Developments in patient care - chap 5

Question 1

Medival era

What was the role of the Church during medieval era?

Answer 1

were essentialy religious institutions:
* principal concern was the health of the soul over the health of the body
* emphasis was on care and religion rather than treatment and cure

Question 2

Medival era

Who ran almost all the medieval hospitals?

Answer 2

the Church

Question 3

Medival era

What were the different types of hospitals?

Answer 3

Leper hospitals
Almshouses
Christian hospitals

Question 4

Medival era

What % of hospitals cared for the sick, what did the rest do?

Answer 4

10% cared fo the sick
* 47% housed the poor and elderly - no medical care
* 31% leper hospitals which provided no medical care
* 12% gave shelter to poor travellers + pilgrims

Question 5

Medival era

What was leprosy, what were Leper Hospitals?

Answer 5

• a common and incurable disease - victims were forced to wear special clothes and ring a warning bell as the walked + were’nt allowed to marry
• People thought those with the disease were being punished by God
• Were built on the outskirts of towns to limit the mixing with the rest of the population
• provided lodging and food but no treatment

Question 6

Medival era

What were Almshouses?

Answer 6

• medieval equivalent of the modern care home - were a response to an aging population
• offered sheltered accommodation and basic nursing - no medical treatment

Question 7

Medival era

What were some featues of Christian hospitals?

Answer 7

• set up, paid for and ran by the church - looked after poor and sick
• didn’t treat sickness but aimed to make patients comfortable
• people who were seriously ill and in need of constant care were often no allowed in - would stop people concentrating on the main purpose - pray and attend religious services

Question 8

Medival era

What did Christian hospitals provide/ do, and didn’t?

Answer 8

Did:
* nursing, clean and quiet conditions, regular meals and warmth, and sometimes sugery and medicine
* staff were brothers and sisters in religious orders - cared for the sick and tried to save their souls

Didn’t:
* staff did not attempt to cure them
* few, if any, doctors

Question 9

Medival era

What were Christian hospital patients expected to do and why?

Answer 9

spend most of their day praying and confessing their sins
believed that they were poor and sick because they’ve sinned and now need to rid them selves of their sins

Question 10

Medieval era

What was the extent of change in the medieval era, why?

Answer 10

limited
reliant on church rather than facts

Question 11

Renaissance

What did the Renaissance, onwards, see?

Answer 11

decline in the role of the Church administering patients care

Question 12

Renaissance

Who closed monastries and when?

Answer 12

Henry VIII - 1530s

Question 13

Renaissance

What was the impact of the closure of monastries?

Answer 13

• the Church stopped being a supporter of hospitals and that role had been taken on by voluntary charities
• in some areas town or city councils stepped in to take over the running of Almshouses
• In London the authorities petitioned the crown to provide funds to endowed hospitals

Question 14

Renaissance

Across London how many major hospitals were endowed with royal funds, what were they called and name them?

Answer 14

5
‘Royal Hospitals’
1. St Bartholomew’s hospital
2. St Mary Bethlehem
3. St Thomas’s hospital
4. Christ’s hospital
5. Bridewell hospital

Question 15

Renaissance

What was the extent of change during the renaissance, why?

Answer 15

Large
crucial break away from church and beliefs

Question 16

Industrial era

Who else in the 18th century paid for hospitals?

Answer 16

private individulas
charities or towns

Question 17

Industrial era

What are some examples of endowed hospitals?

Answer 17

1719 - Westminster Hospital - London:
paid for by a private bank
1724 - Guy’s Hospital - London:
paid for by Thomas Guy
1729 - Royal Infirmary Hospital - Edinburgh:
paid for by wealthy patrons of Edinburgh donated funds

Question 18

Industrial era

What did the development of scientific enquiry lead to?

Answer 18

the founding of the Royal society in London - 1662 and various medical societies:
– did much to encourage new scientific discoveries

Question 19

Industrial era

What did the founding of medical societies provide oppurtunities for?

Answer 19

discuss ideas ideas about medicine and to analyse and evaluate the results of experiments or trials in new surgical processes
- led tothe growth of enlightenment, an age of scientific advancement
- advancements in medical knowledge

Question 20

Industrial era

What was the impact of industrial revolution?

Answer 20

• sharp rise in population levels - increased demand for hospital provision
• part of the demand was met through financial donations from wealthy industrialists - believed that God had givenmthem responsibilty to improve the lives of the poor and sick

Question 21

Industrial era

What was the role and function of endowed hospitals?

Answer 21

• primary role to look after the poor sick
• patients were looked after by nursing helpers - who undertook manual work + ensured that the patients were:
  1. washed
  1. kept warm
  1. fed regularly
• able to treat patients with herbal remedies
• simple surgery e.g removal of bladder stones
• issue of medicine

Question 22

Industrial era

What were the effects of the continuity of growing population?

Answer 22

• resulted in the establishment of general hospitals in cities across the country
• 1800 - 3000 patients in hospitals to 7619 in 1851
• specialist hospitals began to appear
• setting up of small hospitals in rural areas run by general practitioners

Question 23

Industrial era

What were the conditions like in these new hospitals?

Answer 23

• generally poor - cramped stuffy wards - helped infections to spread quickly
• quality of nursing was poor - untrained nurses, dirty, ignorant and often drunk
• basic standards of hygiene
• many thought nursing was a job for uneducated women

Question 24

Industrial era

What 3 females changed nursing, when?

