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To think that David Cameron is out of touch with the realities of the NHS?

(72 Posts)
Lougle Wed 05-Dec-12 12:39:25

I've been listening to Prime Minister's Questions.

David Cameron wants to introduce 'hourly roundings'. That is, that each patient under a nurse's care should have a 'nurse by the bedside, at least once an hour, checking that they have had water, that they're not uncomfortable, that they don't have bedsores....'

Let's think about this. One nurse can have up to 15 patients on a normal ward now. In 2003 as a Newly Qualified (ie. 3 weeks qualified) RN, had 12 patients in the morning, then 18 in the evening.

So, working with 15 patients. Each hour, the nurse must visit each of them. That means that the nurse has 4 minutes per patient, per hour.

What happens when patients need washes, morphine (requires two nurses to sign out, check, administer), theatre prep, admission?

catgirl1976geesealaying Sat 08-Dec-12 19:55:57

I'm sure it's just the way it's edited but the Midwifes on OBEM appear to do shag all other than chat, drink tea and eat biscuits most of the time

I'm surprised they haven't complained about being portrayed that way.....

GhostShip Sun 09-Dec-12 00:19:50

OBEM is not a good portrayal of a labour ward at all.

MummytoKatie Sun 09-Dec-12 02:14:35

I think it sounds an excellent idea! Except blatantly the current staff don't have time to do this so we need additional staff. I don't think it needs to be a nurse though - an experienced HCA could do this role.

I would assign each HCA 10 patients to ensure they can do it properly.

Our local hospital has 700 beds.

So 70 HCAs @ £7 an hour * 24 * 7 * 52is just over £4m. I think the hospital covers a population of about 500,000. So £4m / 500k * 60m is about £500m.*

I guess he'd better start taxing Amazon!

* Note these figures are done at 2am in my head as if I switch to the calculator on the IPad I'll lose what I've typed and I'm too tired to type it twice!

Pilgit Sun 09-Dec-12 07:52:39

Don't know what the answer is but currently i am sitting in a hospital bed (gave birth on friday, DD2 in special care - she's fine now and should be with me today) and getting excellent care from the staff here. But I also know that when the ward is full they will be stretched.

There is a great deal of wastage in the public services (inc NHS) where money that could be spent on front line services is diverted to committees, quangos and middle management with no clinical input. There is a need for some of this but surely not all that there is. or maybe i'm just being naiive.

Can't see how this idea is going to have any impact, except to load more paperwork and duties on an already stretched staff. Can't they stop tinkering and address the things that actually will have an impact on the day to day? i.e. staff levels, pay levels, reducing paperwork, morale?

x2boys Sun 09-Dec-12 09:55:48

I think what most politicians and the general public dont seem to realise is that most nurses do care but we have so much bloody paperwork to do which we are told we have to do or our jobs are in jeopardy that it leaves very little time for patient care the NHS is screwed and completley lost sight of patient care !

FolkElf Sun 09-Dec-12 09:57:05

My dad received shocking care in the two weeks up to his death.

The night he died we arrived and were told that my dad had already died as we were walking through the ward doors - no side room, no seat offered. I wasn't even through the door. We got there and all the nurses were at the nurse's station sitting down. One of them was on the phones, one was using the computer and one was completing paperwork. The others were just sitting down.

We could hear a woman screaming from the other end of the ward "help, help. Please help me. Will someone please help me?" Repeatedly for the hour that we were there.

There was an elderly woman lying on a trolley masturbating in the corridor in full view of everyone. No dignity.

When we left our deceased father in his room to go home, we had to help an old man in full view of the nurses because he couldn't get to them shuffling along with his walking frame and he was clearly confused and in need of help.

We walked past the nurses on the way out. None of them made eye contact with us. they didn't even look up. My brother said "well bye then" a couple looked up and said "yeah, see you" and that was it. They did bring us plenty of tea, I'll say that for them. But other than that I was disgusted with the 'care' he received the whole time he was there.

