What are *you* going to do about the poor standard of nursing care in hospitals?(93 Posts)
I've changed my nickname to hide my identity I post on other areas. I am a nurse with nearly 30 years experience. Everybody needs to be aware that the standard of nursing that your family will receive if they are admitted to hospital is is at best sub standard and at worst life threatening. If something is not done soon then the situation will only get worse. Nurses have never been angels but now they are in many cases actually putting patient lives at risk. YOU the general public need to speak out because it could be your mother/father/son in hospital receiving this so called care,
What precisely are we supposed to do about it?
We also have jobs that need doing. That's what a nurse's job is - I viewed recent stuff in the press about how families should be taking time to go and feed and toilet their familiy members in hospital, as nurses were too busy, as unreasonable - some people can, and I'm sure we all would if we had the time, but what about those with no family members? Who is looking after them if nurses can't be bothered?
If things are that bad, tirednurse, you should be whistleblowing like mad - not telling us to do your job for you.
i am also a nurse who qualified 30 years ago.
need to rethink the training. Students i have had recently think they are above meeting the basic care needs of patients. All they want is to get hands on drug trolley.
At a recent interview I mentioned my concern about unqualified nurse undertaking care that they have not had the proper training for and my concern that nursing care standards are falling. I didn't get the job and was told in the interview feed back that even if the system is not good I have to accept it and work with it and that boat rockers were not wanted by this particular trust. I have also attempted to whistle blow in the past when a man died unnecessarily and have been advised by my union rep. to let it go because 1. it wont make any difference and 2. the trust will then find a way of getting rid of me. At the end of the day if my family are admitted to hospital then I will ensure that they are properly looked after but you cant do this and I am trying to make the general public aware of what is going on.
My Grandma was in hospital last year after suffering terrible nosebleeds (epistaxis is it?). She is 86yo, insulin dependent, has debilitating arthritis and is very frail. My parents were away in Greece at the time (my Dad is her main carer and she goes into a short term residential home for a week twice a year while he has a break) and there was only me to visit her. I practically moved in to the hospital to ensure she was getting her insulin, being fed and washed. It was beyond disgusting but not through lack of trying from the nurses. They were lovely and tried so hard but there were so few of them. The bays had 8 beds in them and there were 6 bays. I saw no more than 3 nurses on the ward at any given time. People were sitting in their own faeces, several old people sobbing and calling out for help, buzzers ringing interminably. When I got my Grandma home, I stripped her and put her in the shower. She was covered in blood, poo and urine and she should NOT have had the indignity of being bathed by her grandaughter. Basic care didn't even happen.
I wrote to the hospital, to my MP, anybody who would listen really. But I doubt anything has changed.
I did suggest that they buy a television or borrow one or I'd bloody give them mine as a small thing that could help. There were people there with no visitors at all, asleep most of the day, crying for the rest of it and the only form of entertainment came via hospedia which was ££ and they couldn't work it. I remember years ago when my Grandma had her knees replaced, they had day rooms with radio and television and crafts/books. And something that simple helped. Everything that isn't an essential (so a bed really) has been stripped away.
I think hospital care is frightening. I had an emergency op this spring, was in a room at the end of a corridor, nurses took ages to come, and I went ages without painkillers, and was snapped at when I asked for some. I ripped my canula out and bled everywhere, and had to sleep in the blood until DP came the next day and sorted some sheets out. I remember sobbing with pain in the middle of the night begging the nurse to give me some painkillers and she snapped that 'you shouldn't be in any pain'. I am normally very forthright and confident, but 3 days in hospital, hair full of grease because I couldn't have a bath or stand long enough to have a shower, covered in blood in dirty sheets, panicked, in pain and frightened, reduced me to someone pathetic. I felt the lowest of the low. When I was discharged they had me carry my own bags out, 3 days after abdominal surgery.
I then ended uo with MRSA which took months to go and I have ghastly, raw scars.
I came out of there adamant that I wouldn't go into hospital again. God help those who are ill.
