A profession that goes beyond duty of care

When Florence Nightingale was tending British soldiers in the bloody Crimean War in 1854, she recognised that wounded soldiers were dying of injuries that didn't have to be fatal.
With some simple analysis "The Lady with the Lamp" discovered there was one common factor: infection, and that the nurses had no understanding of hygiene around these patients.
Her observations changed health care forever and that's the reason why May 12 - the anniversary of Nightingale's birthday - is International Nurses Day.
The theme of this year's celebration is "Closing the gap: increasing access and equity".
The International Council of Nurses says that despite myriad of achievements in health services, there are still major gaps in the health status and life expectancy between high, middle and low income countries, between men and women and between rural and urban residents.
The council believes nurses have an important role in achieving health equity and developing a clear understanding of how the health sector can act to reduce health inequities.
Sandy Blake, director of nursing and general manager for patient safety with the Whanganui District Health Board, has seen massive changes within nursing during the 40-odd years she has been working in the sector.
Mrs Blake says she has great respect for the basic beliefs that Nightingale championed.
"But the bigger thing about this annual celebration is that it says nurses are important, that they have pride in what they do ... This day is a chance for patients and others to perhaps thank the nurses for what they are doing.
"We're here for the right reason and that is we care about our patients," she says.
She says nurses are the frontline staff, dealing with doctors, patients, patients' families and patients' friends daily. "Their greatest role is their advocacy on behalf of those patients because they're seeing them and monitoring their progress constantly."
Mrs Blake says that since she started as a trainee nurse four decades ago, there has been a quantum shift in what nurses are doing.
"I trained in 1970 and nursing practice then was relatively simple.
"We washed patients and walked them - which we still do today - but our nursing was very much around tasks. As a junior I cleaned bed pans all day and hardly ever saw a patient.
"There was no technology. The first automated intravenous system I ever saw came into a hospital I was working in in 1974, but for a long time it sat in a cupboard because we'd been taught not to use machines."
Now the interaction between nurses and technology means nurses have to be very technically aware and able to programme the machinery properly.
"But at times we forget that our patients value us far more if we wash them, walk them, be kind to them and talk to them. I think for a while we lost our focus from those core needs," she said.
"This is what we're working to do in Wanganui Hospital and that's to bring that important focus back."
She says the qualifications for nursing have changed, too, with the expectation that nurses be more highly educated.
There has also been shift in health care, in accordance with the influx of highly qualified nurses. Nurses now shoulder more of the specialist work and with that, comes more responsibility.
Mrs Blake says the profession is seeing some nurses prescribing drugs in the wards.
"The pathway for nurses now is more exciting and that's probably because the medical profession is realising just how highly trained our nurses are," she said.
She said that as the health service evolved it was important that nurses knew not only how to work in the hospital, but also in the community.
Mrs Blake says she still holds to those core values that Nightingale laid down - empathy, care and advocacy for the patients.

Gentle art of nursing
A newspaper advertising campaign for the then Wanganui Hospital Board in the early 1960s speaks volumes of nursing as it was.
The "learning" involved hands-on work in the wards and trainee nurses would do none of the "old mop and broom work". Their training would take them into the children's ward where the nurses will "lose their hearts to the cute little patients".
Off duty, the trainees stayed at the Lambie Home "rightfully acknowledged as the finest in the Dominion", where recreation pursuits included table tennis, a sewing room - "an ideal place and willing hands to help you make that party dress", or they could "tinker" on one of the home's pianos. "Playing piano is quite a social acquisition and it's easy to stir up a sing-song," the advertisement waxed.
Nurses were given 16 uniforms which were regularly laundered and were paid an allowance for six pairs of stockings and two pairs of shoes each year. "Within months of graduating, many mature nurses capable of assuming responsibility are earning in excess of 1000  a year."