During his two weeks there we regularly arrived to find his meal had been put on the tray in front of him but he was too weak to eat it and no one had helped him. When I mentioned this to the nurse she said "we can't force patients to eat". No you can't. But if you are going to go through the charade of putting food in front of him, you might at least make some attempt to help him eat it if he is too weak to pick the cutlery up himself.

Patients who were unable to pick up cups and drink were given jugs with a different coloured lid which meant that staff members doing care rounds knew to include offering a drink etc. I know this because there was a poster reminding them to do this at the nurse's station. Everyday I asked them to give my dad the different coloured jug lid. And they didn't. He couldn't support the weight of a small plastic cup so he only drank when we visited him. And he was clearly thirsty because for 2 hours a day when we visited he drank a fair bit. When I mentioned this they said there was no need to offer him water as he was on a saline drip. Maybe not a clinical need, but certainly a human one!

That was people not doing their job properly and thinking "these people are on their last legs anyway so who cares".

This was an eldery care ward.

I'm a teacher so I'm very reluctant to join in with any of the 'bashing' of other public sector workers. I know how hard it can be, how demoralising and how the govt has little idea of what it's like to be doing the job. But my dad's treatment was indefensible.

FolkElf Sun 09-Dec-12 09:59:54

I have also had great care at the hands of the NHS. My daughter would be dead without several of them.

but I find that the standard of care between departments in the same hospital and between different hospitals differs hugely.

x2boys Sun 09-Dec-12 10:21:47

on my days off at present but on friday was on a long day from [7.30am to7.45pm] currently working on a psychiatric intensive care unit all i managed was two cups of tea in the shift and a quick sandwich in my legally required un paid 1 hr break did nt take the whole hour as the ward was so busy when i went off at 8pm [officially finished at 7.45] there was yet another incident and the staff were looking at me as though i sdhould stay but i,m afraid my kids will always come first in my sixteen years as a qualified mental health nurse morale has never been so low

chris481 Sun 09-Dec-12 12:42:03

"What is your definition of good basic care within a hospital setting Chris?

Hygiene?
Nutrition and hydration?
Medications and investigations?
Falls prevention?

It's all part of basic care in a hospital.
Unless you work in that setting, you cannot really understand the time constraints with so few staff. "

By good basic care I was thinking mainly of the things even an unqualified person could do. It is not acceptable for them not to be delivered due to staff time constraints. Double, triple, quadruple the staff (hence budget hence taxes) if necessary to deliver. (That's not to say I wouldn't support absolute standards for the majority of things that require qualified staff - I'm just leaving that argument for another day.)

The standard is, if you were taking care of your own sick child at home, one-to-one, what degree of neglect would you consider acceptable? How long without water, medication, toileting, cleaning? It is never acceptable for hospital to have lower standards than that.

Let me be clear, I'm not claiming this is possible on current budgets, I'm not in a position to judge. I'm merely stating what the standard should be.

Someone else was hmm at my suggestion that we pay whatever it takes to achieve this standard. However most (admittedly not all) people have families and it doesn't make sense that just because we've out-sourced the job of caring from families we should automatically tolerate lower standards than if we hadn't done so. Most people do not spend very much of their lives in hospital, it shouldn't be a impossible burden to finance standards like these, given that the cost is spread over the rest of their adult life.

GhostShip Sun 09-Dec-12 12:46:51

It was me who hmm 'd. I don't think we should have our taxes risen more just because our government can't sort it's finances out. Some of us are scraping by as it is. That doesn't mean I don't support more money going into the NHS - but raising people's taxes isn't the way to go.

Brycie Sun 09-Dec-12 12:50:37

"Staff across all area of the NHS are drowning in paperwork"

That would be all those Labour targets. Tories have sacked six thousand managers appointed in the Labour years - what on earth were they doing that they aren't missed?