DD had her appendix out a couple of months ago, I stayed in hospital with here the entire time (thank god this was allowed) with DP coming for a couple of hours to reprieve. They simply didn't have enough staff to care for all the kids and I felt very sorry for the children whose parents couldn't stay with them all the time.
I don't think nursing staff are cruel - but the systems seem designed to be against the patient, and there is simply not enough staff on the wards imo.
Very, very scary. Don't be sick or old.
show have seen on another thread that you have had your baby - I hope all went well and congratulations
I'm a nurse with 20 years experience and at every level I've worked at (from student up to ward manager) I've never denied the value of good basic care and always been 'hands-on'. The cost of that is hours and hours of unpaid overtime, disregard of how difficult the situation is by non-clinical managers and a general feeling of disillusion by excellent staff, and this was on a specialist ward which was known for good care. I got out of ward work and now work as a nurse specialist in the charitable sector. I'm lucky that I can provide the care people deserve and am privileged to see some fantastic care both in the community and in the hospice setting. Incidentally I do hear many stories of great care in hospital as well as the awful stuff too. I can't imagine what some places are like and how hard it must be to work there.
Thanks Gerrof. I did post a birth announcement over -> there somewhere.
When I had dd I came out of the hospital a sobbing, shaking, humiliated mess. The 'care' is one of the reasons I couldn't even countenance having another. This time around I was on a brand new ward with newly trained adequate staff and I did NOT want to leave. They were absolutely, utterly brilliant and now I know how it should be done, I'm even angrier about how it isn't iyswim.
Ok but what are you and me going to do about it. True there are often not enough nurses for the number of patients but its more complicated than this. Nursing care is done by nursing auxiliaries who have had poor training they all train each other to follow a routine where the patient is not at the centre of the care they receive. Trained nurses don't believe its their job to care for patients but lack knowledge due to the ridiculous way their training is done to properly undertake the roles they put themselves in. I have heard and seen the most ridiculous things and seen patient conditions get worse and even die because of pure ignorance on the part of the trained and untrained staff. MY DH a non medical person would not have made such fundamental mistakes.
Secondly nobody actually cares in the truest sense of the word for the patient I asked one student nurse, a third year, what her understanding of empathy was and how she applied to her work she said she didn't even know what empathy meant.
I am so pleased - I didn't want to allude to it but I know from previous threads that you had a terrible time with your first baby, I am so pleased that this time is different.
My SIL had a baby last December, her third. First two births a walk in the park, this one she had to give birth on the ward as everywhere was too full, and she had terrible care all throughout. She came out of hospital looking shell shocked, and said if that had been her first baby, it would have been her last. It's terrible how widespread inadequate and humiliating care is.
Oh the birth was shite matey. Repeat of last time but the care was exemplary. <shakes fist at crap pelvis> Birth announcement here. It was a world away from last time in so many ways.
tired, what do you want us to do? I wrote letters, I officially complained. What is there to do about it beyond this? I haven't the time to train as a nurse and offer better care so not sure what else I can do.
How lovely . I am so, so pleased for you (beautiful pics as well, and lovely names).
Sorry for hijack OP.
Hi there. Firstly, sorry to hear about your experiences - when my wife gave birth earlier this year our premature daughter we found that the delivery team and the SCBU were fantastic but the maternity ward, where my wife recovered from her caesarean, was hopeless.
Due to the unique set of circumstances surrounding our daughter we were privileged to experience both NHS and private health care. The contrast between the two is scarcely believable. The private health care, in this case the Lister Hospital in Chelsea, was flawless. Test results were available in minutes rather than days, cleanliness was unbelievable and even the room my wife was in would embarrass many hotels.
As a medical professional, what is your opinion of privatisation? What would be the consequence of separating NHS healthcare funding from NHS healthcare provision? What would be the problem with a voucher system for healthcare whereby the patient can choose which hospital they attend?
