Dropsafe

by Alec Muffett

Matrons, Carry-On, Florence Nightingale and the Miasmatists?

I was listening to the radio the other day – may have been the Today programme, I can’t remember – and there was a discussion regarding Florence Nightingale, brought about by some new biography or somesuch.

I was only half-listening, but my attention was nailed when one of the speakers, presumably the one brought in to offer a “balanced viewpoint”[1], implied that Nightingale was deeply harmful to her charges because she was a “miasmatist” (someone who thinks disease is caused by bad stinks rather than microbes) and she should have known better / been better educated by that point in time, and moreover she created the archetype of the hospital Matron (cue Carry-On imagery) without which we were all much better off.

I am not going to speculate upon what Florence should have known at that time and in that place – or whether she reverted back to “miasma” thinking later in her life… but I do know that my next-door neighbour Eileen was a nurse in the 70s/80s, and tells me that her Matron was an absolute terror regarding proper procedure. Her views on modern hospitals include:

“It’s not like it used to be – If you failed to wash you hands moving from one patient to the next, you got a severe telling-off. If you did again you were out the door, love. Fired. Just like that. But I saw them today going from patient to patient and not doing any of that.”

…and I found myself tying the ideas together and thinking: “Is that it? Are the vast amounts of MRSA and C.Diff cross-infection (etc) at least in part due to anti-authoritarian and cost-cut pruning of people whose job it was to ensure physical hygiene was maintained?”

Somebody said “let the pills sort it out”, maybe?
—
[1] ie: Devil’s Advocate in spite of any amount of weight to the positive side of the argument.

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Comments

2 responses to “Matrons, Carry-On, Florence Nightingale and the Miasmatists?”

  1. bartb

    I found this article about the large impact the use of checklists (combined with giving both doctors and nurses involved in patient care the authority to enforce that all steps are followed) enlightening: http://www.newyorker.com/reporting/2007/12/10/071210fa_fact_gawande?currentPage=all

    Reply
  2. Simon

    MRSA and C diff are both problems as a result of the use of antibiotics.

    The “vast amounts of MRSA and C Diff”, reflect general infection rates that are very low by historical standards. It is clear the NHS was slow to respond to the development of MRSA, but this is just a short glitch in otherwise declining trends in nosocomial infections.

    Note also people in hospital (after surgery at least) are now also sicker, since a lot more minor surgery is done as outpatients.

    I did some reading around when Branson was in the news saying hospitals are not being run like airlines. He has a point about them not sharing best practices as well as they could. Although even this is variable, and at the individual level, many NHS employees closely follow NICE announcements and other best practice information.

    I predict that ignorance of current state of germ theory of disease will continue to kill people unnecessarily, but probably less and less each year as long as society progresses steadily.

    The newspapers picked up the specific issue of colonization of medical staff with MRSA, which caused me to do some reading around. The benefits of trying to eradicate MRSA colonization from medical staff are not completely black and white, however if it happens the next big newspaper story will probably be VRSA or VISA infection rates soar (from nothing, to nearly nothing, but no doubt the press will be able to paint as a 10,000% increase in VRSA rates or some such, and bemoan the state of our hospitals cleanliness).

    Reply

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