Column #101 - October 1, 2000
VETERAN NURSES REFLECT UPON THE
STATE OF NURSING TODAY
by Glenn Tunney
On June 5, 1965, a modern
new Brownsville General Hospital facility on Simpson Road near Brownsville was
dedicated. It replaced an aging structure that had served the community
well for fifty-one years. Yet even as that state-of-the-art building
opened to its first patients thirty-five years ago, the economy and population
of the Brownsville area had already begun a long downward slide.
The decades after the opening of the new Brownsville General Hospital saw a steady decline in the fortunes of the steel industry, brought layoffs and closings to area coal mines, and witnessed the passing into history of Hillman Barge. Even the venerable Monongahela Railway, a fixture in the community since 1903, was absorbed by a larger corporation that removed its headquarters from the borough.
It should not be surprising then that the Brownsville General Hospital has also fallen upon hard financial times. As these words are written, the hospital's future is more clouded than at any time since it opened during World War I in the yellow brick building at Fifth and Church.
Blanche Pursglove and Oleda Davison were nurses at Brownsville General Hospital when the hospital's future was not in question. Blanche was a staff nurse and a head nurse in both the old and new hospitals, and Oleda was a staff nurse at both locations for forty years. The pair has eighty years of experience at Brownsville General Hospital, during which they have watched the nursing profession evolve.
Our series concludes today with these two veterans of the wards sharing their insights about nursing and about Brownsville General Hospital. Some of Blanche's comments are excerpts from her 1989 interview with researcher Hannah Millward Fisher, while Oleda's thoughts were expressed to me recently in an interview.
Both retired nurses commented upon what they perceive as a shift in emphasis in the way nurses are now trained. They feel that academic knowledge, rather than practical nursing skills, now seems to be the primary focus of modern nursing schools. While knowledge is important, they wonder if the pendulum has not swung too far.
In her last years at Brownsville General Hospital, Blanche could see the evidence of this change in nursing education.
"When we were trained at the Brownsville School of Nursing," Blanche explained, "we had many patients to care for as student nurses, not just one or two at a time as is sometimes the case in nurses' training today.
"Working as head nurse, I found this to be true about these young girls coming out of school, where they had only one or two patients to care for during their training. They were just totally lost and frightened to death at caring for so many patients at once, because they didn't get the kind of training that we did.
"I think that what we need to stress is having more practical care put into the nursing training now. Theory is wonderful. These young girls, you can tell that they're up on theory. But when it comes to taking care of patients the way we were taught to take care of patients, it isn't there."
Oleda Davison echoes Blanche's sentiments.
"Nurses today know the theory and the book work, but they are not as strong on the mechanics of practical nursing care. Ideally, I think the best nurse today is one who has taken the one year training to become an LPN (licensed practical nurse), then taken two more years of schooling and become an RN. They know how to give a bath, for example, and perform other practical skills.
"At one time, it was standard hospital nursing procedure at Brownsville General Hospital to bathe each patient every morning, and later in the day, their face and hands were washed again and backs were rubbed. You don't see that any more now. This is not just at Brownsville hospital. This is everywhere."
Hannah Millward Fisher asked Blanche why she felt recent nursing school graduates did not receive sufficient training in the practical aspects of nursing.
"I think that maybe what is happening is reducing the time spent in nurses training to two years," Blanche replied. "I really feel that to turn out a nurse that is going to be well versed in everything, you need a three-year course. I think that third year, putting these girls onto a wing to take care of a wing, is what you need in your third year, and they're not getting it."
Blanche gave an example to illustrate her point. "I had new nurses come in," she recalled, "and I would say to them, ‘we're going to have to catheterize this patient,' and they would say, ‘I've never catheterized a patient.' We had a nurse that was a four-year student from a university, and I asked her to give a Fleets enema. She said, ‘I've never given a Fleets enema.' I don't see how you can turn nurses out and expect them to manage if you're not going to give them better training.
"Another thing that I have noticed with new trainees is that they do not have sterile technique in their mind. You really have to watch them when they're doing dressings. Really, you have to teach them sterile technique once you get them onto the wings."
Blanche feels that her demanding nursing education at the Brownsville General Hospital School of Nursing in the 1940's had a far-reaching effect upon her.
"I feel that the training we received helped to shape our lives as nurses and in family life, even to managing your home. I feel that we learned to be on schedule and to be organized, and that has been a help to me all through my life."
I asked Oleda Davison, who spent her entire career in nursing, "Would you recommend that a person choose a nursing career today?"
"No," she replied.
"Because unless they start out as LPN's and learn their practical skills well, they don't learn the things they need to be a complete nurse."
Hannah Millward Fisher asked Blanche Pursglove the same question in 1989. Even then, Blanche could see the changes that were happening in nursing.
"I enjoyed my nursing career," Blanche told Hannah. "I wish that nursing would go back a little to the way it was. But the way I see it now, I am inclined to discourage my grandchildren from being nurses. The hospitals are so short of help.
"I am discouraged with nursing. I really am. Right before I retired, we had the new nurses coming in, and I could see that there was something lacking in the training. It seems in the hospitals that so many people complain about not getting good nursing care, and it is really discouraging.
"I think that right now , Brownsville hospital is a little bit better, but it was in a really bad slump. Brownsville hospital has always had a reputation of giving you excellent nursing care and having kind of a homey, family atmosphere. Patients would go out and say, ‘gee, we really got good care in the Brownsville hospital.'
"They aren't saying that as often now. And I feel that after talking to people who have been in the bigger hospitals and in Pittsburgh, you are getting the same complaints. That you are not getting good nursing care.
"I have heard people say, ‘you know, when a nurse walks into my room, I want her to look like a nurse.' I don't know why they aren't wearing their caps and looking like a nurse. You never know for sure if she is a nurse or not. People really want nurses to look and act like nurses. I think the discipline taught in the nursing schools needs to be emphasized. I think they need to get back to a dress code, and they need to get back to bedside nursing and making the patient feel like they are important.
"I hate to say this, but from the top, they are not getting the right guidance. Things are not running properly at hospitals now. I could see it at Brownsville, and I can tell by the way my acquaintances who are younger nurses elsewhere describe it to me. I think it needs to be looked into, to see where we are going wrong. There has to be a swing back in the very near future or we are facing disasters.
"I don't want to paint too bleak of a picture. That is my view after forty years of experience. I think that the morale of nurses in hospitals is so bad. It is at an all time low. If you are not happy in what you are doing, how can you give it your best?"
These are the thoughts of two women who have seen nursing first hand over the past half century. Are they right? Has nursing care today become too hurried and impersonal? With increasing demands upon nurses to learn to operate a dizzying array of high tech equipment and administer dozens of different medications, has it become impossible for a caring nurse to do her job the way she would like to? Has TLC become the biggest casualty of the push toward cost efficiency?
I can still hear the words of Blanche Pursglove speaking from the tape recorder as she concluded her 1989 conversation with Hannah Fisher. "If you are not happy in what you are doing," she said to Hannah, "how can you give it your best?"
To Blanche Pursglove, Oleda Davison, Helen Shallenberger, Anne Rymarchyk, Helen Kelly, Ruth Gomery, Mary McClelland, and to the hundreds of nurses who have served in the wards and halls of Brownsville General Hospital over the years . . . thanks for giving it your best.
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