Please note, I am a firm believer in universal free healthcare for all, I am merely asking whether, in your opinion, the current system of provision (i.e. without meaningful competition by a centralised bureaucracy) is the best method of increasing standards.
I've had the experience of private care too when my son was born and I am extremely lucky & grateful my company provides this cover.
To me the problem we have in the NHS is partly that there is too much demand and because the NHS is such a behemoth, money isn't always efficiently spent.
So my suggestion is perhaps the govt should reduce demand on the NHS by encouraging those who can to go private. So for example offering tax breaks to companies offering private medical cover. That said, politically it's a bit of a non-starter. Labour would be able to push that through but if the Tories tried it'd be seen as creating a two tier system for the rich. Ho hum
I work in have and do sometimes work in SCBU it is very environment from the rest of the hospital and certainly different from what the care adults will receive. I have and do work in the adult private sector as well I do not see any significantly better standards of nursing care in the private sector to the NHS. The vast majority of private patients are elective i.e. they do not have long and complex nursing needs. I have also worked in private nursing homes where the standard of nursing care is so awful prison would be a better place for these elderly people I don't exaggerate. Its not just about money, although this certainly plays a part, and will do more so as many trusts are very over spent its about the whole training and ethos of nurses which when combined together means that you and your relative will receive at best substandard care from nurses. I know that people talk about clean rooms and waiting for blood test results for ever and that this is an issue for many but I'm talking about nursing care.
I worked for a few years for a company which provided me with Bupa. I didn't fall ill during that time. I left this year and after 2 months had my op, and then dd had hers.
I am very tempted to pay the couple of hundred quid for private bupa care. I hate feeling like this as I have always thouhgt the NHS is a wonderful thing, and all previous hospital experiences were fine.
Hum. Maybe on discharge every family should be given a simple care questionaire. Then hospitals (or individual wards) should be made to look at why what they doing doesn't work, when others can do a decent job - presumably with broadly similar resources.
My 93 year old MIL has been in and out of various hospitals during this year (Gloucester, Tewkesbury, Blackpool and Preston - we moved her up to a nursing home partway through) - and as far as we can see the nursing care has been good in all of them. Maybe not quite as good as in the (excellent) nursing home - but decent - not like what poor ShowOfHands granny went through at all.
There have been admin and medical cockups during all this, but that's (several) different stories.
I think Grimma's idea is a good one. In most organisations you get an opportunity to give feedback. We all know what the feedback sheets for hospitals would look like.
I also think lack of empathy is a huge and real problem. Actual clinical lack of empathy.
We could request a Mumsnet campaign to bring in feedback sheets/care questionnaires in hospitals?
>We all know what the feedback sheets for hospitals would look like.
We'd have rated most of MILs care as 'good' - part of the reason for feedback is to find out where is good, or even excellent, so that failing institutions know its possible, and who to learn from.
Yes, you're right; maybe they are afraid to bring in feedback sheets because all the feedback they get at the moment is from people who have reached the end of their tether. If forms were routinely given out, I bet most people would be overwhelmingly positive.
Commercial organisations welcome feedback - criticism is useful if you can learn from it. Its not something any organisation should fear.
We have feed back questionnaires available on every ward. Do you really think they make a difference? The private sector only quick in and out patients not long term sick elderly people with complex requirements.
'available' isn't the same as 'given to' (I've no idea if feedback forms are 'available' on any of the wards MIL has been in) and they make a difference if the culture of an organisation is that they matter.
Riiight so I am responsible for teh NHS as well as being a carer X 3 with no respite, a wife to someone with occasional care needs himself, mother to our other child, student, trying to amke an income, campaign for the condition my kids have.....
People care, we also have llimits,, I passed mine ages ago. I actually did 2 years of nurse training many moons ago and do understand what you are saying, (and about empathy- it's my MA research topic so absolutely LOL) but there are so very many things needing sorting that nobody can do everything.
Niceguy2, I don't think that you could expect people (typically they will be the rich) to pay into a system but not derive any benefit from it. If they are allowed to opt out of paying into the NHS it will collapse anyway. Restricting access to free healthcare to only the poor is a non-starter.
