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to hope that the report on mid Staffs hospital will shake up the NHS?

(173 Posts)
grovel Wed 06-Feb-13 17:47:44

It was just awful and everyone from the then government through management to clinicians and nurses come out of it badly.

I don't for one moment think it reflects all (or even much) of the NHS but it does suggest a direction of travel which needs to be reversed - from caring service to self-obsessed bureaucracy.

YANBU.
I refuse a hospital here, the one I'm supposed to go to because of appalling care, I swear, the only reason I'm alive is because I discharged myself.
(RAH in Paisley btw)

LurkingBeagle Wed 06-Feb-13 17:52:40

YANBU to hope for a shake-up.
I think YAB slightly U to think it doesn't reflect on much of the NHS - the report could so easily have been written about parts of all of the NHS hospitals I have ever been in.
Personally I hope it engenders a positive and sensible debate about healthcare that acknowledges the weaknesses in our system and tries to adopt some of the strengths of (say) the French or Swiss system. I am all for the duty of candour too - not before time smile

it will, it already is, I have just started a support worker role and am on a training program and nearly everything we are learning is being linked back to the report. I havent had a chance to read the findings yet but I will over the next few days, but just feel reassured that the changes are already happening.

YANBU.
The sooner we stop trying our health service like a supermarket with a market economy, the better.

ConferencePear Wed 06-Feb-13 17:59:32

I haven't read this second report but I did get as far as page 146 on the first one. I had to stop reading at that point because I was so angry and upset.

Whatever the failings of the management structure, I cannot find any excuse why doctors, nurses and health care assistants should speak to patients as though they are sub-human nuisances.

grovel Wed 06-Feb-13 18:00:23

ditavonteesed, thank you. Good luck in your new role.

LurkingBeagle Wed 06-Feb-13 18:04:59

ConferencePear - I agree. But the fact is they do, every single day. One of the major issues I think we need to grapple with is how that kind of culture (i.e. where it is perfectly acceptable to treat patients like dirt) became embedded in a supposedly caring service.

It also must be the only time in history when 1000 odd people have died prematurely (and apparently unlawfully), and not one person is going to be tried or punished for it.

It really makes me so angry. Kudos to the families of victims - the report came about because of their campaigning and hopefully things will change drastically as a result.

grovel Wed 06-Feb-13 18:11:54

Lurking, I find that really astonishing too. I hope to God the answer isn't that they are simply reflecting the world outside.

meddie Wed 06-Feb-13 18:22:11

I find that hard to believe as well Conferencepear, but I can see how it happened.
You had a toxic culture where those who did try to raise concerns were bullied harrassed and forced out of their jobs.
Staff felt disenfranchised,stressed, not listened to and I suppose at some point they may have just given up, why should they give a crap if no one above them is and is penalising them from it.
The staffing levels were appalling and the skill mix was too. The majority of staffing on the wards was provided by untrained staff.
Nearly 1000 incident reports were filled in by staff highlighting unsafe staffing levels, poor care and problems. The were actually seen in a managers bin.

The NHS went down the pan when commercial managers were brought in and finance became god.

Before that hospitals were ran for the patients, suddenly these people were in charge who had no inkling of patient care and were target driven, Its very difficult to measure 'good care' but its easy to measure waiting times in a&e. So how was that managed?
Hospitals were fined for breaching the wait times, so instead of dealing with the issue of why this happened (not enough staff, inefficient systems) they fiddled the wait times, or invented side rooms off a&e called clinical decision units. So the patient even though still in a&e wasnt actually there on the figures.Instead they were stuck in a side room, overlooked and uncared for.
But the hospital managers could claim over 98% of people seen within 4 hours.
This is no indicator of quality of care, yet it became one.

The parts of the report I hope they take on board are:

a)Staffing levels and guaranteed safe minimums.
b) protection for whistle blowers, so staff can safely raise concerns without being bullied, harassed and witch hunted until they resign or are suspended.
c) regulation of HCA's . I have met some good ones but I have met some absolutely appalling ones. They never took the job because they wanted to its just a means to earn money and they dont care about the patients.
d)Managers have a duty of care to the patients, so they are penalised if they allow poor staffing and unsafe working practices to continue.

KatyPeril Wed 06-Feb-13 18:26:15

My Grandad was convinced that Matrons needed bringing back on the wards. Sadly, he died in Stafford hospital before christmas so won't get to see the outcome of all this.

KatyPeril Wed 06-Feb-13 18:27:08

I should point out he had good care! I think they've changed. It's a lot better than it was years ago (and I've a few stories)

tiredemma Wed 06-Feb-13 18:30:13

Every nurse in our hospital has been sent a pdf of the report (by our lead nurse) and is expected to attend a one of many planned sessions over the next few weeks to discuss its findings and how we 'change'.

XBenedict Wed 06-Feb-13 18:31:19

I really hope it shakes up the NHS and things change as a result. I have just completed a Return to Nursing course and I'm trying to now get a job.

I would LOVE to work on the wards but having small children I am unable to work unpredictable shifts and late shifts would be very very difficult however I could work during the day and night shifts but the local trust will only offer 24 hour 7 day a week contracts. I can't commit to that despite the ward I did my placement on asking me to apply for the vacancies they have. I wonder how many other nurses are in a similar situation.

LurkingBeagle Wed 06-Feb-13 18:32:11

All of my bad care examples were from 2006 - before Stafford and while the previous government were supposedly hosing money at the NHS.

Meddie - your post makes a lot of sense. Part of me can't help believing this is down to the sheer arrogance and lack of empathy of many medical professionals of all stripes. I have too much personal experience of it to believe it isn't also a factor here. (Sadly).

ajandjjmum Wed 06-Feb-13 18:37:15

I was shocked to hear that only 25% of the staff at Stafford would send a member of their own family to the hospital.

XBenedict - how many more good nurses are not being employed because of the inflexibility in rules?

And how does a degree teach you to care?

grovel Wed 06-Feb-13 18:39:27

meddie, thanks.

There were criticisms of staffing levels but my sense of the report is that it does not imply that Staffs needed much more money. It, and the wider NHS, needed to re-prioritise. Am I right?

iliketea Wed 06-Feb-13 18:47:21

I hope it does shake things up, in particular to sorting proper staffing levels and training for registered and unregistered staff.

I can see how it happened - staff report many many times to management about unsafe staffing levels / poor quality patient care and it gets completely ignored. At some point, staff get fed up being ignored and at such low staffing levels, end up burnt out and managent inaction gives the impression that staff concerns don't matter; in turn staff feel that they / the care provided doesn't matter and you end up with this situation. It's absolutely wrong, but I can see how it happens.

Understaffing is particularly rife on wards that have high needs patients e.g. elderly care where you may have 1 RN and 1-2HCAs for 15 or so patients. If even half of those need assistance with personal care, toileting, eating and drinking before any specific medical needs such as wound care / medication /obs are met it is a physical impossibilty to meet all those patient's needs. Having appropriate minimum staffing levels might help to improve standards of care.

I actually think GP comissioning will only make matters worse with more private companies providing healthcare with profit as the main goal - although the cynic in me thinks that it means DC could blame "private companies" rather than there being a problem in the NHS which costs money to sort out.

fridayfreedom Wed 06-Feb-13 18:52:46

Meddie, your post makes a lot of sense.
The worrying thing is that this could happen again... we continue to have staff shortages and with the focus on cutting costs very experienced staff are replaced with junior grades.
As for whistleblowing... people know there are things that are very wrong but they are worried about speaking out because so called annoymous routes to whistleblow are in fact identifiable. People can not afford to lose their jobs, especially those at a senior grade because there are no vacant posts around.
Those in charge very often come purely from business and have never worked at the coal face to see some of the awful situations people are in. There is a culture of let someother organisation pay for this so we save our own budget.
However this does not excuse poor patient care and neglect from those who are paid to care, a kind word and attention to dignity costs nothing!

timidviper Wed 06-Feb-13 18:57:59

I agree with what you've all said re staffing levels, priorities, etc but do think we also need to look at nursing training.

I work in the NHS and have been shocked, and I know a lot of my colleagues have too, at the attitudes, standards and lack of care shown by some (please note some, not all!) younger nurses. There seems to be more uncaring nurses coming through now that there ever used to be. A friend was recently hospitalised on the ward on which she was once senior sister and lodged a formal complaint about the nurses', she was appalled and stunned that those behaviours were tolerated.

meddie Wed 06-Feb-13 18:58:10

Its so complex its hard to know where to start, but hospitals cannot be run like sainsburys, with a target driven culture and tick boxes taking priority.
We need strong managers in place who value the patient care and experience above all else.

Staffing levels are desperately low in many parts of the country and there is a wealth of studies showing that the more patients a qualified nurse has responsibility for the higher the death rate. These are constantly ignored by those who make policy decisions because it costs money.
recommendations are 1 nurse to 7 patients, above that the death rate rises by approximately 7% for every patient over that number.

Some of our hospitals currently run with 12 to 15 patients per nurse.Its physically impossible to provide good care for all your patients in this scenario.

managers replace nurses with untrained and cheaper staff. So on paper they can say we have 4 staff to 28 patients but 2 of them are untrained so in reality that's 15 patients per qualified nurse.

Its a false economy. it leads to more complications thus longer stays, compensation claims and time taken in dealing with complaints etc.
USA,Australia and Canada all have legal nurse to patient ratios.

claig Wed 06-Feb-13 19:02:36

On Channel 4 News now.
Calls for a 'revolution' in the NHS.
4 trusts have worse figures than Mid Stafford.
Possibility of criminal charges if there is a failure to report nelect in future.

meddie Wed 06-Feb-13 19:07:36

I hope so. I think its the only thing that will make the bean counters sit up and take notice, if they faced punitive measures when they failed.

Pandera Wed 06-Feb-13 19:08:46

But surely the nurses involved in these cases played a huge part? They are on the front line and from what I can gather directly responsible for a lot of the charges.

poppypebble Wed 06-Feb-13 19:08:49

I've spent time in one of the hospitals now being urgently investigated because of the high mortality rates.

It was hell - because there were 2 nurses for an entire ward. My drip was not changed when it ran out - the alarm was simply silenced and that was it. I'd been admitted because my kidneys were shutting down with dehydration, but there simply wasn't time to change it. I was left to vomit all over myself and my bed and not cleaned up until my mum arrived and did it for me.

Luckily I wasn't too seriously ill, but had I been older or sicker I don't think I'd have survived.

grovel Wed 06-Feb-13 19:10:08

From my (possibly simplistic) point of view I wanted to know 2 things when my mother was very ill last year (and unable to fight for herself).

1. Who is in charge of / responsible for running the ward?
2. Who is responsible for my Mum's treatment?

I never got a satisfactory answer to either question. Apparently nobody was accountable for anything.

The 'bean counters' face immediate scrutiny if there are any financial problems in a Trust but not if there are quality issues.

Quality of care should be the priority.

