Nurses should never rise above it all

More and more, nurses are doing things that traditionally were the role of doctors. From taking blood, setting bones, prescribing medication, the list is endless. Our role has changed, but not always for the better.

In British hospitals I've often found nurses either too busy to do the basics, such as washing a patient, turning patients in bed, toileting, or even doing patient dressings. Often I found a nurse assistant doing a wound dressing and I wouldn't even get to see how the wound was progressing. Often these assistants are only doing as they have been instructed, which is understandable as six months ago many of these helpers were working in the supermarket.

Nursing means taking care of a whole patient. It's not taking blood, giving antibiotics, changing infusions, prescribing medication. All of these jobs are a part of what we do now, but they are useless if the basics are not performed properly. It's no good giving a patient the latest antibiotic if he hasn't been turned for two hours and his pressure sore has broken down and become infected.

In the very act of performing a bedsponge, you automatically do an assessment of a patient. You look at the heels, elbows, buttocks and other pressure points. You feel the skin under your hands, is it soft, brittle, dry, hardened. You talk to the patient, are they confused? You see how well they move as you roll them around the bed. You listen to their breathing, are they coughing when you turn them. Do they feel warm? Does he or she open their eyes?

Some nurses don't have time to do this, while many other nurses think they are above these jobs. More than one charge nurse, or even just a senior nurse, has refused to help me lift a patient up the bed, even though they were they only staff around at the time. "I'm too busy" or "Find an assistant" are the usual responses.

We can't afford to be too high and mighty to do the grunt work. It's an integral part of the job. I guess I'm just a modern old fashioned nurse, and always will be.