Tirednurse, thanks for your response. I understand that long term ailments are more complex and elective surgery much simpler, but is a large institution like the NHS in the best position to deliver improvements in healthcare in either case? With regard to the improvement in nursing performance, wasn't their a plan to reintroduce Matrons (from what I understand, they're only slightly less intimidating than a Regimental Sergeant Major but with more facial hair!!!) to improve nursing standards? What happened to this, seemingly, sensible proposal?
> long term sick elderly people with complex requirements.
That's my MIL .... I've listed 4 hospitals in different parts of the UK that seemed to have managed good nursing care.
My suggestion was in the light of the OPs question 'what can you do' - one thing we could do is help identify - from the patients/relatives POV - which hospitals/wards represent good practice and which don't.
Coccyx, also have 25 years experience, am also shocked by some, not all, of the attitudes of nurses who have qualified within the last 5 years or so.
When asking a new staff nurse to help with some basic nursing care told "NO chance, I'm not a skivy, get an HCA to do that!" Was too [shocked] to answer at the time.
I too had a horrible experience of being on a big ward after emergency surgery - the woman next to me cried all night with pain, begging for relief, and the night nurse just said, oh, she's fine, really, she's just making a fuss. I was AMAZED by the callousness, lack of interest and sheer abruptness - some were absolute saints, but others seemed to come from cast of beyond the evil dead. Very little was done to help people with some mobility make use of it; idea was for all of us to lie still... and not complain. I have no idea why it is this bad. (Also my surgery was bungled, but that's a separate issue).
What am 'I' going to do? Complain like heck at every possible opportunity!!! Between myself, family and friends I've seen excellence from NHS staff but also a lot of really awful, neglectful treatment. One cousin is now in very bad shape with stomach cancer after being told for 3 whole years by his GP that his health concerns were 'all in the mind'. It's not British to complain about doctors or nursing staff and it's heresy apparently to criticise either them or the sainted NHS that they serve. But if we don't complain & complain bitterly whenever we meet such incompetence, nothing will ever improve.
IME there is a lack of customer care, which private businesses have worked really hard at and now, in many cases, do really well.
I find a lot of nurses seem to see patients as real nuisances. Obviously, they are: they create work for nurses. It is certainly the case that the patient is always wrong, as opposed to the customer always being right.
I have wondered whether it's because they see some much death - they really don't think it matters.
I too have been a nurse for over 30 years. I now work in General Practice.
When I first started my current job I was appalled at how much was being delegated to HCAs. It is positively dangerous. But it is cheaper. This is clearly much more important than providing safe care. (I am talking about potentially life threatening scenarios).
I changed the system in my role, creating more work for myself, but ultimately making the patients safer.
It is all about ticking boxes now, and collecting the cash.
One example that springs to mind was a patient who was about to be started on drugs to reduce his blood pressure. The HCA who had been doing his regular BP checks was using an innappropriately sized cuff - hence the reading was completely wrong.
My own lovely mum died in agony from starvation and neglect in an NHS hospital. The fact that she received no nursing care at all, and the doctors were inexperienced and unsupervised was the reason for this.
I could not be there 24/7, and I have to live with that.
I've seen so many die that I've lost count now from tiny babies through to those over 100 it has not hardened my attitude to people and as I myself get older and my parents get old I realise even more how important good knowledgeable nursing care is.
I could give you hundreds of examples of poor/life threatening/shorting care that I see on a regular basis but wish to retain my anonymity. Relatives are frequently oblivious and even thank us for doing a wonderful job when we've made the situation worse.
I am not a super nurse by any stretch of the imagination but do care about people as if they were my own family asking myself what would I want for my mum/dad/son in this situation. You the general public need to ask more questions, look at charts at the end of beds and speak out against the ridiculous training that nurses do that leaves them not wishing to actually undertake personal care but insufficiently educated to question what the patient needs from a medical point of view.