XBenedict Wed 06-Feb-13 19:11:41

".......but do think we also need to look at nursing training. "

I agree tim I saw a real difference in attitude (from some not all nurses) returning to the wards after 10 years.

meddie Wed 06-Feb-13 19:12:48

The big thing that came out of the francis report for me was that despite complaints from patients and concerns raised by staff. Nothing was done, they just weren't listened to or it was brushed under the carpet.
As a nurse I have never felt so ignored. It feels like our experience is not valued at all.
We are the ones working with the patients, we are the ones trained in patient care and yet ours is the weakest voice when it comes to making decisions about the service that's provided.
Its totally frustrating to come on shift and have low staff numbers and yet managers are forcing us to take admissions or to carry out non emergency surgery, because they dont want to have to register a 'cancelled op' on their statistics, when we tell them its not safe, you are basically told to get on with it and 'just cope'.

Pandera Wed 06-Feb-13 19:15:17

Did the hospitals have a drastic shortage of nurses?

claig Wed 06-Feb-13 19:15:32

It almost sounds like a mafia with a code of omerta where it was discouraged to report what amounts to crimes. It is disgraceful and frankly resignations are nowhere near enough, there should be jail sentences.

meddie Wed 06-Feb-13 19:18:01

SauvignonBlanche. you just nailed it. that's totally true.

ConferencePear Wed 06-Feb-13 19:19:55

Something else has just occurred to me. Where were the unions in all of this ? If I was forced to work in conditions that drove me to behave so badly and no-one would listen to me I would consult my union.
Or are they completely powerless these days ?

I've spent too many years working in the NHS Meddle.

meddie Wed 06-Feb-13 19:20:21

Stafford did yes.
They had 10% of vacancies unfilled and on the wards the skill mix in some areas was 40:60 with the 60% being untrained staff

meddie Wed 06-Feb-13 19:21:00

The unions are about as effective as a limp noodle

claig Wed 06-Feb-13 19:21:44

Somebody on the news today said she thought the unions were in with the management.

LurkingBeagle Wed 06-Feb-13 19:22:01

Claig - I agree.
Sadly I think it will keep happening. I am totally in favour of minimum nurse ratios, but I also think attitudes need to change. While I was being treated for cancer, my call bell was simply left hanging out of the wall by a nurse because I had the cheek to use it to ask for pain relief after major abdominal surgery. Stress or no stress, I don't know how people like that sleep at night. The sheer terror of ending up back in a place like that is one of the main reasons I have since left the UK.

The unions are pretty powerful but their priority, naturally, is their members.

Pandera Wed 06-Feb-13 19:22:58

But how well trained do you need to be to wash someone or prevent a fall? Surely that is common sense & compassion??

iliketea Wed 06-Feb-13 19:24:27

I actually disagree that it's education for registered nurses that is the problem. Registered nurses have a duty of care / to advocate for a patient. It is drummed into students that they have a duty to report poor or unsafe care. I think the culture of a work environment with good leadership is far more important. Newly registered nurses need nurse leadership to set an example of how concerns are taken seriously and dealt with. If you start your first nursing job where you see poor care, raise the issue and it's swept under the carpet or more experienced members of staff are disillusioned by reporting their concerns, as a new member of staff, you will very quickly "fall into line" with the ward culture. No amount of improving education for new nurses will change the ward culture - it needs ward management to lead the way and set the standard that more junior members of staff will follow and feel supported to higlight concerns they have.

XBenedict Wed 06-Feb-13 19:24:30

I guess it depends how many other patients you are expected to wash and prevent falling at the same time. The ratios are shocking at times.

ChestyNut Wed 06-Feb-13 19:26:14

Everything Meddie said with bells on!

They absolutely must introduce minimum safe staff to patient ratios and recruit to the many jobs currently frozen.

This business structure and target ledness needs to revert back to good old fashioned patient focused care not a conveyer belt of as many discharges as there can possibly be irrespective of safety angry

Management should be held more accountable for leaving wards grossly understaffed and guilting nurses to work well over their hours for time in leu if it's ever staffed enough to take it.

Cameron is an absolute TWUNT!
Hourly nurse rounds are a fabulous idea if there's any staff to do them.

angryangryangry

claig Wed 06-Feb-13 19:26:17

A midwife on the news today said she would recommend young people to go into midwifery but not in the UK. How did it come to this in our nation?

Andrew Neil said today is it still right to call the NHS the envy of the world? Maybe the envy of the thitd world, but not th envy of Europe.

meddie Wed 06-Feb-13 19:28:49

see this is were I have an issue with untrained staff being the ones who now do all the basic care.
I was trained to use this to assess my patient. Their skin condition,are they showing signs of skin breakdown, do we need to increase their pressure area care,their level of nutrition,are they dry? under nourished? to observe their colour, their breathing, to use that time to chat to them about any concerns.
Instead you have someone (not all) who just see it as giving someone a wash,
The trained nurse has to hope and pray that the HCA doing this can recognise problems and report them to her, or otherwise she is nursing blind.

iliketea Wed 06-Feb-13 19:29:12

Pandera - the thing is, having a wash is never just "having a wash" - it's assessing self-care skills, pressure areas, skin care, nutrition amongst other things and you while you don't need training to wash someone, you do need to be trained to know what you are assessing at the same time and why. That's the same for all sorts of other "basic care" - but you need to have education to ensure you understanding what you information you are gaining from doing "basic care"

AppleOgies Wed 06-Feb-13 19:30:26

What surprised me is how many of these hospitals are 'foundation' hospitals.

MyDarlingClementine Wed 06-Feb-13 19:34:36

There is a general attitude in this country of moaning and letting things slide without actually targeting the problem, and dealing with it.

There is no structure and no one knows what on earth is going on except in a few lucky areas.

Pandera Wed 06-Feb-13 19:34:51

Was patient care not just as good if not better years ago when nurses had less training? Has training really improved care? Genuine question.

MyDarlingClementine Wed 06-Feb-13 19:37:23

I would like to see a hospital similar to those shown in the "doctor" films of the 60's and the " Carry on " films.
Clean bright wards with a Strict Matron in charge, and doctors doing the rounds every day. Lots of nurses scurring round.

claig Wed 06-Feb-13 19:38:24

'There is a general attitude in this country of moaning and letting things slide without actually targeting the problem, and dealing with it.'

Agree, but I think it is deliberate.

We only know the full extent of what happened as Mid Stafford due to teh beave patient group Cure the Nhs who campaigned tirelessly without support for years. But Channel 4 has found 4 trusts with worse mortality figures than Midd Staffs at that time, and we don't know the extent of what happened there because there were not the same patient groups to campaign tirelessly. Why weren't all these "executives" investogating all of this? Where were they? Picking up their salaries?

mumzy Wed 06-Feb-13 19:42:14

I listened to the interviews with mid staffordshire trust staff on Today this morning and what they're saying rang very true. However we have to remember these cases happened between 2005-2009 when the NHS was flooded with money and couldn't fill one post in three so money as not the issue but the chasing by the trust for foundation status. I work for the NHS in London and feel we are losing our compassion and our ideal of always putting patients first. Our first priority nowadays is meeting targets for number of patients seen, waiting times, first contacts etc etc in fact the patient is almost seen as a nuisnce in some instance if they can't be made to fit into a criteria by which a box can be ticked. Whose to blame? Ultimately its the politicians who issue these diktats to NHS chief execs and they are passed down via managers to the practioners on the coalface. All the political parties have used the NHS to win themselves votes and change after change have left patients getting poorer care and demoralised staff. Why are staff demoralised? Its because we are not valued by our managers and ultimately politicians who refuse to recognise the pressure that the NHS is under ( increasing population and ageing population) and don't support us when we say we cannot provide the level of care to our patients that we want to because there simply are not enough of us. The NHS managers are also incapable of tackling staff who are incompetent and whistle blowers are bullied or hounded out of their posts. PFI hospital projects have left many trusts almost to the point of bankrupcies and cutting staff numbers further is now the most common way of making savings. I could go on and on but how can we learn from this ? Well i think the british public need to appreciate how expensive it is to run a decent national health service then when politicians say they willl deliver a world class service then we will know they are talking rubbish. We also need to realise the NHS cannot treat everything so we need to decide on our priorities maybe families need to help care for relatives in hospitals as in other countries or we start charging for anything other than basic treatment on a sliding scale system or maybe we need more of a nanny state to make the population to take more care of heir own health. But we need to be honest about what the NHS can provide and what it can/ should not provide. The NHS should also be independent of politicians and run by a multidiscplinary team of medical and business experts. The best thing about working in the NHS is when you feel you have made a difference and some one's quality of life has improved as a result. Rant over !

meddie Wed 06-Feb-13 19:43:26

There have been e petitions runnign for years trying to get staff ratios addressed, they dont get signed, people cant be bothered or just fail to understand how important this is. Yet someone starts a campaign to save a local woods and the papers jump on it and suddenly its a major issue and something is done.
I dont know why the media are unwilling to take on the cause of nurse to patient ratios.

grovel Wed 06-Feb-13 19:47:36

ChestyNut, Cameron may or may not be a twunt but Staffs happened on Labour's watch. I started this thread and profoundly hope (though it's not my business) that it will not become party political.

At the last election the Labour party criticised the Tories for committing not to cut NHS funds. The Tories committed not to re-organise the NHS. None of this is helpful.

MyDarlingClementine Wed 06-Feb-13 19:50:32

Claig its dreadful, there really is an all pervading ignorance whereever you turn and a lack of wanting to improve things and move forward.

Instead a feeling of hopelessness and constraint.

Where is the QCC in all of this?

meddie Wed 06-Feb-13 19:51:13

I wish it wasnt political as well, but the NHS has been used for political point scoring for years. It needs to be divorced from politics and get back to what its meant to be about and this is providing good quality health care.
My heart sinks after every general election when you know that whatever party is in power, the first thing they do is start re organising the NHS, usually to its detriment. Then 4 years later, before the changes ahve even been had time to be fully put in place or evaluated the next shower of incompetents comes along and reorganises it again.

Honestly Clementine you wouldn't. The number of complaints would sky rocket.

I'll give you an example.
If I said "Thank You" to the RAC man who came to my rescue, and he said "Just doing my job madam" I'd think "ooh, nice" smile
If a patient said "Thank You" to me and I gave the same reply it implies "I'm doing my job.No more.Bare minimum. Because I get paid for this not because I want to help you"

I used to love The Royal -Wendy Craig as the ward sister chastising the patients. The nurse who was a Nun threatening to send a snorer to have his nostrils sewn up.

I know it's drama/fiction. Lots of my patients trot out the Bring Back Matron line.
But would they really want that?
In this work climate it would be bullying/harassment

poppypebble Wed 06-Feb-13 19:52:21

I don't think it is just staffing ratios though. Basics were missing when I was on the ward of doom. Nurses talking about which doctor they were hoping to shag whilst administering the medication, deliberately putting the call button out of reach etc. In fact, the best care anyone got on the ward was when the student nurse was on duty. She did all of the things the actual trained nurses couldn't be bothered to do. I'm sure they were busy, but to be honest they also didn't seem to give a shit about any of us.

edam Wed 06-Feb-13 19:55:15

David Nicholson, the current chief exec of the NHS, was ultimately responsible for mid-Staffs, as the then chief exec of the Strategic Health Authority. He has been promoted by both Labour and Tory. With him in charge, how can patients and the public have any confidence that the kind of top-down management by dictat, silencing any questioning or concerns, demonising whistleblowing, will be reversed?

