"Die Fähigkeit, zu bestehen", Der Bund, Volume 102, Number 57, 4 February 1951
Google translate:
A new profession for women: Caregiving nurse?
Proposal by Baumgarten, P. D. Dr. Franziska
The welfare officer in industrial plants has proven her worth. She plays the important role of mediator between supervisors and employees, successfully preventing many conflicts or resolving disagreements. The nickname "peacemaker" given to some factory welfare officers demonstrates that their services are highly valued.
The scope of activity of social workers should definitely be extended to another area that is currently still closed to them (with very few exceptions), namely the field of hospital care. Just as in industrial companies the "human factor" in the superior-employee relationship calls for a neutral intermediary, the same is true in hospitals, the medical equivalent of an industrial enterprise.
It is true that some large Swiss hospitals already employ social workers who address the needs of patients. However, these are currently only exceptions, and their work primarily focuses on managing patients' material interests: handling financial matters, liaising with health insurance companies, visiting children placed in foster care, etc. But the hospital social worker should also fulfill another important task:
The psychological state of patients, especially those forced to spend an extended period in the hospital, is generally given very little consideration. Little thought is usually given to the emotional shock a person experiences when, suddenly torn from their work and familiar surroundings, they are forced into a completely unfamiliar environment—a silent, bare room—where their will is disregarded and they must submit to the instructions of strangers, all while remaining uncertain about the outcome of their illness. It often happens that patients perceive the entire hospital routine as a form of psychological abuse, against which they want to rebel, or at least complain. They often try to spare their relatives from hearing their complaints.
It is therefore advisable that a neutral intermediary be present between the doctor and the patient, as well as between the patient and the nurse. Due to their current workload, hospital doctors cannot always explain their prescriptions in detail to the patient, and the same applies to the nurses. These prescriptions often cause anxiety or distress to patients, many of whom agonize over trying to understand the meaning of a new instruction and are filled with mistrust. Consequently, their recovery progresses more slowly than expected.
The nurse can provide information and thus offer reassurance. On the other hand, despite their great patience and understanding, nurses can sometimes hurt the feelings of despairing or simply complaining patients with curt answers, or even by ignoring their concerns and requests. A refusal is taken especially hard by the typically embittered patient, who perceives their suffering as undeserved, something that is happening only to them, and who suffers greatly from such feelings.
In such difficult situations, a hospital social worker can be helpful, someone who understands the human psyche and is able to adapt to the patient's individuality, objectively assess the situation, and offer reassuring arguments. Often, she can soothe the patient simply by listening to their complaints, allowing them to vent their bitterness.
However beneficial the role of the chaplain may be, it is impossible for him to concern himself with the details of medical treatment and hospital life. Relatives are also rarely able to do this; their visits are usually brief (except in private clinics), and they are, after all, personally involved; their complaints are often given little consideration. The social worker, as a neutral party and a confidante of both the patients and the doctors, has a different kind of authority, and she can also take the time to discuss the case of a psychologically troubled patient with the nurse.
For the nurses, this new role would mean a relief, because through the social worker's mediation, they could tell the patient things and teach him things that they themselves would otherwise suppress in order to avoid upsetting him. For them, discussing the patient with the hospital social worker would also provide an opportunity to release pent-up emotions.
A very important question arises: How should this hospital social worker be trained? Opinions on this will likely differ considerably, since for many professions newly required by the ever-growing needs of modern life, not only practical experience but also the existing training opportunities are decisive. Consider, for example, the significant difference between the training of career counselors in France and Switzerland; even at two universities in the same country, the training for the same profession can be structured quite differently, as is the case for psychologists in Basel and Geneva. Therefore, our suggestion here can only outline general guidelines: I would recommend that the hospital social worker receive partial training as a nurse and complete a social work program for women, while simultaneously attending certain lectures in psychology at the university. Since the introduction of a diploma for practical psychologists is currently being considered at universities, the completion of the social work program for women will likely become superfluous once this plan is implemented, while obtaining the aforementioned diploma will become mandatory.
The welfare nurse should not be seen as a supervisor, a higher authority, or a new type of manager, but rather as a colleague on equal footing with the other nurses, simply fulfilling a different role in the care of the patient. This is based on the understanding that, in addition to physical care, emotional support, even if limited, is absolutely essential. "I would rather do without a convenience that modern technology provides," said a patient who had been in the hospital for many weeks, "than miss out on a word of encouragement." She is not an exception.
A woman's maternal, nurturing feelings are often directed towards the helpless, yet not all women who feel this way can bring themselves to become caregivers. Many women would therefore benefit professionally from this new type of work, and they could accomplish much good in this new profession.
The argument of a lack of funds should not be raised against the plan to supplement hospital staff in this way. One should never consider only the "financial factor." Caring for emotional needs is a duty. If hospitals always find the means to purchase expensive equipment, then it should be pointed out that, by the same token, emotional needs should also be addressed. The soul of the sick, the anxious, the despairing and embittered, the suspicious, and the disappointed must not be neglected. Psychological support, too, can work wonders.
This article apparently stimulated a lot of discussion, and the paper published three responses over the following several weeks:
"Fürsorgeschwester" Der Bund, Volume 102, Number 59, 11 February 1951
" Zum Thema : Spitalfürsorgerin" Der Bund, Volume 102, Number 81, 18 February 1951
"Weiteres zum Thema: Fürsorgeschwester" Der Bund, Volume 102, Number 93, 25 February 1951