A new nursing role?

..she is only the instrument by whom the doctor gets his instructions carried out...

Some people firmly believe that progress is a Good Thing and everything from the past is a Bad Thing. Recently, I was watching a news report about how boys read more when using a tablet or other electronic gizmo; some ‘commentators’ thought it was great (which it is!) others started batting on about the feel of books etc. I then wondered if anyone said the same thing when schoolchildren started writing on paper… “Oh, it’s not the same as using a slate and chalk…”, or when the inside lavatory was introduced...”Oh, it’s not the same as popping down the garden in the freezing rain…”

So, is the Nurse Associate (NA) role (see the Policy & Management Section) a forward or retrograde step? Well, I would have gone the whole hog and bought back the State Enrolled Nurse (and would also reinstate the State in Registered Nurse, but that will have to wait until I rule the world…). I am rather unconvinced that that a one year ‘training’ is the best way to address the issue of recruitment and attracting those who do not have the qualifications to do a ‘uni’ course immediately. And while organisations can determine the numbers required at a local level, I would very, very strongly suggest that the actual course is heterogenous across the country – you know just like SRN and SEN training used to be – in order that everyone knows what the NA can and can’t do at the end of it.

A couple of years ago, I came across a series of textbooks written by the magnificently monnikered J McGregor Robertson MB, CM, FRFPSG*. These were penned in 1907, and the sections of the duties and qualifications of a sick-nurse would make a perfect template for the NA role. Here is an example or two:

Qualifications of a sick-nurse

• Intelligent, painstaking, careful, exact and methodical
• Scrupulously clean & tidy in her ways and appearance
• Her breath must not be foul-smelling (several recipies for tooth powder and mouthwash are given)
• All her work must be done  without fuss/noise and without drawing attention to what she is doing
• She must not be a gossip or a chatterer
• Her own symptoms and ailments are not to be referred to at all

The nurse’s dress & behaviour

• Dress must be of soft material that will not rustle, and of a quiet colour
• A white apron, with a pair of close fitting linen cuffs, and a white cap (quite right too!)
• She should go about the sick-room...with a decided step...not shaking the floor with her movements…
• Have warm hands - a cold hand or a clammy hand is an abomination

Duties of a sick-nurse

• She must begin with the idea firmly planted in her mind that she is only the instrument by whom the doctor gets his instructions carried out – she occupies no independent position in the treatment of the sick person (so no need for a degree after all…)
• She has no opinions or thoughts
• Patient observation
• Recording food/drink intake/output, temperature, (but only bare facts – she will not colour the report with her own explanation)
• Preparation of food

There we are then. The NA role sorted.

Any applicants?

* Dr McGregor-Robertson, according to his obituary (BMJ March 28th 1925), was a great advocate of the ‘Scottish Nurses’ Association’, and worked tirelessly on behalf of Scottish Nurses, so don’t judge his thoughts too harshly!

”Oh, it’s not the same as popping down the garden in the freezing rain…”

P.S.

I’ve always loved the word ‘discombobulated’. It sounds like a word Ken Dodd would use, along with tattifilarious. And because it has the word ‘bob’ in the middle, in my mind, I hear Lord Blackadder saying it whenever I read or hear it.

So I am happy to report that a few weeks ago, I was discombobulated, and still am. Read why in Comment & Opinion

Picture Credit: Costumes. Circa 1480. Thanks to Liam Quin for kind permission to reproduce (http://www.fromoldbooks.org)