Developments in patient care - chap 5 Flashcards
Medival era
What was the role of the Church during medieval era?
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
Medival era
Who ran almost all the medieval hospitals?
the Church
Medival era
What were the different types of hospitals?
Leper hospitals
Almshouses
Christian hospitals
Medival era
What % of hospitals cared for the sick, what did the rest do?
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
Medival era
What was leprosy, what were Leper Hospitals?
- 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
Medival era
What were Almshouses?
- medieval equivalent of the modern care home - were a response to an aging population
- offered sheltered accommodation and basic nursing - no medical treatment
Medival era
What were some featues of Christian hospitals?
- 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
Medival era
What did Christian hospitals provide/ do, and didn’t?
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
Medival era
What were Christian hospital patients expected to do and why?
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
Medieval era
What was the extent of change in the medieval era, why?
limited
reliant on church rather than facts
Renaissance
What did the Renaissance, onwards, see?
decline in the role of the Church administering patients care
Renaissance
Who closed monastries and when?
Henry VIII - 1530s
Renaissance
What was the impact of the closure of monastries?
- 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
Renaissance
Across London how many major hospitals were endowed with royal funds, what were they called and name them?
5
‘Royal Hospitals’
1. St Bartholomew’s hospital
2. St Mary Bethlehem
3. St Thomas’s hospital
4. Christ’s hospital
5. Bridewell hospital
Renaissance
What was the extent of change during the renaissance, why?
Large
crucial break away from church and beliefs
Industrial era
Who else in the 18th century paid for hospitals?
private individulas
charities or towns
Industrial era
What are some examples of endowed hospitals?
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
Industrial era
What did the development of scientific enquiry lead to?
the founding of the Royal society in London - 1662 and various medical societies:
– did much to encourage new scientific discoveries
Industrial era
What did the founding of medical societies provide oppurtunities for?
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
Industrial era
What was the impact of industrial revolution?
- 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
Industrial era
What was the role and function of endowed hospitals?
- 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
Industrial era
What were the effects of the continuity of growing population?
- 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
Industrial era
What were the conditions like in these new hospitals?
- 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
Industrial era
What 3 females changed nursing, when?
- Florence Nightingale
- Mary Seacole
- Betsi Cadwaladr
* The Crimean War (1854-6)
Industrial era
What influenced Florence Nightingale to be a nurse?
believed it’s what God wanted her to be
Industrial era
What interested Nightingale about the war?
conditions experianced by sick and wounded British soldiers
Industrial era
When did Nightingale arrive in Crimea, who with?
November 1854
38 of the best nurses she could find
Industrial era
What problems did Nightingale + the nurses witness there?
- 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
Industrial era
What support did Nightingale get?
- 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
Industrial era
What actions did Nightingale take?
- 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
Industrial era
What results did her actions see?
- 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%
Industrial era
When did Nightingale publish Notes on Nursing, what did it include?
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
Industrial era
What was the importance of Nightingale’s work?
Hospital design undergone radical change e.g good circulation of air
nursing had finally been recognised as a profes sion
Industrial era
How did Mary Seacol contribute?
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
Industrial era
What was the extent of change during the Industrial era, why?
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)
20th century
What were the changes in government attitude during the 20th century?
- 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
20th century
When was the first National Insurance Act?
1911
20th century
What was the National Insurance Act?
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
20th century
Who were some opposition to the 1st NIA, how did Lloyd George overcome this?
Nation Insurance Act (1)
Doctors
by paying each doctor more money for each patient they saw
20th century
When was the 2nd NIA, what was it?
Nation Insurance Act
1913
extended the scheme to include unemployment insurance
20th century
What were the limitations of both National Insurance Act’s?
scheme was restricted to certain trades and occupations - did not cover:
* families
* unemployed
* elderly
* mentally ill
* chronically ill
20th century
After becoming prime minister, what did Lloyd George promise?
‘a land for fit heroes’
20th century
How did Lloyd George attempt to fufill his promise?
initiated a building programme for over 200,000 new houses to be built - to replace slum housing
extended National Insurance to cover a greater proportion of the workforce - could now claim sickness AND emplyment benefit
20th century
When was the Beveridge Report published, how many copies did it sell?
December 1942
over 600,000
20th century
What did the Beveridge Report identify?
‘five evil giants’ - that needed to be tackled by government action:
1. want
1. disease
1. ingnorance
1. squalor
1. idleness
20th century
How was each giant tackled?
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
20th century
What are the main features of the NHS Act
- 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