Answer 24

1. Florence Nightingale
2. Mary Seacole
3. Betsi Cadwaladr
   * The Crimean War (1854-6)

Question 25

# Industrial era What **influenced Florence Nightingale** to be a nurse?

Answer 25

believed it's what God wanted her to be

Question 26

# Industrial era What **interested Nightingale** about the war?

Answer 26

**conditions** experianced by **sick** and **wounded British soldiers**

Question 27

# Industrial era When did **Nightingale arrive in Crimea**, who with?

Answer 27

**November 1854** 38 of the **best nurses** she could find

Question 28

# Industrial era What **problems** did **Nightingale + the nurses** witness there?

Answer 28

* **1700 wounded** and **sick** soldiers in a field hospital * many were suffering from **cholera and typhoid** * they were housed in **filthy wards** * not **enough** beds or medical supplies * also... army doctors **resented Nightingale's presence** and **opposed her interference**

Question 29

# Industrial era What **support** did **Nightingale get?**

Answer 29

* Minister of war supplies * Head of the Army Medical Department * Dr Smith made sure that she recieved **sufficient supplies** of the **medical items she needed** * had **financial backing** from **The Times**

Question 30

# Industrial era What **actions** did **Nightingale** take?

Answer 30

* first task - **clean** the wards * patients were given... a **regular wash, clean clothes** and had their **bedding changed** regularly * **prevent spread of illness**: patients were **seperated** according to illness, plenty of **space** was put **between each bed** and fresh air **circulated from open windows**

Question 31

# Industrial era What **results** did her actions see?

Answer 31

* after just 6 months - only 100 out of the 1700 were still confined to bed * death rate in the hospital fell from 42% to 2%

Question 32

# Industrial era When did Nightingale **publish *Notes on Nursing*,** what did it include?

Answer 32

**1859** Set out the **training** nurses should recieve - **very strict:** * Nurses were only allowed to go out in pairs * they had to live at the hospital * had to keep a diary of their work were taught to be as **clean as possible**

Question 33

# Industrial era What was the **importance** of **Nightingale's work?**

Answer 33

Hospital design undergone **radical change** e.g good circulation of air **nursing** had finally been recognised as a **profes sion**

Question 34

# Industrial era How did **Mary Seacol contribute?**

Answer 34

**1855** - opened **'British Hospital'** to treat wounded and sick soldiers **1857** - published an **autobiography**, *The **Wonderful Adventures of Mrs Seacol in Many Lands***, helped **raise the awareness** of the contribution of **nursing during the Crimean War**

Question 35

# Industrial era What was the **extent of change** during the **Industrial era, why?**

Answer 35

**Vast - Turning point** **Solved many problems:** Untrained, in **1850** - trained nurses in **1900's** Lack of cleanliness - **Clean wards** Poor sanitation (1850) - Good sanitation (1900)

Question 36

# 20th century What were the **changes** in **government attitude** during the **20th century?**

Answer 36

* stopped following a policy of *laissez faire* (**that it was not their job to interfere with peoples lives unless they had to)** * introduced a series of **welfare reforms** - designed to **help people** who fell into difficulty through **sickness**, old age or unemployment

Question 37

# 20th century When was the **first National Insurance Act?**

Answer 37

1911

Question 38

# 20th century What was the **National Insurance Act?**

Answer 38

**Lloyd George proposed an insurance scheme:** * **workers + employers** making weekly contributions into a **central fund** which was used to give workers **sickness benefit** and **free medical care** if they became **ill** * those contributing would recieve free and a payment of **10 shillings per weeks** for 26 weeks if absent from work **due to illness**

Question 39

# 20th century Who were some **opposition** to the **1st NIA**, how did **Lloyd George overcome this?** | Nation Insurance Act (1)

Answer 39

**Doctors** by paying each doctor **more money** for **each patient** they saw

Question 40

# 20th century When was the **2nd NIA**, what was it? | Nation Insurance Act

Answer 40

**1913** extended the scheme to include **unemployment insurance**

Question 41

# 20th century What were the **limitations** of **both National Insurance Act's?**

Answer 41

scheme was **restricted** to certain trades and occupations - **did not cover:** * families * unemployed * elderly * mentally ill * chronically ill

Question 42

# 20th century After becoming **prime minister**, what did **Lloyd George** **promise?**

Answer 42

'a land for fit heroes'

Question 43

# 20th century How did **Lloyd George** attempt to fufill **his promise?**

Answer 43

initiated a **building programme** for over **200,000 new houses** to be built - to **replace slum housing** **extended National Insurance** to cover a gre**ater proportion** of the workforce - could now claim **sickness AND emplyment benefit**

Question 44

# 20th century When was the **Beveridge Report** published, how **many copies** did it sell?

Answer 44

December 1942 over 600,000

Question 45

# 20th century What did the **Beveridge Report** identify?

Answer 45

**'five evil giants'** - that needed to be tackled by government action: 1. want 1. disease 1. ingnorance 1. squalor 1. idleness

Question 46

# 20th century How was **each giant tackled?**

Answer 46

**by the Labour party:** **want** - National Insurance Act 1946 - provided benefits for many e.g pregant ... **squalor** - 1946 and 1949 Housing Acts provided financial aid to rebuild towns and cities + council houses **idleness and ignorance** - 1944 Education Act, provided free primary and secondary education **disease** - 1946 Nation Health Service Act **(NHS)**, setting up of a free health service for all

Question 47

# 20th century What are the main features of the **NHS Act**

Answer 47

* for the first time **every british citizen** could have **free medical treatment** * all hospitals were brought **under state control** under the control of the **minister of health** * consultants in hospitals **recieved salries** and all treatment to patiens was to be **free**