I too love reflecting on how things used to be and I've watched the steady deterioration of holistic nursing care and the subsequent role of "nursing" becoming a rapid, task orientated one, a push for maximum efficiency / turnover and minimal contact with patients. Gone are the days of having time to move beyond clinical duties and maybe read to the blind elderly man, provide valuable and empowering education or chat with your colleagues. I am saddened that the powers that be will never appreciate the value of nurses having TIME to actually LOOK AFTER people. The patient who feels as if they were well cared for does not go home anxious, is well educated about discharge/preventative care and does not need to be re-admitted because they were pushed out the door. Injury and illness prevention will be a thing of the past as there is no short term vote winning financial benefit, already in my neck of the woods, vital community sexual health clinics and other services are being dismembered. Having the time to genuinely care for a sick person of course can't be quantified and these days it seems to only be about numbers and of course, money.
Believe it or not, with the new "physician frontloading" system in my ER, a written nursing assessment
has become almost obsolete. I would say that about 60% of the time the intern sees the patient the minute they arrive, so a "nursing assessment" has become "refer to medical officer notes". I believe nursing workload will increase at the expense of autonomous practice as our litigation focussed / instant gratification / entitled society demands specialist input for minor issues. We will not be able to assess a wound and select an appropriate dressing, we will follow a strict pathway for everything right down to how to wash someone with appropriate boxes to tick. I think nursing judgement will all but be removed from day to day patient care. Fortunately, I also believe that those of us who love nursing will perhaps figure out a way to bring things full circle. Hmmm, now I will try and think of something more positive to write!