Liz Charalambous is a nurse and PhD student. She tweets at @lizcharalambou and is a regular guest blogger for the BGS.
This year heralds the 70th anniversary of the British Geriatrics Society. Founded in 1947, the society sought to alleviate suffering and improve standards in the care of older people.
It seems almost impossible to imagine the world back then: a clunky analogue era of post-war rationing, George VI, the dawn of comprehensive schools, and of course a Labour government planning the inception of our beloved NHS. The future social determinants of health were given a nod to by Beveridge’s post war ‘giants on the road to reconstruction’, namely poverty, disease, ignorance, squalor, and idleness, by the undertaking of a newly introduced welfare state. The grimness of post-war Britain held the promise of a brighter future for all, with government commitment to better access to social housing, employment, social security, education and health.
Life was on the up.
However, the downside was that evidence based medicine was virtually unheard of and an autocratic, hierarchical modus operandi reigned supreme. For example, my formative years furnished me with the faint memory of a choice between a eusol and liquid paraffin wick, or egg white and oxygen, as a futile panacea for pressure sores. An unfortunate older colleague once told me the story of how she had to physically carry a hefty commode to a patient in urgent need of it in the middle of a consultant’s ward round. This is because the bow-tied and heavily moustachioed venerable autocrat demanded silence on such occasions, and the offending receptacle was in possession of squeaky wheels.
My own mother described how her early nursing career was spent sweeping fires and working on Nightingale wards, nursing rows upon rows of polio patients entombed in the dreaded negative pressure ventilators, or ‘iron lungs’ as they were then known.
Power was almost tangible, hierarchies were monolithic and seemingly permanent. Starched caps, cuffs, buckles and belts, and the jingling of drug cupboard keys became the instruments of power. Remember, these were the days before equality, women’s lib, and celebrating diversity. Nursing was a predominantly female occupation and the majority of women did not pursue a career. For instance, on the announcement of her forthcoming nuptials, my mother was abruptly assigned permanent night duty by matron, and swiftly allocated to geriatrics for her transgression.
A ritualistic and common practice on Christmas day saw each consultant visit the ward to observe the solemn ceremony of carving the turkey. Many a chuckle was had by patients and staff alike to see surgeons struggling valiantly with unwieldy blades and formidable, recalcitrant birds.
Thankfully, we count ourselves fortunate indeed that we live in more enlightened times with the near eradication of polio; the advent of technology; evidence based practice and medicines; patient and public involvement driving services and research; collaboration between healthcare professionals; shared governance; and the previously unimagined wonder of pre-packaged festive turkey slices.
It seems the differences between the forties and the present day are divided by a huge chasm, both sides seemingly unrecognisable to the other. Yet I see there are more similarities than differences in the era of the birth of the BGS, and today.
Some once extinct therapies and practices are, in fact, returning. The benefits of maggots in wound cleaning have been recognised again; the encouragement of patients to get dressed and get out of bed has entered a renaissance by the newly created social movement which has captured hearts and minds through social media to #endPJparalysis; and the looming fear of antibiotic resistance has prompted us to rethink our systems of hygiene with an increased global emphasis on cleanliness and handwashing.
Yet in an era of navigating new horizons in healthcare and rediscovered treatments, some things continue to remain steadfast and constant. Whether in an era of starch and subordinates, or equality and emancipation, we can confidently trace the roots of our practice back to the philosophy and motivations which drive us in our mission to help older people remain healthy and supported to live their lives.
This has not changed in the last 70 years.
Who knows what the next 70 years will bring? I believe that the drive and passionate persistence of healthcare professionals who care for older people will remain constant. In an era of endless challenges and change, I remain hopeful that our past will continue to serve to inspire our future as we continue to collaborate and work together in our pursuit of excellence in the care of older people.