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practical philosopher

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Comments (152)

  • Comment on: UKIP moots return of enrolled nurse and end to graduate training

    practical philosopher's comment 27 April, 2015 8:43 am

    This issue has nothing yo do with ukip and everything to do with the profession at large. It demonstrates what we have failed to do as a profession which is to point out that what we do is a scientific job. By constantly anchoring ourselves to some sort of social aspect we have never said that what we do in principle is governed by science, lead by science and is dependent on science. Nurses do a scientific job, just the same as every other profession in the healthcare profession. By pretending that relationships and the undefinable aspect of 'caring' is what mandates our role we allow a wide spectrum of well meaning but fundamentally ignorant people, outdated but interested dinosaurs and involved but uninformed bystanders to weigh in and force their opinions on to us.

    The undeniable truth is that Nursing is a science. The outcome overall of patient recovery and indeed care is totally independent on how you are perceived, how you act and how patients act.
    The application of healthcare delivery is simple and finite. It is the provision of nursing and it stands wholly apart from what relations you have. One might make the experience 'feel' better with a bright and sunny persona but that is not WHY patients recover.
    People ought to always be nice, friendly and courteous, but that is as dependent on environmental factors as drug delivery is on having the time and resources to do so.

    Instead we have constantly played the stereotype and all of us are trapped within this pointless wasteful paradigm. We can see in other countries that the profession has made enormous strides, simply because they do not have the delusion that their country invented nursing thus being free from the need to constantly play up a xanadu yesteryear that truly was the dearth of decent culture and a servile mentality.

    Enrolled nurses, much like nurses were removed because they were a hideous spectre. An anachronism that haunted our society. Instead of resisting their renewal, apparently we welcome their return. A shameless call for authority where none was needed. Matrons kept order through fear and bullying. Those with rose tinted glasses fail to understand that they existed purely because they were women thought to require an all powerful warden. Matrons did not raise standards, they established them and then preserved them in aspic, allowing the feminist movement to be utterly wasted between the 1960's and 1980's. In the USA nursing definitively took off whilst in the UK hats and graduation trinkets remained the peasants reward.

    The other issue ukip and all others forget is that few actually want to do nursing. Despite high enrollment, nursing has among the worst drop out rates anywhere. Not because of the intensity but because courses fail to meet expectations. With my cohort few could tolerate the vast amount of unusable theory and wishy washy pseudoscience paraded as researched and evidence based. Its lack of practical application and hypocrisy was plain to see. Students arrive expecting to learn about the body and instead fall asleep in lectures that do not meet the intellectual requirements necessary to take part in the delivery of health care. They will have to suffer being excluded from conversations everyone else is having. They will not learn why a drug works, how an operation occurs, how anaesthetics reverse, why pain is their purview,, how to assess an abdomen. These are our things. Instead they will sit and listen to lectures on dementia with the lecture programmed to invest them as the person with the power to influence what has eluded science and psychology, and the saddling of changing peoples behaviour with the impression that they are the sole provider of life changing influence.

    But Nursing is a science. Nothing more and is was never anything else. The rest is garbage

  • Comment on: The big question: how can the ward sister role be strengthened?

    practical philosopher's comment 14 March, 2013 10:46 am

    I think the real issue here is of communication. I liked my Ward Sisters because they did two things woefully lacking in my current job:

    1. Update me after the ward rounds so I could action things.

    2. Tell me what they know about things that appear to be a surprise later on. Staff nurses need to know what their manager does with their day. Not in detail but in a way that suggests they are a team. I believe this is where the gulf comes from and why the divisions appear. She ought to lead the shift. Where I work now the Sister is there but often a Staff Nurse is in charge, however the Sister doesn't swap places with the Staff Nurse! Not great.

  • Comment on: 'Your enthusiasm and commitment will rub off on others'

    practical philosopher's comment 23 August, 2011 11:34 am

    Lol i wouldn't worry about writing style.
    your comments attract controversy. that's a good thing.

  • Comment on: The image of nursing: Not good enough for a feminist?

    practical philosopher's comment 15 July, 2011 9:43 pm

    michael stone | 1-Jul-2011 11:50 am

    I have no idea what you are getting at here or the relevance. Their feelings are of course their own but this is a fallacy in terms of how you do your job - objectively.
    I won't abide by the wishes of patients if they are contrary to my training education and best practice. Nor will i be subject to their whims - if indeed they are whimsical. In the ara i work in i have one goal which is to recover them from surgery and send them home. Failing a successful recovery i will care for them until theyare transferred somewhere else, sent home or die.
    I canno tgauge anything other than how they feel from 'how they feel' and even then i have to tread through a quagmire of psychological and sociological processes that may or may not be present.
    If feelings were as important as you say and not the end goal, why aren't psychologists and counsellors readiliy available to speak to patients. Why don't pre-assessment clinics employ people to quantify those fears etc so i can plan for them?
    The subject that you talk about is valid. But it has a finite conclusion - it is only useful to a degree and its outcome dependent on people and relationships which cannot be guaranteed.
    I chose science because then what you are talking about becomes clearer if the science is sound. Nurses wouldn't have to focus on combining science and psychology.

    Anonymous | 1-Jul-2011 3:32 pm
    Well i agree you aren't being sexist but you are missing the point which is self-evaluation existed before reflective tools were created. It is a human behaviour from lookingin the mirror and noticing weight gain and ageing to thinking about arguments and conversations you've had.
    It is a human behaviour and ones benefits from reflection are only mediated from your own opinions.
    All my university reflection without fail stated that 'i reflected and changed nothing as i did it the right way the first time and the outcome was good.' all of those assignments passed despite me noting that i had learntnothing from the process and several sharp criticisms of the process.

    Self evaluation is good. but it is only valid if the element you are reflecting on involves only you and no other elements that are out of your control. e.g empty beds, waiting times, delays, cancellations.

    you cannot reflectadaquately on giving a subcutaneous injection to a fresh new patient who felt it was very painful. You can't really ponder on your technique if you were trained and experienced. You cannot really say you could have given the patient more information and comfort if you already did and the patient was consenting and comfprtable prior to the injection. You cannot claim to have done anything different if your mental checklist, safety, right drug, correct site etc was correct. If the patient is not used to being injected then perhaps you could muse over that but what could you do the next time?
    How REALLY will it change your thinking? Will it make you MORE aware that injections hurt or were you unaware that injections are always usually painful but amazingly well tolerated?

    That you see no differences between foreign nurses are yourself is no measure of the difference in their style. Merely it is proof that you do not realize that the adaptation course they are often required to complete effectively denies them the ability to work as THEY were trained in order to align their vastly superior technical and knowledge with our care (not science0 based philosophy.

    If you want to see the difference ask them about the values of blood gases. Ask them to tell you about blood results or acute abdominal assessments. Ask yourself why for example in the philippines the nurses and not the doctors consented patients? Or why they alone could administer single drugs. Then ask them about their nurse:patient ratios.
    That you see no difference wither means that your own brand of nursing is essentially cultureless (unlikely) or that imagine a universal nursing culture with this country leading the way/ being the first amongst many.
    It is not, we are not.
    Open your eyes.



  • Comment on: Nurses who wash uniforms at home may put patients at risk

    practical philosopher's comment 30 June, 2011 11:19 pm

    I wonder what other credible health care professionals will look back and have what they wore and how their hair was as the main topic of discussion....

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