Mid-Staffs may have happened when NHS budgets were under less pressure, but the hospital itself was desperately trying to cut costs in a misguided but politically demanded attempt to chase Foundation Trust status. That's why they cut nursing numbers to the bone - it didn't matter if patients were ignored as long as the bosses hit their targets. That attitude came from the very top, from the Dept of Health and the SHA trying to please their masters. With current demands from the govt. that the NHS cut £20bn over five years, can anyone really believe it will get better, not worse?

Flambemoi Wed 06-Feb-13 19:57:13

I an a consultant in the 52 bedded admissions area of a large English hospital.
Today, on my ward, we had 1 trained nurse for every 6 patients. We had 3 additional clinical support workers, 3 additional HCAs, one ward administrator, one volunteer, three ward waitresses, two cleaners (working all day), two receptionists, a discharge co-ordinator, 8 doctors, and two porters. The ward is bright, clean, cheery in atmosphere. Things happen in a timely fashion, the staff are without exception caring and polite, they are all excellent practitioners in their fields and standards of care are high.

I would have no hesitation in recommending my ward to any friends or family and would be treated there myself.

I am just trying to balance the general doomery and criticism that seems to be the background sentiment here. Yes of course there are problems in some places and the Mid Staffs lessons must be learnt - but please don't think that every hospital is like this.

What is needed are clinical leaders who are entirely committed to and focused on care quality and who are supported by managers that realise that investing in safe efficient well-resourced front line care is cost efficient.

And busy working multi-tasking Mums to run these units wink

claig Wed 06-Feb-13 20:00:22

'they also didn't seem to give a shit about any of us'

The problem is none of them are afraid, from the bottom to the top. They can all blame something other than themselves - cuts, staffing levels etc.
There is no accountability, accountability is evaded and no one os punished. No one will probably be jailed. Many of teh culprits have been moved to other trusts and still receive their pensions etc. There are no consequences, they can get away with it. That is why they don't give a shit.

Put criminal sanctions in, make them afriad of negligence and ma;practice and they will change their attitude and the culture from the top to the bottom will change. After that we can fix the staffing level problems, once we have reinstated core values.

fiventhree Wed 06-Feb-13 20:01:19

Hurray for illiketea!

Having worked in plenty of bits of the NHS and in all sorts of change projects over many years, I know one thing for sure-

The NHS is like any other organisation in that everyone takes a lead from their own manager. The culture travels down.

Also, you can have a good ward next to a bad ward if the management style is different in each.

Also look at your experience with schools- if you have a head with poor leadership skills and a bad attitude to parent involvement, regardless of any rhetoric they may spout, then the school secretary is highly likely to be a snooty worsit- learned by copying the boss.

What matters is good leadership at every level.

Pandera Wed 06-Feb-13 20:04:29

Flambemoi - that is really heartening, your ward sounds fantastic, perhaps they could employ you in Mid Staffs or at least listen to your advice grin

LurkingBeagle Wed 06-Feb-13 20:06:46

But Flambemoi - an awful lot of hospitals are like Staffs. I have never met a clinical leader who I believed was focused on quality above all else. There is simply no other explanation for the shambolic care I have seen and received. The focus seems to be on the staff's convenience more than the patient's comfort. It stinks.

And while we're at it, prompted by your post, why the hell is the UK alone is still having Wards anyway? They went out with the ark in most countries and surely increase infection risk.

SocialClimber Wed 06-Feb-13 20:14:41

I am so torn on this.

I am having a hard time saying it's not the nurses at fault. Of course they are stressed and overworked, they have targets and they are put under pressure, but so are so many in other industries. I work in the rail industry. We have targets, we get frustrated and stressed that managers feel it's more important to fill reams of paperwork in rather than get out onto the railway and fix what's wrong. However, not ONE of the workers who goes out (on my patch anyway) lets standards slip or doesn't do their job properly. If we don't inspect or maintain the railway, people would die. Simple. People aren't doing their jobs properly in the NHS and people are dying. So for that, I think some blame has to lie with the doctors and nurses, after all, if they had compassion they would stand and fight.

That said, it goes a lot higher than that. There are processes in place in our industry that ensure that we HAVE to do our jobs properly. If we don't, we lose our jobs, or we are severely reprimanded or have to retrain.

The whole NHS system needs shaking up, and I hope this is a step in the right direction.

ginmakesitallok Wed 06-Feb-13 20:20:50

The report is horrific. I agree with those who have said that NHS governance procedures are too driven by finance and targets, forgetting that patients are the priority. Whatever the reasons, the doctors, nurses and managers involved should be bloody ashamed of themselves, they should all be sacked.

claig Wed 06-Feb-13 20:23:01

'If we don't inspect or maintain the railway, people would die.'

The reason that standards cannot be allowed to slip in your industry is because the people who let them slip would be held criminally liable. It is not an option to let them slip, the consequences for teh individuals are far too serious.

But in hospitals, a nurse can remove the alrm bell out of a ptient's reach and there will be npo consequences, because the whole system covers for it, right from the top down. The form filling and box ticking and target reaching is the system from the top and people are not afraid of consequences.

What happened in Staffs happened years ago and now finally after mnany years we have the report and recommendations are made, but what happened in the intervening years? Why did teh wheels turn so slowly when people's lives were involved. Will tough penalties be enacted or will it just be more calls for "training" and will the words responsibility and accountability be downplayed?

Without urgency, without penalties, without sanctions, without public examples being made of negligence and mistreatment, the whole decline will be allowed to continue.

Let's hope there is a revolution, let's hope sanctions are implemented, let's hope accountability and responsibility are instilled.

AppleOgies Wed 06-Feb-13 20:28:34

Where can we get the report?

ChestyNut Wed 06-Feb-13 20:29:27

Im largely not interested in politics grovel but am interested in our failing NHS and don't agree with lots of his statements and plans for the NHS.

I really think the front line staff who are on the wards need to be given a voice as to why such terrible issues are arising.

I in no way condone anything that happened but it's sad that nurses are often all tarred with the same brush sad

utterlyscared1 Wed 06-Feb-13 20:29:52

Flambemoi

Yes I accept that there are good wards, hospitals, GPs etc, but there are others that are not. I do wholly believe that your ward is run as you say and understand the pressures that probably come from above.

In cases of mistakes, however, there appears to be more attempt at cover-up than treating complications and ,if this involves a child, then the mother put on an fii allegation to prevent a complaint/medical negligence action (even where there is no suggestion of instigating such and the health of your child is all that you care about). Medical records go missing and previous medical history denied at the mere question of diagnosis or the realisation of a mistake is made.

I have never complained despite several hospital mishaps, have always been curteous and never argumentative with doctors, have always put my child's needs above my own etc, but none of this matters!

From personal experience, this is the most awful and frightening experience that will live with me forever. Having spent years fighting for diagnosis/treatment and grieving for the difficulties that my child does and will continue to endure, this is the result.

Please be assured that this is not a personal attack on you, but merely a statement as to how it is (or rather how it has been for me).

claig Wed 06-Feb-13 20:32:02

They can let people lie in their own faeces for days, drink from vases and beg their families not to let them die in those hospitals, and they feel no fear at all. They can say they are overworked and nobody does anything. It must have been an open secret and yet where were teh regulators, why didn't they speak to the patients who begged their loved ones not to let them die there, why didn't they put the fear of God into the staff who let people lie in their faeces for day?

They are all liable, and the ones at the top who turned a blind eye are the most liable of all.

AppleOgies Wed 06-Feb-13 20:40:18

Right I've found it...

summary.pdf Executive Summary here.

AppleOgies Wed 06-Feb-13 20:40:55

Bugger..

summary.pdf

AppleOgies Wed 06-Feb-13 20:41:50

http://cdn.midstaffspublicinquiry.com/sites/default/files/report/Executive summary.pdf

It's here if you copy and paste!

SocialClimber Wed 06-Feb-13 20:49:45

"The reason that standards cannot be allowed to slip in your industry is because the people who let them slip would be held criminally liable. It is not an option to let them slip, the consequences for teh individuals are far too serious."

I agree, and that's correct. Which is why things need to change at the top and I agree 100% with your last paragraph.

But although you're right, the consequences would be serious for the frontline men (manslaughter charges etc) the threat of this is not the only reason we go out and do our jobs properly. We are trained from day one to have a deep rooted idea of safety and what needs doing to keep it safe, ie keeping people from harm. This is where nurses must be lacking, IMO. It's not that they're overworked or stressed all of the time, so are we and we are working to ridiculous targets and pressure from above, we would never leave something unsafe. Not because of the threat of liability, but because we would never want death or an accident on our conscience.

SocialClimber Wed 06-Feb-13 20:50:36

Maybe that's what the NHS needs. Direct culpability for malpractice.

claig Wed 06-Feb-13 20:51:43

One woman said on the news last night that her mother begged her not to let her die there. Her daughter knew it was a desperate place but she didn't want to complain for fear of teh treatment that teh nurses would give to her mother if she made a complaint. The family hoped that her mother would get out and then they intended to make formal compaints. But her mother never made it, she died in that godforsaken "hospital".

It is teh patients that have fear and their families that are too afraid to compalin, but the medical staff have no fear at all. And who allowed this to happen? The politicians and the "managers". What a disgraceful situation.

The whole country prays that it will change. That is all we can do. How dreadful is that. The patients are powerless, the families are powerless and we are powerless and the powerful preside over the whole disgusting disgrace.

claig Wed 06-Feb-13 20:55:25

'We are trained from day one to have a deep rooted idea of safety and what needs doing to keep it safe, ie keeping people from harm. This is where nurses must be lacking, IMO. It's not that they're overworked or stressed all of the time, so are we and we are working to ridiculous targets and pressure from above, we would never leave something unsafe. Not because of the threat of liability, but because we would never want death or an accident on our conscience.'

You are right. It is more than just fear. It is about morality. Somewhere along the line the NHS has become corrupted, the ethics and values have been twisted and contorted and immorality has been allowed to have full rein.

Corygal Wed 06-Feb-13 20:58:22

There is one solution - make staff potentially liable for criminal charges of manslaughter, ABH, GBH, or murder.

You can laff but everyone else in the UK already is when they're at work - eg lorry drivers are still prosecuted if they mow down a cyclist - even soldiers can be taken to court for harming someone else - so why not care staff that kill?

claig Wed 06-Feb-13 21:01:40

'There is one solution - make staff potentially liable for criminal charges of manslaughter, ABH, GBH, or murder.'

That is exactly right. That is the obvious solution that should have been implemented years ago. But will the powerful do it?

iliketea Wed 06-Feb-13 21:03:07

Actually, I think that patients / relatives making formal complaints is something which can change things. I know of nurses who have completed incident forms about low staffing levels resulting in patient neglect (2 members of staff for a ward, most patients needing assistance of 2 people for toileting etc), who advised relatives to make formal complaints to PALS. Ward staff had reported staffing problems, but it was only when formal complaints from patients or relatives started being recieved, and linked to the nurses incident reports that changes were made.

SocialClimber Wed 06-Feb-13 21:04:45

Claig, I don't cry often but I did reading/watching about that story. Heartbreaking, and yeah, powerless. sad

Corygal, I agree.

