This distressing photo of an 81-year-old man neglected in hospital provokes a troubling question: What has happened to kindness – and compassion?

HE’S PAST humiliation now, but what the late Gerry Feeney reportedly suffered in a geriatric ward at Beaumont Hospital must have been so degrading for him that I cringe at giving an account of it in the newspaper.

The 81-year-old patient, who had Parkinson’s disease and respiratory problems, was left in a soiled incontinence pad, in public view, with the lower half of his body uncovered, according to his niece, Ann-Maria Feeney. He was not washed, and his family don’t believe he was helped to eat, as his flimsy hospital gown was covered in food, she says.

It feels like a further trespass on the man’s dignity to even read about this, never mind write about it. So what must it feel like to be responsible for it, I wonder?

‘If [a nurse] allows her sick to remain unwashed, or their clothing to remain on them after being saturated with perspiration or other excretion, she is interfering injuriously with the natural processes of health just as effectually as if she were to give the patient a dose of slow poison by the mouth.’

That was Florence Nightingale in her 1859 Notes On Nursing. But you don’t need the advice of a starched Victorian to care for someone who’s helpless. Common sense tells you the three primary responsibilities are to keep them warm, clean and fed.

Amid all the fuss about recruitment embargoes and overcrowded emergency departments and Hiqa reports on inferior hygiene in hospitals, there is something even more worrying in Gerry Feeney’s story. It shows a catastrophic failure of nursing, a failure that can’t be entirely done away with by blaming the system as usual.

FEENEY was not, apparently, neglected during his time in the emergency unit – where nursing staff are under so much undue pressure that they voted for industrial action in January. He was allegedly neglected in a geriatric ward. What does this tell you? If the health system is so overburdened that someone’s care must be sacrificed, is it more likely to be that of an elderly person?

Like many other professions, nursing in Ireland is self-regulating. It has a code of conduct, the third principle of which focuses on ‘safety, competence, kindness, compassion, caring and protection from harm’. Someone has obviously been plundering the thesaurus there, but the standard of conduct is clear: ‘You should be kind and compassionate.’

A Co. Galway GP this week said hospitals are routinely violating the human rights of elderly people. Dr Mary Rogan said older patients are too often given nappies to wear because there are not the staff to help them to the toilet.

This is the opposite of compassion, by any lights. This is cruelty. Imagine how you would feel being forced into a nappy, as an adult. Now add 30 or 40 or 50 years to your age. Does that make it feel any better?

Thought not.

Rogan blamed under-staffing. ‘Nurses have too much paperwork to be able to do their job,’ she said. This is telling. But. If you’re a nurse, and you’ve a choice between neglecting the paperwork or neglecting the patient, which do you choose?

In the UK, a major report on Mid Staffordshire NHS Trust in 2010 found that patients were so thirsty they were drinking from vases; that they were left lying in their own urine and faeces; that they were ‘humiliated’, ‘routinely neglected’, and left in pain.

An Age UK report in 2011 found that 157,000 people had left hospital malnourished in 2008. In the same year, a Care Quality Commission study of dignity and nutrition found that elderly people in hospital were getting neither.

In Britain, this series of alarming reports led to a public focus on the training of nurses. Whereas once they had learned their trade on the wards, perfecting hospital corners and being roared at by Matron, the early 1990s changed all that.

Project 2000, the brainchild of Margaret Thatcher’s health secretary John Moore back in 1988, was a well-meaning attempt to raise the status of nurses by taking their training out of the hospital and into the lecture hall.

As usual, Ireland followed suit. Nurse training in this country changed in 1994 from an apprenticeship programme to, first, a three-year diploma and then, in 2002, a four-year degree. There’s now a perception – shared, anecdotal evidence would suggest, by many nurses themselves – that nurses are ‘too posh to wash’, and that bedpans are beneath them, if you’ll excuse the turn of phrase. And yet despite this concerted effort to raise their status, nurses are still apparently too demoralised to do their job.

Let’s give the conditions for nurses an airing. A student nurse makes an almost laughable €6.49 an hour, rising to €7.79 an hour in the last three months of their placement. Not even minimum wage. A staff nurse starts on a little over €27,000 a year, rising to a maximum of €43,800. And it will come as no surprise to discover that, once you start managing instead of cleaning up puke, things get considerably better: the top pay of a director of nursing is almost twice that of a senior nurse, at €81,552.

And the HSE, as we know, loves its administrators. The health service is patrolled by legions of middle managers and supervisors, all busy taking their bureaucratic responsibilities very seriously indeed, while patients lie weeping in their own filth.

Of course the country is coming down with gifted, capable, dedicated nurses working in almost impossible circumstances. We’ve all met them and marvelled at them. But if others have lost sight of the reason for what they’re doing, why are they still doing it?

This hints at another problem with modern nursing training: it places educational aptitude ahead of native ability. You can’t be a nurse without an honours degree, and so there are many, many people who might make excellent nurses and don’t get the chance, because they lack the academic chops.

IT’S NOT just nurses either. Remember when GPs used to make house calls? Remember there was a time when you didn’t have to sit for hours in a doctor’s waiting room, chatting about the weather with Typhoid Mary, before being seen? Healthcare workers generally have spent the past couple of decades climbing steadily upward on the ladder of social status, which must be gratifying for them. Unfortunately there’s nobody climbing up behind them. There’s nobody to do the work they’re too important to do now.

Florence Nightingale’s Notes On Nursing has a whole chapter on reassuring patients. It reads as almost far-fetched today. Imagine that reassuring sick people was once seen as the job of a nurse. Now it seems it’s not the job of a nurse even to see to the physical comfort of the sick, never mind their psychological comfort.

The thing is, if nurses aren’t going to do the nursing, then who is? Someone has to. We can’t be sacrificing the dignity of old men and women on the altar of professional standing.