long live florence nightingale!

we are all familiar with this nursing icon.

born in 1820 into a well-to-do english family in (surprise, surprise.) florence, italy, she went against her parents wishes for her to take the expected role for a woman of her status, ie. marry & become an obedient wife. her decision to take up nursing, a career with poor reputation (has this perception changed 2 centuries on?), caused untold distress to her family, esp her mother. however, her subsequent contribution to the nursing care of wounded allied soldiers in the crimean war (england, france & turkey vs russia) is legendary & appropriately led her to be honoured "the lady with the lamp". so much so that nurses these days have been called nightingales.

my mother was an assistant nurse (a rank below a staff nurse) with the government clinic (school health section). she worked office hours except when there were epidemics (eg. cholera & typhoid in the late 60s), then she had to do shifts to provide vaccinations round-the-clock at the causeway. as was her forte, she took care of the family's health. she sponged me when i had high fever, cooked porridge when i had poor appetite & dressed my wound with gauze & flavine when i was injured (this was before the advent of band-aid) . she single-handedly put me through varsity before she retired, & for the last few years, she's been a full-time care-giver to my father who has taken ill.

so, how do our modern-day nightingales match up?

in my line of work, i cannot but deal with nurses, from the students to the trained & near-retired; i've enjoyed working with them, treating them as members of the healing team. but i really just can't help noticing that the quality of student nurses recruited for training has nose-dived over the years that i've been a medic. in each batch, most are average with the occasional outstanding one but, by & large, the rest are just.....clueless. & clueless student nurses eventually become clueless nurses.

this situation cannot be good for health, pun intended. i saw an advert for a nursing diploma placed by a private institution(which is accredited by the national accreditation board, no less!) & was startled that the minimum qualification was credits in BM, maths & science, & just a pass in english. to me, that means in this era of online (english-language) medical/nursing journals, multi-slice 3D CT scans & robotic surgery, you could very well have gone through arts stream with just a smattering of english, & voila! you could theoretically be nursing a critically-ill patient with a few drug-eluting stents implanted under full anti-coagulation.

maybe i'm just being overly dramatic.

am i?

i encountered a nurse the other day, supposedly trained in intensive care, who is not able to explain the various ventilatory modes of a mechanical ventilator. would you like to be the patient with severe pneumonia (lung infection) with a tube inserted into your wind pipe, tethering between life & death, & this is the nurse rostered to look after you? incidentally, this nurse is a foreigner, recruited as a temporary measure to fill in the vacancies left by our own nurses who have gone to the middle-east in search of greener pastures (oases??). i mean, RM9000 a mth tax-free plus accomodation & airfare vs RM1500 is a no-brainer, right?

(what's the quality of our foreign nurses? this quandary is no different from the domestic maid situation. how often have we lamented about the problems perpetuated by these foreign maids? if we pay them RM450 a mth & our neighbour offers SGD600, in whose kitchen would they, esp the good ones, rather cook? anyway, i digress.)

so what we have is a nursing shortage partly caused by an exodus to the middle-east (& elsewhere), & in order to attract school leavers to join the profession, private institutions have sprung up, offering diplomas & requiring only mediocre exam results. so, as for medical courses, in our hurry to fill in the missing numbers, have we compromised on the quality of students? the health minister gave a hint of this here & here. & what about the lecturers & clinical instructors at these institutions - are there enough full-time, qualified teachers to propagate the art of caring & healing? so many variables, so much uncertainty.

which reminds me of what yoda said of anakin in episode 1 : clouded, his future i see.

long live florence nightingale!