Corygal Wed 06-Feb-13 21:10:43

Care staff that kill are problems that aren't going to go away, are they, unless they're stopped, or at least put off a bit, and the idea of prison might help.

What really needs to happen is a few people popped into gaol in the way that bad care home owners have been over the past few years. And Stafford killed hundreds and hundreds more people than have ever died in bad care homes, so there's bound to be plenty of choice.

Trouble is the medical profession is notorious for looking after itself too keenly - that's how Shipman got away with it. Now, rather like banking, it stinks. That's unfair for everyone. The govt must take control - no more cosy self-regulation and no more criminal exemption for anyone, inc managers.

MyDarlingClementine Wed 06-Feb-13 21:12:22

" And Stafford killed hundreds and hundreds more people than have ever died in bad care homes, so there's bound to be plenty of choice. "

Unfortunalty we dont know that.

Springdiva Wed 06-Feb-13 21:13:03

One thing that bugs me is that the nurses don't go on strike - it's because they are caring, you see, they always put the patients first - or that's the bullshit that used to be spun.

Well that's hardly going to stand up now but surely to god a few of the nurses who could SEE there was a problem could have gone on strike or threatened to.

Plus the doctors must stand by seeing their patients dying - it is beyond belief that they can sign death certificates for patients who should have been recovered and sent home. Really these staff should be shot.

But employment laws do seem to add to the problem, I mean sending bad nurses for 'retraining' rather than sacking them and banning them from the job is adding to the problem. I bet there are many untrained staff doing the job because they can't find anything else and alot of trained staff just hanging on in there for their pensions.

Corygal Wed 06-Feb-13 21:13:04

Well, Stafford were caught doing it, which is a start. 1,000 killings is a lot.

claig Wed 06-Feb-13 21:15:21

Well said, Corygal. Exactly right.

claig Wed 06-Feb-13 21:21:47

We can't believe how nuns could be so cruel in teh Magdalene Launderies and how the Irish stae and Church were involved, and we can't believe how medical staff can be so heartless and how the state presided over it all.

It seems like a nightmare, but tragically it is real. We have to face facts and make drastic changes. Nothing short of a 'revolytion in the NHS' can stop the rot.

SocialClimber Wed 06-Feb-13 21:29:34

Nurses can't legally go on strike.

Springdiva Wed 06-Feb-13 21:35:57

Nurses can't legally go on strike

That didn't used to be the case, didn't realise it had changed.

claig Wed 06-Feb-13 21:38:39

One woman said that she and her family made sure that they stayed with her mother 24 hours a day, in order to make sure she was cared for. The other woman whose mother begged her not to let her die there, could not stay 24 hours a day and that is why she made no complaint because she feared what would happen when she could not be there.

That is how bad things really are. That is no way to run a health service. Many people should feel ashamed, but shame is not enough, many should also be prosecuted.

SocialClimber Wed 06-Feb-13 21:39:42

Sorry, that was supposed to be a question mark. I was asking because my SIL and I are having a heated debate and she said they can't. But I thought they could if it was in the interests of patient care. Ironic if that's true.

Springdiva Wed 06-Feb-13 21:41:08

Looking online nurses were discussing going on strike in 2011 due to pension changes - so unless things have changed since then they can strike.

ChestyNut Wed 06-Feb-13 21:43:20

As far as I am aware they can social as long as skeleton staff are left to maintain safety.

But that's it most of us won't because we have a responsibility to the patients.

SocialClimber Wed 06-Feb-13 21:45:27

Thanks for clarifying. :-)

I just found this: "Nurses are legally entitled to strike but the Royal College of Nursing, which represents two thirds of all nurses, has a ruling that they should only walk out where it is not detrimental to the wellbeing or interests of patients."

So Spring, in that case I agree with you!

XBenedict Wed 06-Feb-13 21:48:59

"Nurses and midwives must ensure that patient safety is not compromised by industrial action"

Not sure how that would work if you were due on a shift, how could nurses walk out?

Whorulestheroost Wed 06-Feb-13 21:51:16

I'm a district nurse and haven't worked in hospital for over 16 years but what I can tell you is this, It takes me probably 4 times longer to fill in paper work than it does to carry out hands on care. Risk assessments, care plans, Cquins, falls assessments etc etc. This is just for one patient, I see around 10 in a 7.5 hr day. The NHS is so focused on cost cutting a target chasing that it has forgotten what it is all about. Yes what happened at Stafford was appalling, but I doubt it is alone and I doubt that it won't happen again until this changes.

GeorginaWorsley Wed 06-Feb-13 21:52:50

As a nurse of 25 years standing,trained under the 'old' system,I am horrified by what happened at Mid Staffs.
However one thing that has changed over my period of practice is that trained nurses used to nurse,with the assistance of 'auxiliaries' and ward based students.
Our course was hard,we worked fulltime and had to study as well,each ward placement was followed by school of nursing placements that linked theory to practice.Now nurses are expected to do the job junior doctors did then,we have to give powerful intravenous/central line drugs,constantly check drs prescriptions to ensure correct dosages given,liase with many different outside agencies,cope with rapidly increasing population, .
I work on acute paediatric ward.We areusually 'full' but management refuse to close as we will be financially penalised.
So more and more pressure is piled on ,no more staff are available.Or can be called in for financial reasons.
Staff on my unit work 12 hour shifts,usually without a proper meal break.Years ago we worked 8 hour shifts.We were told to accept 12 hours or there would be job losses.And before anyone shouts'tory cuts' this was prior to the 2010 election so on Labour's watch.
There is no excuse for cruelty,but i despair of how we can carry on like this,I really do.

ajandjjmum Wed 06-Feb-13 22:24:36

Thank goodness there are still some good nurses like yourself around Georgina. But surely to make sure someone is eating, that they are comfortable, that their water jug is full doesn't need a nurse's skills, these truly caring roles can be carried out by people without your knowledge, but with the right attitude and empathy?

Over the years with our various 'oldies' we have had experience in a number of hospitals, both in the West Midlands and Lincolnshire. My father had MRSA and his wound was allowed to leak onto the floor, which was not cleaned properly. A poor man died, and his body was left in the bed for over six hours, and I then heard a nurse phone the mortuary saying they'd got someone for 'Rose Cottage'. He'd been lying there for 6 hours! The snarling attitude I've been answered with when asking for test results etc. - or on another occasion, the nurse hiding in the linen cupboard trying to avoid me! And the nurses laughing and giggling through the night around the central station, with no concern whatsoever for the patients closeby trying to sleep.

And it's true what people say, whilst those you love are inpatients, you don't want to make too much fuss incase they suffer, and when they're out (hopefully), you just want to put it behind you and forget it - until the next time. sad

mummyplum1 Wed 06-Feb-13 22:44:32

I'm afraid I have only had time to skim read the thread but I wanted to say that I totally agree with everything the meddle has said. (I'm and NHS doctor married to an NHS doctor).
She is absolutely spot on in my opinion. Huge kudos for taking the time to write all those comments meddle and explain things so clearly. The more people who read them the better and who stop believing the government led rubbish in the tabloids. The whole political/ management thing that is going on is 100% rotten to the core. The vast majority of them don't care about the patients like most doctors and nurses, only about balancing the books and their bonuses.

logitech56 Wed 06-Feb-13 22:50:25

The Medical Registrar
2 hours ago
Dear Jeremy,

Today, in order to admit an elderly woman with pneumonia (who, by the way, is still sitting in the emergency department eight hours after her arrival), I have spent three times as long filling out bits of paper as it took me to take a history and examine her. Cannula monitoring charts, VTE risk assessment, falls risk assessment, dementia CQUIN assessments, drug charts, clerking, forms for bloods, x-rays, add-on blood test form.

Once on the ward, the nurses will have to fill out countless further reams of paper. PAR Chart, stool chart, pressure area assessments, nutritional risk assessments, another VTE risk assessment, another falls assessment, infection risk assessment. In between they'll still need to attend to her needs, administer medications, offer reassurance and personal care, encourage her to eat, drink mobilise. Then there'll be more forms, requesting medications from pharmacy, more documenting, discharge risk assessment score, social services notification of potential need for services and many more.

Now, multiply this by 40-60 for the acute take, and by 24 for each ward. We have four daytime doctors to clerk patients, each ward, if you're lucky, will have 2-4 trained nurses.

Before you start on us, perhaps one thing you can help with is cutting the mountains of admin bullshit we have to deal with daily and let us get back to caring for patients.

There is a reason why a whole hospital stopped working and caring, and it doesn't take Sherlock Holmes to realise you can't just blame the doctors and nurses.

Sunflowergirl2011 Wed 06-Feb-13 22:50:42

Lots of very interestingoints raised on here. as usual more insight than on the tv/ radio news smile As there seems to be a lot of medical people on here, a genuine question... If my loved one was in hospital and I was worried about their care, getting fed /taken to the toilet etc, would I be allowed to stay in with them? .i assume not, visiting hours seem quite strict? Could I insist do you think? Does this happen?

logitech56 Wed 06-Feb-13 22:50:51

something I came accross on fb.

Picturesinthefirelight Wed 06-Feb-13 22:54:28

Can I just give a huge cheer for Julue whatshername the cage owner without who none of this would have come to light.

In over the border in north staffs. Things arnt perfect there but it's far far better than this.

Picturesinthefirelight Wed 06-Feb-13 22:59:06

I remember listening to this radio interview at the time.

claig Wed 06-Feb-13 23:03:36

Put Julie Bailey and Heather Woods in charge of the NHS.
What a waste of space that Sir Gerry Robinson - the businessman with enthusiastic platitudes - was on Newsnight. This is way above that idiot's head.

Julie Bailey was right - hold them to account and stop those who were involved working in public office again. Heather Woods and Julie Bailey showed the RCN up with their arguments. The platitudes of the RCN representative about "all working together" belong with Sir Gerry's platitudes - in the dustbin. These people are not capable of solving this crisis.

GeorginaWorsley Wed 06-Feb-13 23:06:04

Sunflower I would be eternally gratefu for your help,but paeds nurses used to family input obviously!
Have a feeling it very different on adult wards,unfortunately.
Ridiculous,families could be such a help and support imo.

Picturesinthefirelight Wed 06-Feb-13 23:08:42

When my nanna was in north staffs a patient in the bed opposite regularly had food or drinks put in front of her which she couldn't eat without assistance so it was taken away again untouched. My dad used to go and give her a drink.

plus3 Wed 06-Feb-13 23:11:37

I am a nurse and work on a ward with a 1:1 ratio with good reason. I refuse to work in an environment in which I can not deliver the care I wish to. My hospital is a centre of excellence & I am incredibly proud to call myself a nurse, and to be part of that team.

My SIL works in NHS management in another trust. She believes that a 32 bed ward should operate completely well with 2-3 qualified nurses per shift, with HCAs working along side them. It is cheaper. All the nurses have to do is administer drugs - the HCAs will do the caring. She states that nursing care is 'dire' but cannot recognise increasing the ration and that paying experienced, clinically savvy nurses would be beneficial to the patients....

I sincerely hope this report changes things.

