrators. (They’ve already beaten the doctors to a bloody pulp.)
Because nurses are now too important, and too busy with their administrative chores, to deal with patients, hospitals now employ untrained assistants to attend to patients. These assistants prepare patients for medical procedures. For example, my wife went to see a radiologist. The man who entered her cubicle asked her to remove her clothing and then smeared petroleum jelly onto her abdomen was a young hospital employee who had no medical qualifications. He could have been working in the bank. Instead, he was allowed to attend to female patients. By himself.
Modern nurses seem to be trying to reposition themselves as the new cheap doctors. They have managed to acquire for themselves the right to prescribe and to perform surgical procedures. (I am surprised incidentally that the British Medical Association, the doctors’ trade union has not moaned about this. As nurses have acquired more of the powers traditionally reserved for doctors so an increasing number of young doctors have found themselves unemployed – forced to collect dole money or to leave the country to find employment.) Nurses are being given more power (and allowed to make diagnoses, prescribe drugs, perform surgery and make life-or-death decisions) because this is good for the State. Nurses are cheaper to train and less expensive to employ than doctors. However, allowing nurses to have these extra powers is exceedingly bad for patients because nurses are even more likely than doctors to make serious errors when attempting to treat patients.
The news that nurses are to be allowed to decide which patients should – or should not – be resuscitated is terrifying news that should frighten the life out of every patient, every relative and every potential patient – and that means all of us.
My main objection is that nurses simply don’t have the training to make this sort of decision. Nurses should stick to making beds and reading thermometers and caring for patients and they should stop trying to turn themselves into fake doctors. The horrifying incidence of superbugs in British hospitals proves without a doubt that nurses aren’t doing their present jobs properly. The nursing profession has gone rapidly downhill since nurses decided that simply “nursing” patients wasn’t enough for them.
Another problem created by giving nurses extra responsibilities of this type is that the traditional relationship between nurse and patient has been changed dramatically – and for the worse. Nurses now either have to hold back from real contact with their patients (in which case they are failing them) or they have to get to know them (in the traditional, caring way) and then decide whether they live or die (in which case they will fail them because they won’t be able to make the right decision).
Sadly, the modern nurse seems to be ashamed to be a nurse; she wants to be a clinical professional. She wants to perform procedures, prescribe drugs, operate computers and attend meetings. Lots of meetings. It is considered demeaning for a nurse to provide caring these days. They want to be doctors without the pain of a long, expensive education. Nurses want to grab the power the cheap and easy way, without having to spend six years at university. They want equality of money and power with doctors, without actually having to do all the hard work. And so, the nursing profession has lost its way.
There is, of course, a simple solution to this dilemma. Nurses who want to pretend that they are doctors should train and become doctors. And that, of course, is the problem. The vast majority of nurses are, quite simply, incapable of completing a medical degree course. They are, to be blunt, not quite bright enough.
Things started to go wrong in the nursing profession when self-deluded, self-important nurses decided that they wanted to be treated as academics rather than as nurses. Nursing used to be a sacred vocation. Now it’s just a career. I go into a lot of hospitals and the situation almost everywhere is the same. Bedbound patients desperately ring their bells needing attention while overweight nurses sit in meetings drinking coffee and eating biscuits. I have even been in hospitals where nurses regularly refuse to lift patients. “That’s not what we’re here for,” one told me. “We’re not weightlifters.”
It’s about time someone remembered that nursing is a crucial part of medical care. And nurses should be proud to be nurses.
If you want evidence supporting the low quality of nursing care just look at the hospital infection figures. Britain has the highest incidence of Methicillin Resistant Staphylococcus Aureus (“MRSA”) infection in the world. There’s only one reason for that: sloppy nursing. Nurses don’t wash their hands between patients. I’ve seen them go in and out of rooms where patients with MRSA were being nursed without washing or even wiping their hands. Garage mechanics have cleaner hands than most nurses.
Things have got so bad that the relatives of patients in hospital now need to take in antiseptic wipes and clean beds, tables and lockers every day because the staff won’t do this. Patients need to have antiseptic wipes so that they can clean their cutlery.
And bedsores are now so common that no one notices them. Today’s nurses just regard them as “normal.” With rare exceptions, any patient who develops a bedsore has not been properly nursed. Bedsores used to be regarded as a sign of bad nursing. These days they are simply a sign that a patient has been in hospital for more than a couple of weeks.
Nursing ambition has been disastrous for patient care. Misled by the enthusiasms of the over-ambitious and the commercially-minded too much effort has gone into curing and too little into caring. Ironically, there is ample evidence hidden in the world’s medical journals to show that a caring approach is not simply compassionate but is also effective. In a paper which appeared in the New England Journal of Medicine in America, doctors showed that when pregnant women are given the sort of support that can best be given by a kind nurse with a little time to spend, women delivered their babies in half the time and suffered far fewer complications. Many other papers have illustrated the same point: patients need less technology and more care.
