How times have changed Jeanette Smith looks back on 40 years of nursing

Jeanette Smith is Clinical Services/Ward Manager at BMI The Chaucer Hospital in Canterbury. 2018 marks the 40th year since she started nursing and it seemed fitting that she gave us an insight into her experiences of nursing as part of our celebration of International Nurses Day on the 12th of May.

“I started my training in 1978, a time when women were still were encouraged into one of three roles; as a nurse, a teacher or a secretary. Nursing used to be much more hierarchical and Sisters in those days were to be feared and nobody used first names. Nowadays we have more of a collaborative and open culture. Nursing was previously seen more of a vocation, whereas it’s now a profession in its own right and doctors work with us and we have autonomy to make our own decisions.


“It goes without saying that healthcare has advanced phenomenally over the past 40 years, especially around medicine and diagnostics. For example, we didn’t have MRI equipment. Cervical, prostate and breast screening didn’t happen either. This ultimately meant we used to see patients at more advanced stages of disease, when treatment needed to be more invasive and there was a greater risk of complications. There has been multi-disciplinary advances, especially around anaesthetics and technique such as laparoscopic/keyhole surgery. This has significantly reduced the length of time a patient is required to stay in hospital following an operation.

When comparing 1982 with today:

Cataract surgery

  • 1982: 7 days flat bed rest
  • 2018: ½ hour visit

Hip replacement surgery

  • 1982: 21-28 days flat bed rest
  • 2018: 3-4 days of active physiotherapy, ready for home


  • 1982: 7 days hospital stay
  • 2018: 1 night stay/some patients go home the same day

“One of the areas where I have seen the biggest transformation in the past 40 years is around care of the elderly. It’s hard to believe that some of my first patients were officially Victorians! In the 1970’s, once you reached 70 years old you were automatically deemed ‘geriatric’, and geriatrics ‘belonged’ in cottage hospitals and convalescent homes. This is in stark contrast to today where we promote independence in older adults and encourage home care as much as possible.

“I lead the nurse training programme as part of my current role at the Chaucer Hospital. Education is another area of nursing which has changed significantly over the years. As well as the practical element of patient care, there is now a real emphasis on critical thinking. Nurses are trained to be more autonomous in their role, to be able to prioritise their workload and to be confident in making decisions for the benefit of their patients. It wasn’t until 2014 that the Duty of Candour was introduced, which means that nurses also now play a role in in ensuring patients remain informed about their treatment and any complications. In my opinion, however, the key characteristics of a good nurse have remained constant since I was a trainee. The best nurses have always had empathy, compassion and a good sense of humour.”

Jeanette plans to retire from her current role at the Chaucer hospital at the end of this year so she can focus on her family and her hobby of dressmaking. She will continue to work at the hospital on an ad hoc basis in a more ‘hands on’ role, and continue to train junior nurses and healthcare assistants. We’d like to say a massive thank you to Jeanette and congratulate her achieving this milestone.

Date: 12th May 2018