AtoZandbackagain Wed 06-Feb-13 23:14:38

I can't remember hearing anything from the NHS Chief Exec today?

Why might that be?

claig Wed 06-Feb-13 23:17:42

I wonder why Sir Gerry was invited on. I hope that they don't implement a solution of letting loose enthusiastic business leaders on hospitals who think the solution is to 'enthuse' the workforce and provide 'fantastic leadership'. Julie rightly wanted statutory regulations about candour, but predictably Sir Gerry was worried about statutory controls - enthusing the workforce and fantastic leadership was what was necessary.

AtoZandbackagain Wed 06-Feb-13 23:39:50

Sir Gerry did a series for BBC2 a few years back where he examined some hospital up north and made recommendations to improve eficiency - such as making better use of the operating theatres etc.

It was actually a very revealing series that spoke volumes about the NHS mind-set.

I've been spending a lot of time in hospital recently. Have seen some good practice and some very very poor stuff - like the HCA who aimed the thermometer near my ear but not effectively in it!

Have also seen the elderly left to sleep through mealtimes - visitors are banned at mealtimes.

One robotic European nurse response to any question was 'We are giving you the treatment' - like a worn out record. My heart used to sink when she cam on shift.

It's the weasly stuff that annoys me. I was ready for discharge but had been prescribed a drug but it wasn't available. I said I would rather be discharged without it, as the alternative was to spend another day in hospital while they sourced the drug. Someone then said I should ask for the hospital doctor to get my GP to issue me a prescription for the drug that I could collect when I got home - which would not delay my discharge. When I asked for this option I was told quite bluntly by the nurse that it wouldn't be possible as I had refused the drug!

That made me angry.

meddie Thu 07-Feb-13 00:00:50

Well I watched newsnight. I so hope the recommendations are taken on board and actually put into some useful changes,
Sir Gerry was like an enthusiastic puppy. I agree that culture comes from the leaders, but no amount of enthusiasm will enable a nurse to grow a second pair of arms or to be in 4 places at once.

But I fear that what will happen is someone in an office somewhere will develop a set of forms and tick boxes to 'measure' good care, this will then become the responsibility of the ward nurses to fill in,
they will then employ a data collection person to collect this data and bully the nursing staff into making this their priority OR ELSE!!
They will then have to employ a few people to audit the figures then someone else to report and monitor the results.

poor results, because wards are understaffed and you are heaping more work on the nurses and leaving them less time to carry out patient care will be met with, nice new chairs in the patient waiting areas and emails about 'striving for excellence' from someone who has been employed as 'the patient experience co ordinator'.

They will then go on to produce their own set of forms to fill out to guarantee patient experience which will involve ticking a box to say you greeted every patient on arrival and offered them a cup of tea (because it will look good on their CV that they were trying to do something)
meanwhile staff will be sent on improving your customer experience courses and made to fill out 20 page reflective diaries on 'good customer care'
Am I cynical .... yes. I,ve worked too long in the NHS to expect reasonable common sense solutions.

Want2bSupermum Thu 07-Feb-13 04:10:54

Finally we have proof of what we have all experienced at some point in time when dealing with the NHS. Now the real question is how to change the culture.

Living in the US we pay a lot for our medical care but the standards have been very high compared to what I received in the UK. The major differences I have noted are:

1 - They really embrace technology here. Doctors are dictating notes and the speech recognition software and saving everything down onto the centralized server. The PCP's (GP's) are able to access this information as well as any other specialist within the hospital. Scripts are sent electronically to the pharmacy. No paper.... My obn walks around with her tablet. When I needed a CS after being in labour for 24hrs my obn was able to see what timeslots were available while still in the room with me. Two clicks later and I was booked into a timeslot and I signed the consent forms on her tablet. Paperwork was complete with minimal fuss.

2 - Everyone is on 12 hours shifts (7-7) and there were nurses who only did nights (mostly nurses with small children). Each block is run over two weeks and full time is 6 shifts over the two week period. Nurses only working nights received their training during their shift (7pm to 11pm). They also offer job sharing for non doctors so nurses can work 6 hr shifts if this is better for them.

3 - The doctors and nurses seem to get along well with each other. In the UK there seems to be an us and them attitude. How you change this goodness only knows.

The other difference is that patients see what hospitals bill their insurance companies. The birth of our daughter (I had a CS) was $10K. In the UK so many people say the NHS is free. It isn't free. It is very expensive and I think that employees of the NHS and patients should be more aware of what a treatment costs. It might make both sides value the healthcare more.

drizzlecake Thu 07-Feb-13 08:13:10

The other good thing about the US is that it is actually the consultant/surgeon that deals with you. Not some underling that you've never seen before. And they have a more efficient and professional attitude, I feel the local hosp staff here are there to chat to their mates first and deal with patients second.
They see this as 'being friendly', imv being unprofessional. They have this 'there, there dear' attitude to patients which might have been ok in the 1950s when patients were beholden and in awe of doctors and nurses (think stern matron) but is an excuse for sloppy care nowadays.
There is also rivalry between departments which leads to patients waiting around to be discharged due to their prescription not being ready or blood test results not through yet.

Banging a few heads together might help. But sadly no one is in charge and no one takes respsonsiblity.

LurkingBeagle Thu 07-Feb-13 08:53:31

Drizzlecake - you are so right.
The platitudes surrounding the NHS really get my goat too. The first thing Cameron said on PMQ's was "I love the NHS".....well that would be a ridiculous thing to say about the manufacturer of a plane that had just crashed killing hundreds of people. Why is the NHS any different??

No progress is made to improve healthcare in the UK because of illogical sentimentality about the NHS.

Eliza22 Thu 07-Feb-13 09:03:08

I'm an ex nursing sister of 24 years' overall experience in NHS, Community Nursing and Private care. I gave up 6 years ago as my son, who is disabled, was ill. I was a single parent then and could not commit to the unsocial hours. It is a total myth, in my experience, that working as a nurse can be family friendly and flexible.

When I trained, in the 80's I was shocked by the attitude of some qualified staff who I personally found to be bone idle and happier in the office, shuffling paper and poring over targets. This worsened in the 90's and I became a community sister, so hacked off was I with staff shortages, the attitude of management toward members of staff who insisted on taking their days off or even holiday leave confused. By the time I left I had so much "time owing" (overtime, unpaid) that I could have taken a months' leave. Would you expect a solicitor to work overtime, unpaid? No, but then nursing is "the caring profession" made up, in the majority of women and we were always expected to go the extra mile for nothing. there were ridiculously low staffing levels. Nurses from abroad whose English was practically non-existent. Low pay for the auxiliary nurses (as they were then) meant huge turnover and lack of continuity). Agency staff were often placed in impossible situations, at a moment's notice. The wards were filthy. I remember cleaning (with a bucket of antiseptic and soapy water) the toilet doors and handles, in the cubicles, in the patient's toilet because they were worse than a public loo. The same with bedside commodes.... Often human faces on the seats/handles. Bloody awful. No wonder our hospitals are full of C Diff, MRSA and E Coli epidemics. In short, I wouldn't have wanted my CAT in there, never mind a relative.

I remember, as a junior staff nurse just feeling constantly that I was doing half a job ALL THE TIME because staffing levels were crap and so, patients ended up with the absolute basics being done. I'm not proud of this and in fact, when I "whistle blew" relating to care standards just a few years before I left, I went through 18 months of purgatory and witch hunt attitudes toward ME for having the audacity to complain. In the end, the nursing union (RCN) upheld my case. Apologies were made and they were going to "learn from their mistakes". That was ten years ago. Nothing's changed.

Nothing.... And I do mean nothing, would induce me to return to nursing.

Eliza22 Thu 07-Feb-13 09:12:43

Does David Cameron USE the NHS? I think not. It's fine to wax lyrical about the institution when YOU don't have to suffer it. Would Mr Cameron like to know that his mother, sister, wife or friend were lying in a soiled bed, drinking vase water, slowly starving to death because of neglect? Nah, didn't think so.

It made me smile (ironically) over Xmas when the Duke of Edinburgh was rushed into a private hospital and we were given frequent updates on his care and progress. No waiting list for him, then? No lying on a trolley in a corridor without so much as a drink of water, for 8 hours? I'm so glad the poor man didn't have to get himself to the diabolically filthy lavatory only to have a fall and be lying on the floor for twenty minutes, before he was manhandled back onto his trolley and spoken to like a five year old.... "What were you doing Phillip? You KNOW you shouldn't have gone alone!"

It's a disgrace.

XBenedict Thu 07-Feb-13 09:13:59

"It is a total myth, in my experience, that working as a nurse can be family friendly and flexible."

Oh you are not wrong there Eliza I am also a nurse with a lot of experience (but not as much as you) and i would love to work on the wards but I can't due to the inflexible working.

I have returned to nursing after a career break and can't believe how much it has changed. During my 4 month course the most experienced nurse on the ward didn't do a single clinical shift due to management demands, most of the time she wasn't even on the ward. I felt really sorry for her, it was like she was being pulled in two directions, one from her ward staff and the greater pull from trust management. Apart from 3 staff nurses the rest of the qualified ward team had been qualified for less than a year.

LurkingBeagle Thu 07-Feb-13 09:59:39

Would you expect a solicitor to work overtime, unpaid?

Eliza, I take issue with this bit of your post. I am a solicitor and I work overtime without pay every single day. I also have not had an uninterrupted holiday for about 5 years. My ExOH who is a registrar in the NHS? Not so much. Home by 6 every day without fail. Spent a lot of time grumbling about being paid less than me though!

I agree 100% about everything else though smile

imogengladhart Thu 07-Feb-13 10:02:40

Message withdrawn at poster's request.

LurkingBeagle Thu 07-Feb-13 10:04:52

That's good if it means that nobody else suffers as they did in Staffs. I am a little surprised it's only 5 - it could have happened in all 3 of the hospitals local to me. They are all appalling.

Eliza22 Thu 07-Feb-13 10:12:32

Apologies Lurking. I only know that, on the few occasions in my life, when I've had need of a solicitor, I've been billed and had to pay even for a 15 minute telephone consult. When I received the itemised invoice, I was flabbergasted by the minutiae for which I was "billed". I'm sure it's not like that everywhere. But, consistently in the NHS, baring in mind you are on the ward, ready to work by 0710 and can still be there at 2100, there's a lot, a LOT of unpaid work goes on.

Again, didn't mean to offend. smile

Oh, and one hospital in the report, where I worked as an agency nurse ONCE has had an appalling reputation for care and clinical/surgical mistakes since I first was there, in 1988. It is truly a scary place and I categorically refused to go back. I was putting myself unprofessional jeopardy.

Eliza22 Thu 07-Feb-13 10:13:44

In professional jeopardy.... In terms of accountability.

LurkingBeagle Thu 07-Feb-13 10:30:01

Eliza - I know that kind of ridiculous billing goes on. (That's why I complain about every bill from a solicitor I recieve! wink) But I promose that it's the partners - not the salaried lawyers like me! - who benefit. Anyway, off-topic.

Incidentally, my OH's former hospital has a "Protocol" for VIP's, i.e. if a politician or sleb came into A&E, they were given rather better service than the average Joe. So even when they do use the NHS, they don't, IYSWIM.