Meanwhile, the present system ensures that the nurses who run hospitals, who make the rules and who provide the “leadership” are the ones who are least capable of, and least interested in, working directly with patients. The nurses who are in charge are the ones who are least interested in the art of caring, least passionate about nursing as an art and most anxious to climb up the career ladder by exhibiting their prowess at managing meetings, mastering the double-speak that has invaded hospitals and giving “good mouth.” Nursing lost its way when it became impossible for a nurse to rise in the hierarchy without becoming an administrator. Nursing went wrong when nurses started collecting diplomas and degrees. How can you have a degree in caring?
A few decades ago patients were cared for in hospitals which were run by matrons and ward sisters – nurses who still knew how to turn a patient, make a bed and empty a bedpan. Most patients cannot, of course, remember how efficient hospitals were in those days and so, because they don’t know what to expect or what to look for, think they are being well looked after. Most people have low expectations, are inherently grateful for anything that is done for them, are frightened and don’t know what to look for. (This is the only possible explanation for those letters to local newspapers extolling the virtues of the local hospital.) These days the brigades of fat-bottomed nurses who “administer” our hospitals are too self-important even to look at patients, let alone speak to them. You can occasionally spot these nursing administrators darting along the corridors, eyes averted lest they accidentally soil their vision with the sight of someone in pyjamas or a nightdress. Most of the time these nursing harridans lie hidden behind office doors, planning their career progress. Many of them seem grossly obese – a consequence no doubt of doing too little work and spending too much time drinking coffee and munching biscuits. If the salaries of these grotesque beasts were smaller, and they spent less time in meetings, there would be plenty of time and money to make sure that agency nurses were unnecessary. (There is very little continuity in nursing care in modern hospitals. Patients are lucky if they ever see the same nurse twice.) Meanwhile, those nurses who are left at the dirty end of the profession, wander around almost uninterested in their work. Often slovenly and untidy, they do not seem to care for their patients at all. It is frequently difficult, if not impossible, to tell who is in charge. The modern nurses’ office (or “station”) will usually be positioned in a spot where the nurses can hide away from the patients to make their phone calls, eat their chocolates and gossip. Inevitably, if the patients cannot see the nurses, the converse is also true: the nurses cannot see the patients. Calls for help or bedpans go unnoticed.
Today’s nurses are grotesquely unprofessional and are, far too often, rude to patients and visitors. I have received numerous complaints of hospital nurses talking loudly at night (and keeping patients awake). This is quite unnecessary. It is also rude and bad medicine. When I last worked in a hospital, doctors and nurses would whisper even when working on emergencies so as not to waken patients. Today’s nurses are badly trained. And most don’t seem to know how a good hospital should be run.
Ever since the Greeks built the first hospitals it has been recognised that flowers are good for patients. They look good. They smell good. They bring the healing beauty of nature into the ward. But flowers are banned in many modern hospitals. They are considered to be a nuisance.
When I last took flowers to a patient in hospital the nurses looked at me as though I were a madman. After I pointed out that I had bought the flowers in the hospital shop one grudgingly agreed that the hospital didn’t ban flowers. “I don’t do flowers,” said the nurse, as indignantly as if I’d asked her to put on a nice little pinny and bake me a cake. So, I found a cleaner. And asked her for help. “I don’t do flowers,” said the cleaner, looking down her nose. Judging by the state of the ward she didn’t do much cleaning either. Eventually, I found a vase in a filthy cupboard and filled it myself with water. I then put the flowers into the vase, arranged them and left them on the table by the bed. Half an hour after I left, the flowers were thrown out.
Note: The essay above is taken from `How and why doctors kill more people than cancer’ by Vernon Coleman. To purchase a copy CLICK HERE’.
About the Author
Vernon Coleman MB ChB DSc practised medicine for ten years. He has been a full-time professional author for over 30 years. He is a novelist and campaigning writer and has written many non-fiction books. He has written over 100 books which have been translated into 22 languages. On his website, HERE, there are hundreds of articles which are free to read.
There are no ads, no fees and no requests for donations on Dr. Coleman’s website or videos. He pays for everything through book sales. If you want to help finance his work, please just buy a book – there are over 100 books by Vernon Coleman in print on Amazon.
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Categories: Breaking News, Opinion Pages
Socalled “social and health care assistants” have taken over. They are the lowest scum and hardly able to spell their own names. They spent their night shifts getting high – that´s probably the reason they become so talkative, Vernon.
It´s the same downward spiral everywhere from nurses who are no longer nursing over teachers that have been substituted by paid substitutes from some agency or other to heads of states that take orders from unelected bureaucrats.
