Abstract
In Jablonna village I had a brief conversation (through a Polish colleague) with a middle-aged woman who was busy weeding cucumbers. She had been a nurse but had left nursing for market gardening where she was now earning four times as much as she did as a nurse, and three times more than my highly qualified, but poorly paid Polish colleague. (Taylor, 1979, p. 293)
The women’s nurse (who has replaced the midwife) is usually the first worker in the Czechoslovak health care system with whom a pregnant woman seeking prenatal consultation comes into contact. What qualifications is the nurse likely to have? What is the organisational blueprint of her work (she is invariably a woman) and how does it compare to the reality of her work situation? What are the differences between the work environments of the clinic and the hospital? As mentioned in the previous chapter, there is a clear distinction between ambulatory and hospital maternity care in the socialist countries and women’s nurses, like obstetricians, rarely work simultaneously in both settings.
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NOTES
Countries differ in the way that they define nursing care activities, so cross-national comparisons may be misleading. For example, a time-budget study of ‘direct’ and ‘indirect’ nursing care at University Hospital in London, Ontario, found that registered nurses spent 34 per cent of their worktime on ‘direct’ nursing, which appears to be highly comparable to the 35 per cent figures in Table 6.2. However, a closer examination of the Canadian data reveals that ‘direct’ and ‘indirect’ care are defined quite differently: the former is defined as performing ‘activities for the patient in the presence of the patient’, while the latter refers to ‘nursing activities away from the patient but on behalf of the patient’ (Thompson and Wilson, 1981). Moreover, much of what the Czech researchers defined as ‘basic health activities’ is in Canada performed by nursing assistants, not by registered nurses.
Part of the reason for preferring to talk to relatives rather than patients is the fact that it is relatives rather than patients who ‘tip’ (or bring ‘presents’ to nurses) in the form of cognac, boxes of chocolates and so on. In turn, nurses’ reluctance to talk to patients goes a long way towards explaining the widespread lack of enthusiasm on the part of nurses for the ‘rooming-in’ system of newborn care, which is discussed in more detail in Chapter 11.
Deacon (1983, p. 122) claims that since the replenishing of the physicians who emigrated, Cuba has invested heavily in nurses and related auxiliary medical personnel. Quoting from another author, Deacon argues that ‘nurses, nurse assistants and auxiliary personnel seem to have more clinical responsibility in Cuba than do their counterparts in capitalist countries’.
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© 1987 Alena Heitlinger
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Heitlinger, A. (1987). Socialist Nursing. In: Reproduction, Medicine and the Socialist State. Palgrave Macmillan, London. https://doi.org/10.1007/978-1-349-07162-3_6
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DOI: https://doi.org/10.1007/978-1-349-07162-3_6
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