The time of the NHS is up - it's an unworkable ideal. I think health "needs" are expanding with provision rather than the other way around. Time to introduce the mutuality and the charge at access I think.

Brycie Sun 09-Dec-12 12:53:41

I'm with Chris, I must admit. I think a lot of health problems are resolved with "basic care" which prevents them turning into more serious problems, costing more. David Cameron is on the right lines. I think more money would be better spent on community care and keeping people in their homes so that they didn't arrive in hospital in the first place - patients seem so often to deteriorate in an institution.

GhostShip Sun 09-Dec-12 12:57:11

I agree with the basic care things, but it's not the fault of the nurses the majority of the time.

Brycie Sun 09-Dec-12 13:02:58

Anecdotally that's not as true as it looks Ghost ship.

Plus, whatever you do, however little a nurse is able to do, it's possible to do it gently and with care. Anecdotally that doesn't always happen either.

Brycie Sun 09-Dec-12 13:09:26

"Vajazzles are behind a huge rise in hospital admissions for embarrassing injuries to private parts." - Daily Mail

Free at the point of access? Perhaps people would think twice about sticking dangerous stuff around their fanoir if they had to actually PAY some overworked doctor to leave a squawking baby in A and E to sort it out.

GhostShip Sun 09-Dec-12 13:09:48

The fact of the matter is though if working conditions were suitable to allow people to give care then it would happen.

I've heard so many nurses say that they feel as though they're begging to be given time to actually care for their patients, instead of being swamped by paperwork. Paperwork that if left incomplete, can cost them their jobs. I've heard some that have been to the point of giving it all up; not just their jobs but their lives. Moral is very low at the moment.

I'm not actually working for the NHS (yet) but I've worked for a private company and had the same problems - lack of staff, lack of money and too much paperwork. It is so disheartening when it is practically impossible to deliver the level of care you feel the people need. Its absolutely soul destroying in fact and is a reason why I had to leave. For my own sanity.

Brycie Sun 09-Dec-12 13:14:31

"I've heard so many nurses say that they feel as though they're begging to be given time to actually care for their patients, instead of being swamped by paperwork. Paperwork that if left incomplete, can cost them their jobs. I've heard some that have been to the point of giving it all up; not just their jobs but their lives. Moral is very low at the moment."

Again, this paperwork is largely the result of Labour targets. It wasn't introduced by the Tories.

GhostShip Sun 09-Dec-12 13:17:29

I didn't say that it was - I'm just stating how people want to deliver care, but are being blocked from doing so

Brycie Sun 09-Dec-12 13:18:47

Ghostship, I understand. But I'd also say that anecdotally, we are often not talking about frustrated compassion but about callousness.

Brycie Sun 09-Dec-12 13:20:56

As Ann Clywd recalls: ‘Every time I tried to talk to one of the nurses, they were either on the phone or talking to one another. I know they were busy, but it did not explain how they could completely ignore a patient. "

I copied and pasted it from another thread, but I read it at the time and I've read other similar stories. Enough to know that if one of my parents went into hospital I wouldn't leave their side. I don't trust hospital staff at all any more.

SchroSawMummyRidingSantaClaus Sun 09-Dec-12 13:47:36

Have just been told by a family member that nurses who can't get jobs are found a job in the hospital by the government but, they aren't employed or paid by the hospital, they are paid by the government. Just a basic wage with no shift allowance with no additional training because they aren't technically employed by the hospital.

So they basically don't have very much that they can do, nurses require additional training (IVs and such) to do their job, this isn't happening.

So is this just so the government can say that there is more nurses than there technically is?

confused

SpaceOpera Thu 13-Dec-12 21:42:36

Please write to your local paper to ask your new Clinical Comissioning Group to protect the NHS. These GPs, who have never before had to commission services, will be under huge pressure from private interests to put profits before patient care. Join the 38 degrees campaign here.

And if a doctor is standing as an independent for election in your constituency come 2014, vote for them!

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