VERSION|0.5.1|NAME|Dinah|DATE|1366833121|CONTENT|I think the error lies in the de-skilling of basic patient care throughout hospitals and nursing homes.  It could be argued that feeding, washing, dressing and toileting patients does not require training, but if these things are neglected, or done badly, then much of the high-skill surgery and medical techniques will be wasted.  Elderly patients may need fewer high-tech skills, surgery and aggressive therapies, but their fragile bodies do require careful handling in order to prevent bedsores and injuries to skin and bones.  This means carers trained in the correct techniques, sufficient time to do them in, and to ensure patients are fed properly and listened to.  A re-introduction of  trained nurses equivalent to the old SEN grade is overdue. 
 
Another problem is the appalling lack of after-care facilities, leading to bed-blocking in teaching hospitals by patients with nowhere else to go.  Convalescent homes, cottage hospitals and halfway-house facilities have all gone because all the money is spent on the major hospitals.  Good nursing homes are prohibitively expensive, charging up to 1000 per week, and elderly people are frequently forced to sell their homes to finance their care.  If younger people requiring medical attention were expected to do this there would be an outcry.

Nursing is nowadays seen as a career rather than a vocation.  The ideals of dedication, and self-abnegation that nurses were once expected to aspire to may seem quaint and old-fashioned today. Nevertheless, the exacting training, intolerance of bad practice and strict supervision of staff that used to prevail on hospital wards ensured that leaving patients to starve or lie in their own excrement could never have happened.  This is not to say there were no bad nurses then, but at least they were less likely to get away with neglecting or ill-treating patients.
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