Friday 8 August 2008

Cynthia Coultas gives a nurse’s perspective on visiting limitations, and other aspects of nursing children in the

Rowland’s memories certainly back up the importance of parental input and the reason for modern day thinking and the changes to the care of children in hospital. Hence the development of programmes such as those at Great Ormond Street and others.
Like all the other things involved with caring for the sick, visiting is a multifaceted problem. There were unexpected problems when unlimited visiting was instituted, which it took time to sort out. By the time this happened I had moved on to the general hospital, but the principles are the same. On the first day we were all prepared for welcoming extra people to occupy the patients. Brilliant, we would have more time to get on with individual treatments.

As the doors opened, a flood of people surged forward to the bedsides of their loved ones. With them arrived shopping bags, wheelers and arms full of gifts. By 10 am. coffees and teas were being drunk from flasks, and by lunch time sandwiches were being enjoyed by patients and visitors alike regardless of diets! A dangerous situation for diabetics, etc. and nurses had no idea whether patients were eating or just hiding problems behind the aura of fruitfulness provided by their families. This trend continued until the last buses were due to depart and those with cars dawdled even longer.

After a few weeks of this type of scenario, patients, staff and visitors were all complaining of fatigue. Patients were exhausted and suffering from constipation and other associated digestive upsets, staff were unable to perform personal care without embarrassing the patients as they explained what they wanted the patients to do to cooperate, and visitors were finding financial implications on a long term basis.

Also needing addressing was where all these people were to sit. Inevitably the beds seemed the obvious place. Plenty of room for two or three. As bed clothes were pulled tight, wounds groaned under the pressure and wound healing was being delayed. Added to all this of course was the added risk of infections carried in unknowingly by the visitors. I will mention MRSA and then say no more.

Again my point is that there is no easy answer to any one problem and sometimes the tug on the heart strings is the lesser of many evils.
In general, I suppose we can’t overlook what things were like at the time. 1950 was a very early post- war situation, and it is always difficult to put oneself in the mind set of an earlier period and what was happening generally to children. Money was short for everyone so food as well as clothing and everything else had to be completly eaten or worn out before it was thrown away or even still passed down to 'little Johnny'. I remember my father saying that if I didn't eat what was before me it would be returned at the next meal. That was no idle threat! 'Make do and mend', was the quote of the day for making clothing last longer, etc.

Drugs then were very minimal and basic (no broad spectrum antibiotics for example) hence lots of fresh air and rest! TB itself was also something that doctors were learning about, and without the appropriate drugs to help in the treatment they were fighting a very difficult battle.

The point Fred made about the staff being young and inexperienced is also valid. Again this doesn't or shouldn't happen today because the training separates the nurses from the wards until they have gained some knowledge. On the other side of the coin nursing is a very practical work and full knowledge can only be gained at the bedside in order that the intangible can become intuitive. We were taught about diseases and what to look for in a patient who were unwell.

Today nurses are taught about health and have some idea if a patient admitted for a cataract operation is at the time of admission developing a further problem. Not to take over the Dr's position but to know when to call for his attention.