I just cannot believe that the people supposedly running the show did not walk up and down the wards and see this going on. I remember the hospital where I used to live celebrated getting Foundation Trust status by building a bloody great fountain out of local stone on one of the car parks at a cost of 1 million quid! Meanwhile the (mixed) ward I was on had 2 toilets for 12 people (one of which was also the only shower) and was so cramped I didn't even have room for the table thing next to my bed. Nobody should remain in management after making decisions like that, and yet presumably they are still there!!

XBenedict Thu 07-Feb-13 10:37:20

"Incidentally, my OH's former hospital has a "Protocol" for VIP's, i.e. if a politician or sleb came into A&E, they were given rather better service than the average Joe. So even when they do use the NHS, they don't, IYSWIM. "

Arrghhhhh! This is so annoying isn't it? I remember an MP visiting our hospital (a few years ago now) and the faff that went on was unbelievable. Fresh flowers on all the tables in the canteen, we weren't even allowed to use the canteen that day only "invited staff" angry He was shown around selected wards wtf????? I think he should have been shown it how it is, how can we make these people understand if we dress up up visits like this?

HoleyGhost Thu 07-Feb-13 11:16:42

Most professionals in all sectors do a lot of unpaid overtime.

I don't understand why it is so difficult to accomodate nurses with small children. The US example above is just one of the ways it could be done. Obviously, some flexible/bank staff would be needed to cover.

Anything which improves morale and gives staff a sense of responsibility and pride in their area would be a good thing. Enabling continuity of care would do that.

meddie Thu 07-Feb-13 12:24:26

You can have flexibility. There is self rostering systems around whereby you work 13 x 12hour shifts over a 4 week period, 8 days and 5 nights. This allows some flexibility. But it still is never a guarantee you will get the shifts you request and thats where it can causes issues with childcare.
We have staff who work part time or just 1 night a week etc to fit around children, But our area is highly specialised so our manager is more accomodating, as she cannot afford to lose skilled nurses after Mat leave.It costs to much to replace and train them up.

GeorginaWorsley Thu 07-Feb-13 12:52:07

Unless you have family help it is very hard to nurse and have children.
I used to work every weekend so that DH could have them,but that is not ideal from many angles.
I am lucky in now I just work one 12 hr shift a week,usually mon to friday,I was accomodated due to experience.
Nothing would induce me to increase my hours.IMO ward work is a youngsters game,at 45 I just find it so tiring,I walk off the ward like a 90 year old some shifts.
To be on your feet for 12 plus hours without a break is dangerous,imo.
Most drug errors in our trust are made towards the end of a 12 hour shift.
So called 'set' days are rarely allowed so booking nursery places or childminders hard if not impossible.
Add in the Christmas's worked,breaks missed,family occasions missed due to off duty,and I wonder why people go into nursing nowadays.
Especially as some,as in Mid Stffs,don't want to 'nurse'

HurtyGertie Thu 07-Feb-13 12:55:46

I do not see how Stafford hospital will improve at all as they have closed all but one ward now at the nearby Cannock hospital which used to take orthopaedics, elderly patient care etc. I just think it's mad.

maleview70 Thu 07-Feb-13 13:01:28

As soon as targets introduced chaos was inevitable.

Based on that I blame the government that first introduced targets

Managers paid bonuses based on targets will do whatever is neccesary to earn the bonus. It's human nature. The banks have seen it and now we are seeing it in schools and hospitals.

Politicians have a lot to answer for in this country. It's no wonder most young people don't vote. I bet if a popular celebrity put themselves up as an mp next election, the young vote would double but only I you could vote by text message. Maybe Simon cowell should be brought in to arrange it.....MP factor.....and in the constituency of Romford we have boring old right wing ex public school boy, equally boring young Blair wannabee and representing the young we have stacy Solomon. It would be a landslide.

Most nurses do a good job. They are just managed by a bunch of fucking idiots.

stoatie Thu 07-Feb-13 14:11:50

Meddie sums it up perfectly.

"But I fear that what will happen is someone in an office somewhere will develop a set of forms and tick boxes to 'measure' good care, this will then become the responsibility of the ward nurses to fill in,
they will then employ a data collection person to collect this data and bully the nursing staff into making this their priority OR ELSE!!
They will then have to employ a few people to audit the figures then someone else to report and monitor the results.

poor results, because wards are understaffed and you are heaping more work on the nurses and leaving them less time to carry out patient care will be met with, nice new chairs in the patient waiting areas and emails about 'striving for excellence' from someone who has been employed as 'the patient experience co ordinator'.

They will then go on to produce their own set of forms to fill out to guarantee patient experience which will involve ticking a box to say you greeted every patient on arrival and offered them a cup of tea (because it will look good on their CV that they were trying to do something)
meanwhile staff will be sent on improving your customer experience courses and made to fill out 20 page reflective diaries on 'good customer care'
Am I cynical .... yes. I,ve worked too long in the NHS to expect reasonable common sense solutions."

Several people have said "bring back matrons". Matrons were re-introduced years ago. There are several well meaning Matrons and Nurse specialists who regularly audit stuff (tissue viability yesterday) - and i happily showed her the new tick box that had been introduced into our assessment tool (yay I had completed it).

Problem is everyone seems to think the solution is another form/tick box or sticker - the standing joke is they will introduce a sticker saying "nurse/midwife nipped off to the toilet" - however that sticker will not be used [grim] - reality is we are overworked (I did 4 night shifts last week - supposedly 2000-0800, not once did I leave on time and on 2 nights I (and rest of staff) had no break at all - not even 5 minutes.

Sadly when we complain to matron about staffing we are invariably rebuked over somthing we haven't done (because not enough time) rather than Matron rolling her sleeves up (well obv she has no sleeves - remember "nothing below elbow") and actually offering to help on the ward etc.

Sorry for mammoth post and cynicism but after over 25 years in the NHS........

ZolaBuddleia Thu 07-Feb-13 14:30:17

A relative of mine was in ICU in Stafford hospital. When she was no longer so gravely ill, the nurses colluded with her relatives in presenting her as healthier than she was in order to get her discharged directly into family care at home, They were so sure that staying in the hospital and moving onto another ward would likely cause a potentially fatal relapse.

grovel Thu 07-Feb-13 14:36:19

ZolaBuddleia, how terrifying is that!

ZolaBuddleia Thu 07-Feb-13 14:49:48

Yes, awful. There was a good outcome in the end, and luckily my relative had close family who could have her live with them and care for her constantly for weeks. Speaks volumes about the culture though, doesn't it, that nurses felt they couldn't trust other parts of their own institution?

GeorginaWorsley Thu 07-Feb-13 16:33:50

Stoatie I share your 25 plus years and your views completely!

Eliza22 Thu 07-Feb-13 18:51:29

hurtyGirtie. It's an impossible logic isn't it? Staff/bed/equipment/resource shortages..... "Let's put more pressure on..... Lets close a few hospitals". Madness

Also, bottom line, were all bloody living too long in an incapacitated and "requiring greater care" sense.

sarahtigh Thu 07-Feb-13 19:30:32

NO brief for David Cameron etc, but no Governement at all in past 20years I have worked with NHS has really sorted the basic problems in fact in many areas have got worse, in some areas big improvements like waiting times but there is a huge amount of politics done there to meet targets including cancelling urgent (not emergency operations to get patients seen that are on 17 weeks, people being made to wait 17 weeks even if space in 12 weeks so money not used up to fast

when DD was born had EC at 8.30am ( maternity theatres did not open till 9am) so was done in main theatre, I heard theatre manager complaining about IT not waiting until 9 as now his theatre list would be late all day, it did not upset me as I knew set up but I guess lots of mothers would have been upset to hear that their EC was a source of irritation as it would mean they missed targets etc

I work as a NHS dentist in own practice we carefully budget make sure gloves etc are from cheapest supplier at the time ( just like supermarkets the same brand is on offer cheaper at different places at different times so this moth company x is selling gloves at £4 a box next moth company Y will sell same gloves at a discount when you buy thousands and thousands it matter even in 1 small dental practice this saves over £4000 a year imagine that multiplied up but no they just buy from same person all the time that has special price for bulk buying ( I just could not believe that this super duper deal for whole NHS was about 33% more than we would pay even without special offers and so it goes on and on

so much money is wasted in admin, red tape etc if red tape was cut and 3 people doing same thing in triplicate 10-15% reduction could be made without affecting patient care but will all know it will not happen as it is the admin staff that are so wasteful that decide were to cut and it is just never ever their own budget or staff, the whole NHS is just so so badly run

WhenLifeGivesYouLemons Thu 07-Feb-13 20:01:11

We should have a fixed national number for a safe ratio between poorly adult and nurses- for far too long i've been looking after far too many patients only to be told that this is the safe number of staff that a bunch of people in an office deem to be safe...people that have probably never worked on the front line at all!

And sarahtigh is right. I've never known any other profession spend so much time and money on paperwork. The saying is in nursing 'If it isn't recorded then it isn't done'- to the point that records have to be dublicated. And after doing 12 hour shifts without a break people then wonder why 'boxes aren't ticked' correctly :s

The sad thing is that a lot of people are looking at the Staf report and assuming that all the staff don't care when in reality a lot of them will be overworked, underpaid and blamed when 'paperwork' isn't don't correctly when patient contact should be a main priority. It's physically and mentally draining.

alcibiades Thu 07-Feb-13 21:09:22

I worked in our local DGH for about ten years as a secretary, mostly as a temp. During that time, the "systems" took over, and it was depressing to see how much control went from the practitioners to management. I worked for nine months for one of the nicest and most dedicated surgeons, and at the start of that placement, if a GP phoned up with a concern about a patient, that surgeon would take the call, and, if he thought it necessary, he'd ask me to book that patient into his clinic as an "urgent", even if that meant a double booking. But in the short time I was working for him, the system went from consultants being able to make those kinds of clinical judgements to it all having to be done via the computer system. Choose and Book might be useful in some cases, but it became the only way, and in the end that consultant was powerless and all he could advise those GPs who phoned with concerns was to send the patient to A&E.

sarahtigh - In another department I worked in for quite a while, the admin secretary was brilliant at ordering in stocks. Like your practice, and also like many other admin secretaries, she did her research, and prided herself on keeping within her budget. Then it went to one permitted supplier only. One year, the Trust was facing a possible deficit as the year end approached, so all admin orders were suspended for the last couple of months. Secretaries who ran out of paper to print clinic letters had to spend time going to other departments and beg for paper, with notes being taken of who had borrowed what from whom, in order to return those borrowed stocks once stationery orders were once again permitted. As the one permitted supplier was then inundated with orders once the embargo had been lifted, they had to ration the supplies initially. Overall, there was probably about four months of upheaval, and goodness knows how many woman-hours were wasted going around and begging for paper. But, hey, the Trust achieved its budget target at the end of that financial year, and that's all that mattered.

