Put Basic Care nurses in the picture

Monday 18 May 2020

The images we now see on tv of doctors and nurses at work wearing their protective clothing are imposing and seen as heroic. “There’s a reason we’re talking about the heroes in healthcare,” says Margreet van der Cingel, university of applied sciences professor for Nursing Leadership & Identity at NHL Stenden University of Applied Sciences. “And yet nurses are always doing life-saving work but there is then less attention and, unfortunately, less time.”

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During the corona crisis, attention is mainly paid to the technical side of healthcare, such as respiratory support for patients in intensive care. “That is important and often life-saving work,” says UAS professor Margreet van der Cingel. “But nurses working in intensive care, in hospital wards, in homecare and in nursing homes offered care to prevent death even before the corona crisis. It was a sort of ‘invisible’ care that seems less imposing but also saved lives.”

Van der Cingel alludes here to what in the trade is called ‘basic care’, helping patients into bed or into a different position, helping them get out of bed, cleaning wounds and intravenous drips, making sure they drink enough and can get to the toilet. “Actually, they are the day-to-day things that everyone does but that people who are sick or need help are unable to do on their own,” summarises Van der Cingel.

It’s care for this group of vulnerable people that merits the title ‘life-saving care’ according to Van der Cingel. “It’s care that prevents all kinds of other problems arising, such as pressure sores, infections, falls resulting in for instance a broken hip, under-nourishment, urinary infections, the list goes on. We need to make this ‘invisible’ care more visible.”

Various studies carried out both in the Netherlands and internationally indicate that nurses in hospitals do not always get round to doing this essential work. Van der Cingel: “This is for various reasons. Work pressure is of course one factor. It could be that there is too much administration to do or that there are not enough nurses available. It is also mainly thought that it is because nurses have insufficient influence on how they manage their work and priorities. But actually, we don’t really know exactly.”

Which is why the professor is starting up the research project ‘Opting for Better, increasing the influence of nurses on good hospital care’ with the Medical Centre Leeuwarden and other partners and hospitals in the north. Van der Cingel: “We ask nurses what care they don’t get round to and why. We then want to talk to them to find out what they need as a team in order for them to have enough influence that they will be able to do these basic care tasks.”

Van der Cingel assumes that if nurses had more influence and were able to decide more for themselves what was important, then these ‘basic’ tasks would get priority. “The nurses’ expertise means they are well aware that these means they are doing life-saving work. But in addition to this, more autonomy would increase job satisfaction which means they will be less likely to leave the profession. And this is of vital importance in a time when each nurse, in every area of healthcare, is so badly needed.”

Van der Cingel is pleased with the appreciation and respect that has arisen for all the heroes in healthcare during this corona crisis. “But let’s not forget that it is basic care that is so important and saves lives. And this is true for all patient care, before, during and after the corona crisis.”

Margreet van de Cingel is university of applied sciences professor of Nursing Leadership & Nursing Identity at NHL Stenden University of Applied Sciences and studies how the nursing profession can continue to develop.