Sunday, February 19, 2012

"If it takes off the cuticle,it must be working".

So said the immortal Florence Nightingale about the use of chlorinated soda to disinfect nurses' hands back in the Victorian era. It may be one of the only things she said that modern nursing would agree with.

If my nursing instructors at the late Mary Hitchcock Memorial Hospital School of Nursing mentioned Nightingale, what they said was forgettable, for I have forgotten it. And since I was in nursing school in the very late sixties, how much attention would I have paid anyway? It was the Age of Irreverence, and if I could not trust anyone over thirty, why would I have respect for a dead Victorian woman, who ,in the world's memory, is surrounded by a smog of sentimentality? We made fun of our own classmates if they were too traditional, too "nurse-y". We called them "Nancy Nurse" or "Nice Nursie". The only time any of us mentioned Nightingale was to repeat a scurrilous lie that she died of syphilis. We thought this was hilarious.

I have just finished Mark Bostridge's biography "Florence Nightingale-The Making of an Icon", and I have also read parts of Nightingale's own "Notes on Nursing", and I can state after my 40 years in nursing ,that no one in modern hospitals takes her beliefs seriously.

Take her pronouncements on sleep. She believed in it. She thought patients needed it. Never wake a patient from first sleep, she said. How quaint! For today's hospital, like Macbeth, murders sleep. In an ICU the nurses have no tolerance for it. The middle of the night is "Bath Time', and time to drag the patient from bed to chair where he or she will sit for hours. And even if the patient is spared these nurse tasks and manages to fall asleep in a comfortable position, he will be awakened, for the "Skin Bundle" mandates that he be turned every two hours to prevent bedsores. And why do we want to prevent bedsores? We want to prevent them because Medicare will not pay for treating them anymore. Do not look for lofty motives!

Nightingale may have been in favor of sleep, but she was strongly against noise. We laugh at this because noise has become an honorary nurse. Beeps, honks, chirps, screeches are the modern nurse's Little Helpers. They tell us when someone is trying to crawl out of bed, when someone's heart beat is too fast, or their blood pressure is too high, or when a patient has pulled himself off the ventilator-

But these are not the only noises. Pills must be smashed to bits before nurses flush them down tubes. I had a patient call one night and complain about this. "Are you building something out there?", he asked. Another patient groused to the head nurse that he was tired of loud talk at the nurses' station. "All they talk about is their boyfriends and how to make zucchini bread!", he said.

No, if Nightingale walked into one of our hospitals this very night she would not need a lamp. All the lights will be on. The unit secretary's radio will be dialed in to 92Q, and a toddler, spending the night in his father's hospital room ,will be howling. Housekeeping will be stripping the floor, for what time is better to do it than one o'clock in the morning? The nurses may be in the lounge watching ESPN or"Storage Wars" set on high volume.

Poor Nightingale. Now so irrelevant.

1 comment:

troutbirder said...

Oh my! Mrs. T had a double masectomy 6 weeks ago and they sent her home the next night. She had complained about a defective machine next to her bed that kept beeping and nobody knew how to fix. Asking the doctor he made two points. (1) Hospitals are not the place to get any rest & (2) They are full of nasty infectious germs so your safer at home. Case closed. Perhaps Florence would have agreed? :)