People are presented with a pathetic discount version of dignity and life is turned into mere existence.
THE LOWEST COMMON DENOMINATOR HAS BECOME NORM.
It´s low and mean and must be transcended.
We only stop it by building other realities.
This is so right and on target, They will eventually skid to the bottom and then come up to working at McDonald’s
McDonald’s pays almost as much and has better benefits.
“forced to collect dole money or to leave the country to find employment.”
Forced? I’d leave willingly if I could. Why would ANYONE want to stay?
Nurturing is viewed as weakness in our society. Villifying motherhood has had dire consequences that have resulted in more willing patsies for their death cult. The sick power trip of feeling like one has authority over life and death has replaced the nurturing, valuing and respectful treatment of the miracle that life is.
This is accurate. Human life itself no longer means anything. When you have the powerful calling us “useless eaters” where do go from there?
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Real nurses ! This is what we are talking about. This generation is LAZY LAZY LAZY do as little as you can but do expect to get paid more. Especially things that are easy.
All too true. My nurse practitioner in the US rarely touched me or looked at me during appointments. She was glued to her laptop screen, typing in what I said was wrong with me and reading what the machine told her to do about it. The recommendations were always to send me to a specialist, or give me pills or shots, or do some radiological scans. On my last visit, she prescribed a medication she knows I am allergic to. It was indeed my very last visit to her. But all of them here are like her. I don’t know where to go next.
Maybe to a doctor
My doctor does the same thing.Walks in the room, sits down at a computer and types in what I say so some AI can make the incorrect diagnosis. Might as well stay home and use a search engine to find out for myself, avoid all the overpriced useless tests and order the appropriate medication from an online pharmacy.
Try an osteopath. Their training is still allopathic but it’s based on the healing power of touch.
Sounds like you go to VA.
NO ONE gives a sheit anywhere anymore.
As an advanced care RN and a bedside RN before that, there is certainly some truth to what Dr. Coleman has to say, but he also appears to not be cognizant of what accountants and hospital administrators have pushed the nursing profession into, in fact the medical profession as well. What we have is a scarcity of both, more patients to see(quotas and staffing shortages). R.N.s are at the top of the heap. They have traditionally run hospitals from the beginning along with a Medical Director. They set the rules for cleanliness, staffing, triaging of patients and professionalism of the nurses under her supervision. They understood what needed to be done. This was long before insurance came into the picture which I believe took place in the 50s. And I am speaking of US hospitals only as I have no experience in the British system. I have 50 years experience in nursing. I am old school trained, but received much continuing education to keep up with the technology and new info as well as an advanced degree in a beloved clinical area.
I would never hesitate to bedpan a patient, fluff a pillow and bring meds, but I can tell Dr. Coleman, that things have changed mightily since those days when those were our chief duties. It has been at least 30 years unless you were working in a nursing home. My training was rigorous and it was nothing for at least 1/2 the class to flunk out of school or at boards. If you weren’t proficient at the hard sciences you were a goner.
Starting in 80s and 90s, insurance company intrusion into care became militant. Then instead of nurses and medical directors, you had bean counters and hospital administrators who didn’t know crap about the proper way to run hospitals came barging in. They only saw production units of revenue and personnel. R.N.s were required to pick up more tasks, make more judgements and work with less resources. There were less of us, women had other career choices. You had an influx of foreign doctors with less stringent education. Nurses were and still are the front line in keeping these and other dangerous doctors from killing patients. As more was pushed off on the RN, more education and know how was needed, both technological, diagnostic and disease. The nurse should know the patient best, they are there with them 24 hrs/day and physicians are only there for a few minutes with each patient.
Nowadays, nurses take a 2-3hr licensing exam on a computer. Up until the late 80s, most states required a battery of written texts divided into 5 clinical areas, each graded separately. You fail one, you fail them all and had to take the whole thing over again at some specified date in the future. It usually took 2 days for the whole shebang. It seems that this alone lowered the clinical requirements of being a nurse.
In the 2000s, patients continued to be more seriously ill requiring more time and skill, not to mention an increase in mentally ill and confused geriatric patients. Nurses were and are repeatedly assaulted and threatened physically and verbally, I myself included. The hospital supervisors would not do anything about this. Talk about a harsh dangerous workplace.
