Nursing is the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations.

Clean wards are what matter, not meeting targets

From the Telegraph UK England Despite Stafford offering the clearest possible warning about the dangers posed to patients by a lack of hygiene, these two continued to tolerate low standards of cleanliness. It is not as if cleanliness is particularly difficult to achieve: we are not talking about an operation of dizzying complexity on the frontiers of medical technology, but taking basic precautions to ensure that equipment is clean, that soiled mattresses are replaced, that all traces of blood and excrement are removed, rather than left on hospital floors. All that is needed to achieve such a result is to have staff who clean wards and all other parts of the hospital regularly and thoroughly, and managers who ensure that they do so.

Yet both Basildon and Alder Hey seem to have been incapable of keeping themselves at even a minimally acceptable standard of cleanliness. Worse, their hygiene standards were rated "excellent" by inspectors. That is because the inspections were paper exercises, which consisted of managers filling in forms in which they certified that their hospital did the things the inspectors believed were enough to ensure a clean hospital. It was only when inspectors actually visited the hospitals unannounced that they discovered the dangerously dirty reality.

1 Hygiene consisted of the cleaner coming in every morning, putting vim in the en suite toilet, then mopping the floor quickly with the same mop she was using on the corridor. She did not do under the bed or the other furniture. The corridor was opposite a chemo clinic which was full of patients being treated for leukaemia who would then need to be kept in isolation for 2 days. Whilst cleaning (and I use that term loosely) the cleaner would drone on about the bad back she had after tripping on the stairs at her previous job cleaning the local college. Like I was interested - I had cancer. Not one medical person whether they were a nurse, junior doc or consultant used the hand gel on the wall outside the door and my husband came in every morning to help me shower as the nurses offered no help despite my having the use of only my left hand.

2 My late mother trained as a nurse at Great Ormoind St in the 1930s, and obviously before antibiotics were available, let alone the NHS. She never ceased to regale us with the amount of work the junior nurses did cleaning the wards. She found it hard work, but always believed it was work of the utmost importance, precisely because they all recognised the risks and genuinely feared the spread of infection. Now the nursing profession is above such basic but essential work, preferring to get cleaners who have absolutely no understanding of the importance of their work, and are just going through the motions for the sake of a wage. The doctors, nurses and managers rely on antibiotics to solve the problem of infection. But the microbes know a way round that. So here we are 80 or so years later and with plenty of advance in medical technology and knowledge, but a lazy set of health workers, who only know all the shortcuts. Says it all. We don't need regulators and box tickers and targets and auditors, and administrators and computers. We need real health professionals dedicated to excellent care and treatment for patients.
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