Eliza22 Thu 07-Feb-13 21:19:12

If it isn't recorded, it didn't happen. In principle, recording what we "do" to the patient is essential. Problem is, so much time was spent writing care plans (in my nursing heyday) and filling in charts, that implementing the actual plan was nigh impossible. And filling in charts relating to fluid intake/output or pressure relief or nutritional charts? If the staff didn't complete this and questions were then asked.... The chart would be completed post shift. Madness.

girliefriend Thu 07-Feb-13 21:31:21

Hello I am tired so not read all the thread but was talking to colleagues about this today. I am a community nurse and have worked on the wards, now have nearly 10yrs nhs experience.

I have never yet met a nurse who didn't care about their patients. However when I worked on the wards it was usual to have one nurse to 12 patients - all of whom were high need. It is an impossibility to do a good job, you fail before you start because you can't be in 12 places at once.

Its the old saying of too many chiefs and not enough indians and that sadly has always been the case in the nhs and if anything that is getting worse sad

amothersplaceisinthewrong Thu 07-Feb-13 22:22:53

Bring back the State Enroled Nurse.... in large numbers, so that the elderly can be fed, changed, hydrated and treated with dignity.

Eliza22 Fri 08-Feb-13 09:33:03

But, isn't that kind of what they have now amothersplace?

When my dad was in hospital he rarely saw the qualified nurse. She admitted him and her name was given as his prime carer but it was the nursing aids who cared for him and took his observations etc. In a practical sense, the qualified (with a degree) nurse did NO hands on care whatsoever. She "supervised" a team of what were, in my day, auxiliaries.

My dad died in Wales. He had lung cancer with spread and he knew he was dying. He'd gone in to hospital to have his lung drained of fluid. He'd (over the years) had 2 lots of separate by-pass surgeries (the last one privately as the NHS told him, there was nothing else could be done, he lived for a further 14 years) and kept himself fairly fit.

The last time I saw him, he was sat on his hospital bed concerned that the nurse wouldn't give him his medication at night. He said he never saw anyone and he didn't like to 'buzz' cause they were so busy! There didn't seem to be any continuity and the nurses barely knew their patients. They phoned my mum at 0610 the next morning and told her to come in as his condition had "worsened" When she got there at 0650, he was dead. Now, he was not only dead but he was stone cold. They had attempted to resuscitate him (a man of 74 with a total of 12 by pass grafts and lung cancer with metastases). I was still working as a nursing sister then and I was livid. I think what actually happened was this.... The nurses found him unconscious or newly deceased. They didn't "know" him and put out a crash call for resuscitation on a man who had final stage cancer and a buggered heart. They, as a later report said, "worked extensively on him" but he could not be resuscitated. No one, I think, had checked on him on the night shift and it turns out, he was trying to get to the toilet and fell. It was later found that his medication HAD been omitted as he was asleep by the time the qualified nurse did her drug round.

I can only imagine his fearfulness and no one being there for him.

I supported my mum in her trying to find out exactly how he'd died though i knew, shed get no where. It wasn't pleasant reading and after 2 years and a lot of meetings and some condescending "he was a very SICK man, Mrs S) (yes we bloody KNOW!! - so why was he not checked and why didn't he get his heart tabs and whose good idea was it to go through the physically traumatic resus procedure?) there was an apology.

I have no idea how they can fix the NHS but it should start maybe with Mr Nicholson going. I bet he doesn't use the NHS.

Blackberryinoperative Fri 08-Feb-13 11:22:01

Stafford hospital saved my life, my baby daughters life, is not half as bad as some other hospitals and employs hundreds of people in my home town. If Julie bailey has her way, it will close, and the next time she or one of her family needs a hospital it will be twenty miles away.

Nowhere have I seen practical, constructive advice or measures suggested by cure the nhs, only bitter calls for resignations. Yes, those at the top need to be held accountable, but to "cure the nhs" we need to start from the ground up. I fail to see how doggedly requesting apologies and costly investigations will trigger basic care improvements. Stafford has vastly improved in the last four years anyway. Cure the nhs has given the dog a bad name and now Stafford will fail to recover - as a result the people of Stafford will lose their hospital. Thanks Julie bailey. And I wouldn't eat in her cafe, I think she needs some health and safety advice there.

ajandjjmum Fri 08-Feb-13 12:01:52

Maybe if Julie Bailey hadn't fought as she has, Stafford would not have improved sufficiently to save yours and your DD's lives Blackberry.

Having read the experiences she had with her mother, and having experienced some of the NHS 'care' with my own family, I am full of admiration for her and the other relatives who wouldn't let their concerns die along with those they loved.

There are some excellent NHS staff, but I have come across far too many nurses who are clearly there just for their wages, and don't give a monkeys about their patients. Hopefully this will start to change.

I don't think her cafe has had the focus of her attention of late - I think she's been working on more important things. Nasty comment Blackberry!

SocialClimber Fri 08-Feb-13 12:15:05

"I've never known any other profession spend so much time and money on paperwork. The saying is in nursing 'If it isn't recorded then it isn't done'- to the point that records have to be dublicated. And after doing 12 hour shifts without a break people then wonder why 'boxes aren't ticked' correctly :s

The sad thing is that a lot of people are looking at the Staf report and assuming that all the staff don't care when in reality a lot of them will be overworked, underpaid and blamed when 'paperwork' isn't don't correctly when patient contact should be a main priority. It's physically and mentally draining."

I am starting to lose sympathy with the excuses. As I said earlier in the thread, this is how it is in SO many professions, especially the big companies. What you said above is exactly what happens in my industry. We all complain that the people at the top care more about paperwork than they do about getting the job done. Nobody lets their job slip, or doesn't complete an essential peice of work just because pressure is on and paperwork is endless.

Those nurses walked on by when they should have stood up and fought. Not because they were too busy, but because not enough of them cared. And I am not tarring all nurses with the same brush here, many are excellent at their jobs and feel frustrated at the system. But for every nurse that complains about lack of care, there are others who couldn't give a monkeys. Those people should be held accountable. You don't "walk on by" if you care, no matter how busy you are.

Blackberryinoperative Fri 08-Feb-13 12:25:16

She is the poster girl for compenstation culture and she will ensure our town loses its hospital. It's not going on in your backyard so it's easy to look on her as a saint. As far as I can tell she can't back it up with real solutions.

And another thing, clinically trained medical staff are not carers for elderly lonely confused people. They are there for medical purposes and to treat medical conditions. They are simply not equipped for the ever expanding generation of elderly and infirm people whose problems cannot be solved with a drip, some medication and a well qualified consultant. we need a return to focused geriatric wards, like Cannock hospital had. Which is now closing. Thanks again cure the nhs. Draining the health service of money, now we are seeing Cannock hospital closing and more pressure will be on Stafford which is already oversubscribed.

And yes, I've had an elderly relative die at Stafford. There had to be an inquest and apology. But I accept that things are improving and I will not allow my grief to be a catalyst for the destruction of my local nhs services. There is very strong feelings around here about cure the nhs and I would say only 50% are supportive.

HoleyGhost Fri 08-Feb-13 12:27:33

If the required paperwork is excessive, why are the unions not addressing the problem? When I had my dd, every word said to me by a midwife was written down. The spent far more time writing down what they had said and done than they did speaking to me.

To what end?

Springdiva Fri 08-Feb-13 12:48:19

I don't think you have cared for an elderly person social climber - feeding an eldery confused and, probably, not very hungry elderly person can take best part of an hour. Then no doubt they will need the loo, so help to sit up, help into wheelchair (at a frail elderly person's pace) push to loo, help off chair onto loo, stay with them (if confused), wait til done (could be any lenght of time) .......... anyway you get my drift.

For a patient like that a ratio of one staff to 2 patients is prob what's needed..... and that's the personal care, if they need medical care too that's yet more time.

I can't see any way of coping with these patients unless family are allowed in to help.

Springdiva Fri 08-Feb-13 12:52:17

But I get your point that nurses could have fought, which is why I was suggesting a few pages back that they go on strike, or at least get publicity for the problem by picketing outside hospitals, and surely medical staff would join them.

If staff had picketed a hospital for several weeks/months and then were accused of not caring (due to understaffing) then there would surely be more sympathy for them.

ajandjjmum Fri 08-Feb-13 12:58:50

But that's the point Blackberry - things wouldn't have been improving if Julie Bailey et al hadn't made things happen. No-ones grief should be a catalyst for the destruction of the NHS, but to my mind, to use grief as a catalyst for improvement can only be a good thing - and that must be the ultimate aim of 'Cure the NHS'.

And in my opinion, to say that a report of this magnitude has been prepared that 'can't be backed up with real situations' is ridiculous.

Eliza22 Fri 08-Feb-13 13:02:19

I agree about staffing levels. When I worked nights there was often me (staff nurse) and two auxiliaries. Sometimes, we'd "share" a pair of hands from another ward, though it was often an agency nurse who had little experience of that particular ward before and the fuss from the night duty matron when we had the audacity to say we 3, couldn't cope with 36 patients !! After every 12 hr shift I'd go home and KNOW I'd left so much undone or oly half done. It was a mess and not a one off mess either. It was every shift, every ward, ever day.

RedToothBrush Fri 08-Feb-13 13:02:33

Do I think it will shake up the NHS?

Not a chance sadly.

Instead, hospitals will continue to ignore problems if it suits them.

meddie Fri 08-Feb-13 13:58:43

There are crap nurses like there are crap people in every job and I personally could not walk past a patient if they were in distress, I have absolutely no defence for that,

we dont know what staffing levels were like, we just know they were dangerously low and the majority of staff on the wards were untrained and not actually qualified nurses.

I can see there would come a point when you are constantly firefighting and you have to prioritise, when you become so burnt out, frustrated and demoralised that you give up caring, you become snappy or irritable and thats reflected in your attitude.When you just give up because those who are supposed to be managing and supporting you to perform your job turn their back and ignore your pleas.

Those who dont care, carry on not caring and the bad ones are not reprimanded, they become the prevailing culture.

There is so much wrong with the NHS due to constant reforms and trying to run it on a business model, which just doesnt work.
You can monitor the quality of sausages produced or how many you sell, unirformity in taste and texture etc.

How do you measure someone sitting with you and holding your hand and helping you come to terms with your illness? Its not measurable. Therefore its not valued and it takes time. Time which we no longer have to give.

Blackberryinoperative Fri 08-Feb-13 13:58:48

I didn't say real situations. I said real solutions. I feel cure the nhs lacks them.

ajandjjmum Fri 08-Feb-13 14:21:45

Sorry Blackberry - misread. I don't think it's the responsibility of this group to provide the solutions though - but they've certainly highlighted the problems.

What you say meddie makes so much sense - I can't believe that anyone enters nursing thinking 'I really couldn't give a toss about the patients', but the culture drags many down to the base level.

I just hope that the Government will act effectively, and we'll start seeing the caring aspect take priority, rather than the target ticking.

Eliza22 Fri 08-Feb-13 15:54:24

Meddie...very nice summary. I be walked away from people who wanted my attentions. I've also RUN from the ward at the end of my shift, thinking 'thank God, that's it, for today!' I cared about my patients but having only one pair of hands is the problem and that, was utterly soul destroying. I'm glad I 'retired' after nearly 3 decades in the job. I'd had about as much as I could stand.

grovel Fri 08-Feb-13 15:58:02

Meddie, your posts are really helpful.

If I came onto your ward would I know who "owned" the ward from a nursing point of view? And would I know which doctor "owned" my treatment/care?