Finally, Dr. Coleman, it all comes down to the quality of people becoming nurses nowadays. It used to be women with a calling. Now it is a different set of people who are neither drawn by good qualities and/or have a good working ethic. Nursing assistants are drawn from the lowest subset in many cases, looking for a paycheck, having little in the way of professional training, and little judgement of what is even right vs wrong. Because RNs are so overwhelmed and there are so few of them, they are forced to depend on others for basic nursing tasks. This said, Dr. Coleman, you are right about certain things…..always been fat lazy nursing staff acting unprofessionally and when I found myself in charge which was frequently, I made a rule that you could relax only when all tasks were completed, no earbuds, no loud voices, no cell phones. But people don’t really care anymore in many cases (as it is in many other careers). Clients/patients are nastier, more demanding of reduced resources, make scenes, are apt to physically assault you. This is the world we live in, it is hard and also hard to not be on the defensive mode. Most people have been forced by their employers to be nothing less than a slave. The basics of survival have skyrocketing costs. The global administrations of evil so called elites have made this world a living hell for many folks, impoverishing them beyond belief. As Alfred P. Doolittle said, “too poor to have morals” or something to that effect.
If and until we can get the world righted, these problems spread to every corner of everything in the world and usually to the most vulnerable the worst. It is greatly distressing to me, but I do what I can as a person and an R.N.
And who took over that hospital? Look up the hospital you work for on Bloomberg and see who owns it.
Redsheep you used the right name
You are making excuses.
by 1980 ALL standards across the board were dropped by Fed govt demand – ALL medical schools, police, law schools, military, and the list goes on, and the standard continued to drop to the bottom of the barrel by 2000. Every tom, dick, sue, and harry, wanted some of the big money, and they all got accepted into every line of work they were not (prior to 1980) qualified to perform. Most could not read nor write on more than a 10th grade level but got through college on scholarships.
I’ve known several “college grads” who left their professions to get away from the ilk being put into “professions”. They went into blue collar jobs making about as much money and much happier.
Redsheep the only thing you really got right was women became nurses at one point in time because they cared about people. The same reason most doctors did. BUT, back in those days, they also had the aptitude for it. They didn’t just walk in out of the gutter and get the job.
and yeah, please, see who owns your hospital at the very top of the list.
The uselessness of “nurses” today is only the tip of the iceberg. I see, Dr. Coleman, that you don’t appear to be concerned about the style of medicine being practiced. Operations, X-rays, hospital birth, and on and on, it’s all OK with you, just so long as you have a sweet nurse behaving like Florence Nightingale herself. SMH. Did you not even know that medicine was taken over by evil, self-serving entities over a hundred years ago, and that real medicine was discouraged if not outright banned?
Couple of things:
1. The pay is not that great. Inflation has wipped out almost any hope for an RN. Even the pay raise because of inflation(2 years after covid) was 6% for seasoned RN’s. Mind you, inflation has gone up 22% in in the past for years. So you can RN can barly support themselves let alone a family. This one of the reason many RN’s move on, esp. male RN’s.
2. Since covid, there has been lack on ancillary help. No aids, no clerks. So the RN’s has duties, plus cleaning client and answere phones. Is places alot of stress on the RN
3. As for, “You are an essiential worker” That is so lame. RN’s have been terminated for not taking the jab and you are just a cog in the wheel. The hospital really doe not care about, esp HR, and you will be replaced by someone else. Yes, you will be short staffed and hospital does not care. Just do you job.
4. Every since electronic charting, RN’s spend a great deal of time with their faced looking and a screen. The hospital really cares about that check boxes, because if not, the do not get their kick backs from the government.
5. During covid, hospital where a wash in money. Did they give to the RN’s? Fuck no. Again, where RN really that essiental? However, they did spend on agency RN from another state at triple the rates.
6. RN’s should care for their clients, but the corporations really do not care for the employees. RN have more responsibilities with less help. So yes, at times the RN can not get everything done. By the time the RN goes home, one is exhausted and over stressed. Thank you. Did not check spelling. Thanks.
Nurses in America have become very full of themselves because the media has told them they are “heroes” just for doing their job. They are often surly, gossipy, lazy and disinterested in the patients needs. Worse, many are minorities who have blatantly racist attitudes to pale faces. It’s really a humiliation to access the health system these days. All the good ones left due to the mandates.
As a patient, I utterly agree; Doc. And resistant Pseudomonas bacteria run rampant through the wards, As ILL !
Thanks for the article
But, I must tell you — YOU are wrong!
It is the entire medical “establishment”!
From the Senior doctor staff to the lowliest ‘orderly’!
Several years back I was hospitalized and two nurses came in to change my IV. I was an EMT working toward paramedic, so as any patient I watched. They completed their task and were about to walk away not paying attention to what they were doing. Being an EMT I could fix it but it was their job. I called them back, and ask they look at the IV – neither noticed any issue. I them pointed out a bubble in the line that was about a 10in long and about to enter my arm. Neither really cared, but knew it needed correcting.
Fortunately, I was conscious.
But, this has been the attitude for the last 20 to 25 years, and there are numerous stories I could relate.
My personal take on it is the supposed “social media” craze has destroyed any and all effort at humanity. The only thing that matters isn’t care or humanity — it’s all about money and how fast can “I” get it.
Again, thanks for the great article calling the issue out.