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It was the quietest of revolutions

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VOL: 98, ISSUE: 10, PAGE NO: 31

Eileen Shepherd, RGN, DipN

Every movement that challenges the status quo has to make symbolic gestures and many of us who were nursing in the 1980s threw ourselves into the new nursing movement with gusto.

Every movement that challenges the status quo has to make symbolic gestures and many of us who were nursing in the 1980s threw ourselves into the new nursing movement with gusto.

'New nursing' was good, 'old nursing' was bad. New nurses sought to provide personalised care for patients, our banner was primary nursing, we rushed to our cause and the battle line between new and old nursing was drawn. New nurses were radical and revolutionary. They were ward nurses, the grassroots, who had begun to realise their potential to bring about change from the bottom up.

However, as with most good ideas, new nursing was hijacked, sanitised, institutionalised and tamed as debates over the organisation of nurses' work became more important than the underpinning philosophy - that of personalised care.

The symbols of new nursing were rife - multicoloured name badges and colour-coordinated teams were essential accessories. Yet in the consternation over symbols and organisation the message became muddled. As we argued about one team answering another team's buzzer, the real debate over how to develop nurses who chose ward nursing was forgotten.

I am guilty of making a grand gesture - mine was scrapping the back trolley.

The background, the two-hourly ward round, was the 'new nurses' worst enemy. To do the background you set up a large trolley with everything you would need for the ward: bottles, creams, sheets, mouth-care trays, rubbish bags and pads.

The back trolley represented everything that was bad about the old system. So I banished it from my ward. Rather than liberating my team and enabling us to move upwards to a higher, more sophisticated level of practice, this left us with the problem of where to put everything that had been on the back trolley and became the subject of heated discussion at subsequent ward meetings.

Sixteen years later I find myself working a twilight shift. The ward is frantically busy and we are short of staff. No one had time to stock up on equipment, so I set up a back trolley. The tasks were handed out and we do the customary background at 10pm, obs, charts, drugs and getting the patients to settle.

At the end of the shift I asked myself what new nursing was all about. After all I had just cared for patients the way I did 20 years ago. Was new nursing simply another empty gesture, given that the back trolley and task allocation have stood the test of time?

The legacy of new nursing is that it showed the potential of ward nurses to bring about grassroots change. But 'personalised care' is referred to only in mission statements - the NHS has failed to harness the potential of ward nurses.

I hope that modern matrons will stir up the next revolution and spark the enthusiasm of those at grassroots level, but looking around I fear I may have set my hopes too high.

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