For half the lifetime of the NHS, Michelle Parsons, head of nursing and clinical services at Emersons Green NHS Treatment Centre, has been caring for patients and helping to develop colleagues and the services they provide.
Michelle said: “I qualified in 1986 from King’s College Hospital, London. Nurse training was very different in those days. It was a very practical course. You took rotations in every discipline: you saw all of life, from birth and paediatrics to geriatrics and palliative care and everything in between. These days, while the course is much more academic, nurses are expected to specialise much earlier on.”
Michelle says the uniform too has changed. “When I began training nurses had three types of hat that showed where they were in their training. When we graduated, we wore silver buckles on belts that went across our starched aprons. All that has gone now, as rules around infection control have changed. It is a good thing for patient safety and the modern uniforms are a great deal more comfortable; but we all had a pride in our buckles as they showed not only that we were qualified but where we had qualified from.”
Patients are also in hospital for much shorter periods than in the 1980s. Michelle said: “I remember studying examples during my training and being told that a stay of 10 - 11 days after hip replacement surgery was the norm.
“A large body of research has shown that better medical outcomes are achieved if you can get the patient on their feet quickly after the operation, and patients recuperate better at home. With developments in anaesthetics, drugs, technology and physiotherapy, that has become increasingly possible.
“At Emersons Green Treatment Centre, using an enhanced recovery pathway, most patients leave within two days and, if they are fit and responding well, they can be out in as little as 24 hours.”
The ridged hierarchy that people think of from films like Carry on Doctor has also gone. Michelle said: “When I began, consultants were god-like creatures who went on their rounds surrounded by their entourage of junior doctors. No one would dare speak and we were all in awe. That has changed for the better and now we have a very collaborative environment completely driven by the need to give the patient the best possible treatment with all disciplines of staff working closely together. It also ensures patient safety as people are now not scared to speak up.
“Nurses’ roles have expanded; they can take on advanced training that makes them specialists in areas such as tissue viability and deep-vein thrombosis. Now doctors may well ask a nurse for specialist advice.”
There has been political concern and media interest around the number of nurses leaving the profession, but Michelle says that should not put anyone off who is compassionate and who wants to make a real difference to people’s lives. “British nurses are highly regarded and having a nursing degree opens many doors at home and abroad. I spent six years working in Australia, which was not just a wonderful experience, it honed my skills and added to them.
“There are roles that people may not even have thought of, such as nursing in prisons, mental health nursing and opportunities in research and teaching. The only thing that no course can teach you is how to be empathetic and to genuinely like people.”
So, what does the next 70 years hold for nursing? Michelle said: “With a growing and ageing population, and finite resources, I can see nurses becoming ever more involved in preventative healthcare in hospitals and the community. As well as delivering care and treatment, I think they will become pivotal in public health education work; teaching people about drug, alcohol and dietary issues as well as delivering cessation advice.
“More and more patients will become experts in managing their own long-term conditions, backed up by healthcare professionals working in both primary and secondary care. I would advise anyone going into the profession to seek out all the experiences and training you can. I still keep up my clinical training to ensure my nursing skills are on a par with my management skills. Do that and you can look forward to an exceptional and rewarding career packed with memories.”