Aspects of poor nursing care have been well documented concerning care home and hospitals in the UK , Australia and USA (Vladeck 1989, Robb 1967, Newton). Involving neglect of pressure care and failure to feed patients. Whilst good care does exist, poor care continues .
Why is this so? Nursing is a caring profession surely? Or has it been overtaken by the Darwin principle of survival of the fittest? It depends what “fit “ means; does it mean the most caring or the one who gains the most accolades for the best attendance at work or adherence to the manager’s requests? Is anybody who dares to question or raise issues, blocked? Consider Haywood who raised issues in UK but went to press as no satisfaction with internal management. She was removed from register but reinstated following an appeal.
There is also the business orientation of universities in many countries (Popenici 2012) which has implications for the award of registration to students. Is there an emphasis on passing assignments ? It is possible. There are also implications of society at large. Of how much a priority is care? The Government here in the UK has chosen to focus upon the issue of poor care following numerous newspaper reports. Yet sadly, the occurrence of poor care was highlighted many years before in many countries.
Does poor care continue because all nurses have different priorities? Does it depend upon how nurses are educated? In the UK all nurses are now educated at degree level. Yet what the degree consists of, is open to interpretation by different universities. In all countries, we have care assistants largely delivering what once was the nurses role. Training now in the England, is based on Skills for Care but even that is open to interpretation. Prior their training differed in each hospital or care home. In all 3 countries, care assistants do not have to be registered. This means they are free to work elsewhere if they do anything wrong. Unless a good manager tells the truth. Students too are implicated. Some research does indicate that students are afraid to raise issues due to conformity but it is a small study(Levett-Jones, Lathlean 2009 ). Is it the same in the USA or Australia? The difference in healthcare fields is also a factor. Nursing homes/ hospitals do differ in USA to the UK.
Such factors are addressed within the book “The Commodity of Care”, Choir Press due out July.
A large conclusion which surprised myself, is the political influence (neoliberalism) upon care and how issues extend way way beyond the staff at the side of the patient.