FakePlasticLobsters Fri 08-Feb-13 16:59:46

Blackberry it's not about compensation culture. My friend lost four members of her family in that hospital, within the space of eighteen months, her baby daughter, her sister, her uncle and grandmother all died there.

You will have seen her daughter in the news, her photograph is everywhere. And my friend could have died herself after midwives at that hospital tried to inject her with something she is allergic to, something clearly written in her notes, plus she had an allergy wristband on to warn them.

Her daughter wasn't breathing when she was born and they discharged her while she was still blue in colour, telling my friend she was worried over nothing. They missed a problem with her heart and she died a few days later.

My friend and her family have not asked for a penny in compensation and have not been given one.

They want people to be held responsible for their actions or inactions, leading to those five deaths. They don't see this as some kind of get rich quick scheme, it's about justice for a newborn baby and a woman with cancer which went undiagnosed for months despite clear warning signs, and her other relatives who died when they might have lived and who she feels were neglected in their care. Her grandmother was dehydrated and hungry when she died, her uncle died when his bowel was pierced during an operation.

They are seeking justice for those who cannot fight for it themselves, not seeking a payout which will make it all go away. It won't ever go away. And they are fighting to make sure it doesn't happen again, to other families in your town or any other hospital in the country.

And I suspect the other hundreds of families whose relatives have died in that place are fighting for the exact same thing. They are certainly not part of the compensation culture as you call them.

My friend has been hounded by the media for weeks and has virtually gone into hiding to avoid being a 'poster child' for anything. She just wants the doctors and nurses responsible for those deaths and negligence to actually take responsibility for them.

bassetfeet Fri 08-Feb-13 18:27:15

Eliza22
Every post you have written echoes my own nursing life . And Meddie speaks for me also .
I am horrified at what has happened to these beloved and vulnerable people . And truly cannot understand how any human being.. never mind a nurse ..letting this utter cruelty occur .
I resigned at age 54 because I could no longer cope with the lack of staff and support . A nurse since 1973 . Seen lots of change in those years and am not a dinosaur of nursing who hated new ideas at all . Went with the flow and enjoyed the good inspiration .
One of my job loads [ha no patient contact again ] was to order our supplies from the catalogue. Absolutely ridiculous prices . I had to order new office chairs from this book........the price would make you faint . Give me a cab and I could have got them at Ikea for quarter of the price quoted and for sure they would have got through health and safety . Doesnt matter now as dept moved a year later and new stuff bought again . WTF?
So so sad for those who have suffered .

edam Fri 08-Feb-13 23:32:21

Sadly nurses and doctors who DID try to complain, who did try to object and who did point out that things were going very badly wrong were bullied and harassed and driven out of their jobs. There are people in mid-Staffs who tried to blow the whistle. They were ignored, at best, more often threatened, bullied and browbeaten. The current chief exec of the NHS sneered at Julie Bailey and the patient protesters - there are meeting minutes proving this. It happens again and again - whistleblowers lose their jobs, are subject to vindictive made-up complaints, or go mad trying to raise the alarm.

Senior managers, including those at the regulators such as Monitor and the CQC, in the Dept of Health and the NHS Commissioning Board and at every sodding level of every sodding layer of bureaucracy this government and the last has dragged in, need to be held accountable for patient complaints and legal action. They - the people in charge - must be forced to pay attention to patients, not just the latest bureaucratic or political imperative.

If you are running an acute hospital, it is very little skin off your nose if short-staffing means a patient is killed or left permanently disabled. Even if their family sues and wins millions of pounds in compensation, it doesn't come out of your budget and does your career no harm. Reports into serious adverse incidents - the sort that should never happen - get put on a shelf. I was at a conference on patient safety where someone admitted they were the managed in a Primary Care Trust responsible for reading those reports, and that's what happens.

drizzlecake Sat 09-Feb-13 14:03:56

Hopefully there are lawyers champing at the bit to represent some of these people and get justice for them via the European courts or wherever they need to go.

How can hundreds of deaths go without anyone being prosecuted. Jeremy Hunt is calling for a police enquiry. Hopefully something will be done.

meddie Sat 09-Feb-13 16:40:20

Fakeplasticclobster thats appalling. My heart goes out to you and makes me ashamed to be part of the NHS, I cant even imagine the pain your family went through.

Its sad that that it should need legal action . I don't want to work with nurses with bad skills and bad attitudes towards patients, but there should be a way to get rid of them without resorting to legal action and its shameful that it is so difficult to do this in the first place.

When they announced last year a friends and family test I was cynical, it seemed like just another PR exercise to be seen to be doing something without actually investing in what was needed, which was safe staffing and resources. But now I welcome it.

But and this is a big but. they need to implement penalties for managers in charge of hospitals who are failing the friends and family test otherwise what will happen is wards will remain understaffed, patient care will be poor and complaints or failing of the test will result in nurses and frontline staff being beaten with it. Especially as Cameron seems to be latching on to performance related pay for nurses.

Nurses should NOT be rewarded for 'compassion' for gods sake, thats a basic part of your job and goes without saying. Who will decide which nurses will get their increments? how do you even measure 'compassion' will it be the yes wo/men or managers favourite, or god forbid will it be related to hospital performance?
because if you are doing the job , but have no control over the staffing or resources, well you could be the best nurse in the bloody world, but if there's only 2/3 of you for 25 patients, there's no way you can have everyone washed, cleaned, fed and comfortable, receiving treatment on time, monitored correctly, in a clean safe environment, its just not possible,
I have a horrible feeling that this report will be used to drive down pay in the NHS rather than what it should be doing and driving up standards.

Sirzy Sat 09-Feb-13 16:49:14

How do you measure someone sitting with you and holding your hand and helping you come to terms with your illness? Its not measurable. Therefore its not valued and it takes time. Time which we no longer have to give.

This is so true. The hospital my son goes to is fantastic and part of the reason for that is the staff do make the time for hand holding and to do the little things which help for patients.

I think part of the reason to do with that is the fact that every member of staff on the ward chips in and nobody appears to think they are "too qualified" to do the little jobs. I have seen a Senior sister changing a bed because it needed doing and she was free, the Matron once went down to pharmacy herself to pick up our drugs so we could go home rather than wait hours for pharmacy to send them up. Because everyone does their bit it means that the ward is generally a nice place to be and the staff really do seem to care for the people they are looking after.

Eliza22 Sun 10-Feb-13 10:09:54

Jeremy Hunt on bbc1 ten minutes ago, coming out with all the usual guff and ending with his hope that "this (scandalous situation)won't ever happen again". He, who was found to have swindled expenses in that other scandal not so long ago and had a lodger in one of his taxpayer paid for homes. How does this man, get to be in the position he's in?

He should be made to spend a fortnight in an NHS hospital. He wouldn't sit there smiling then !!

edam Sun 10-Feb-13 10:16:07

Sirzy - presumably your hospital also has enough staff to look after everyone. Many of the scandals are happening in hospitals where there simply aren't enough pairs of hands.* Or there is one nurse and a couple of unregistered unqualified healthcare assistants, who even if well-meaning don't have the training to recognise when someone needs help or to care for someone with dementia.

My sister's worked in an assessment unit which is on a different site to the acute hospital. She's had patients who deteroriate and need 999 ambulance to A&E - a nurse is supposed to go with them but she couldn't as she was the only registered nurse on site.

*Mid-Staffs was running woefully understaffed because the management were chasing Foundation Trust status and so determined to cut costs and never mind the impact on patients. The current NHS chief exec was in charge of the strategic health authority at the time, so responsible for ordering Mid-Staffs to cut costs.

ajandjjmum Sun 10-Feb-13 13:06:02

But edam, do you really need significant training to see that someone needs help with eating, or needs their water glass filling up?

iliketea Sun 10-Feb-13 14:02:58

You don't need specific training to see that someone needs help with eating etc. But, as with everything thought of as "basic care" ; it is a time to assess what's going on with a patient - are they able to use cutlery? is there a problem with dentition or swallow? You need at least some training for that.

I love care of older people, but there I value my NMC registration too much to work in a hospital care of the elderly ward. The thought of having 8-12 high need patients to provide high quality nursing care for, with assistance of 1 HCA, leaves me terrified - because it is a physical impossibilty. Even something as simple as making sure everyone gets lunch would take 20-30 mins per patient for those who need assistance. If half need help, that's 90 mins of time to ensure everyone is fed and hydrated, by which time meals have gone cold (excluding any added time for other patient needs such as toileting). Add 30-40 mins per patient for personal care, 5-10 mins per patient for medication (x3 in a 12 hour shift) plus TPR and BP - 5 mins (x2 minimimum per 12 hr shift).
Then add all the other stuff - chasing up discharge plans / completing documentation / participate in DR round / referrals to other HCPs / medical emergencies which will happen / patients needing personal care during the day; there is just not enough staffing time with 1 nurse and 1 HCA to achieve that.

There are a minority of nurses who lack compassion, but the majority just try to give the best care possible. I read some of the stafford report and there were around 200 incident forms submitted that identified poor staffing - and the management team did nothing.

Also - I would like to clear something up - it is bollocks that the extra training to degree level has made nurses less compassionate - my two degrees have not made me have less compassion but they have made me more confident in challenging poor care because I have the knowledge and understanding of the rationale behind the care to support my arguments when I advocate for my patients, rather than just blindly following orders.

x2boys Sun 10-Feb-13 14:31:34

i think most nurses do care i certainly do as do the vast majority of my collegues, but there is a vast and i mean huge amount of paperwork to do mostly on acomputer. AS someone who went to school in the 80,s and is not paticularly computer literate this can take up huge parts of the working day if we dont do it properly our jobs could be on the line i personally would like to spend most of the day with my patients i currently work on a psychiatric intensive care unit so my patients certainly need me more than the paper work does but i have a mortgage to pay and am the main earner in our family so i need my job what can i do ?

whimsicalmess Sun 10-Feb-13 14:34:37

I watched the Stafford doc the other day, was horrendous obviously rotten from the top down.
Unfortunately I know it is an NHS problem, I recently gave birth, was left screaming , by the time they came I had given birth, only to have no examinations at all until my postnatal, very lax on giving out food , which especially when breastfeeding is not good.

bemybebe Sun 10-Feb-13 14:38:56

Being a foreigner I would love to know when people think this mythical time was when NHS was great and caring and wonderful and no managers in sight. In my vast NHS and private care experience, the care is only as good as the clinicians in direct charge of your case and the hospital management overall. Unless I am missing something obvious.

x2boys Sun 10-Feb-13 14:42:14

just read your post i like tea and completeley agree degree level ,diploma level traditional training makes not a jot of difference to how compasssionate somebody is i am saying this as a project 2000 trained nurse one of the first diploma level nurses.The same thing was said about us not enough time on the ward etc but if thats the only training available to you its hardley the nurses fault that they have to now have a degree to be a nurse you are either a compassionate person or not. I have recently moved from a dementia care ward where patients where looked after well mainly by the HCA,s as the nurses were to busy doing paperwork however as it was totally dementia emphasis was placed on getting people to eat persoanl care etc on abusy general ward with medical emergencies wether somebody has eaten can be overlooked

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