Yes, I'm sure not all nurses are hardened to death; I didn't mean to imply that. But I am myself bitter about the way a lovely neighbour died. His life may not have seemed significant to health staff; but it was to those of us who knew him. And indeed to him.
> look at charts at the end of beds
Yes, that is certainly something we can do - my DH always checks MILs chart when we visit. This is in some ways more to do with the medical and 'system' aspects of care than the nursing ones - but definitely a good idea. The other thing if you've elderly relatives is to try to be aware of all their various conditions and go through them with the ward sister/and or doctor as soon as you can after admission. And make sure you've got a recent copy of their prescriptions. In this day and age there should be information systems to ensure that the hospital already has full details of meds and history, but it doesn't seem to exist.
Very true, but hard for those without a medical background to understand.
OP - what do you think the impact of the Tory reforms will be on this? Make it better or worse?
As a student nurse, due to qualify in a matter of weeks, I have to agree with a lot of comments made re nurse training.
I came into nursing with extra thick rose tinted glasses on, wanting to "make a difference" - cliched I know. Boy was my first day on a ward an eye opener!
I've always loved doing what's termed as "basic care" - helping someone wash, plumping up pillows, feeding, all the little things that make such a difference. But while on clinical placement (the time spent in a clinical environment rather than the classroom) we have enormous books to complete, and get signed off by a mentor on the ward; without which we fail the placement and not allowed to progress further.
I've lost count of the number of times on this placement I have been told by my mentor to stop doing "healthcare assistant jobs", ie basic care, and do more "management work". Yes I know the paperwork etc is important, but if someone's buzzer is going because they can't get themselves out of bed to use the toilet, surely that's where my priorities lie? But if I don't meet the management objectives set out in my placement book, I won't qualify as a nurse. Simple as that.
they need to go back to training in hospitals with matrons overseeing them have lectures etc in evenings a lot of trainee nurses do not take pride in themselves nor qualified nurses it is going to be worse now as this is last intake of diph in nursing it will be degrees all the way so what if u have a degree u still need a good bedside manner and rapport with patients.
our local trust has brilliant training programme for health care ass and they can do a variety of courses to upgrade their skills and most of them have to go on refresher courses every year.
also the mentors who are meant to be helping students havent the patience to train some one or the time .to busy to mentor etc etc so its a vicious circle half the nurses are in wrong proffession
Someone mentioned Matrons up thread. They are back on some wards and great!!
The ward DS has been treated on numerous times has a matron and she contributes a lot to the ward being fantastic. Nothing is to much for her (she has even gone to pharmacy to pick up meds so we can go home, spent 30 mins sat with me as a shoulder to cry on etc) and that attitude is reflected in the attitude of every member of staff we have encountered on the ward.
If every ward/department was run in such a way then I think the NHS would be much better off!!
The modern matrons at my trust spend ALL their time in meetings, collecting audit data, costing services etc.
No, this isn't the case. Poor care isn't because nurses are heartless and lazy. Why the hell would anyone go into nursing unless they actually wanted to care for people? You think there's anything attractive about the money (!), the 13 hour shifts followed by 2 hours unpaid overtime every night, just so you can complete the bare minimum of paperwork required to protect yourself when a complaint is made in 5 years time. Nurses are human too, and everyone wants to be good at their job. But just how quickly can you wash and toilet 8 bed-bound elderly patients? Is it really true that the nurses who fail to feed 8 people their dinner, in a compassionate and unhurried manner, before it gets cold, do so because they "can't be bothered" to be in 8 places at once? Lazy sods.
It's shit being a nurse. I want to help, I want to be a good nurse, but there isn't enough time in the day. It's hard enough to be the sole carer of half a dozen dependent adults, but these people are SICK and as well as the basic washing and toileting and feeding and talking they need observations and medications and blood taking and dressings and handover to ward round. They need taking to theatre, to X ray, ECGs and drug trials. Painkillers, morphine checking out (with 2 qualified nurses and the CD book and keys) and they need that NOW. We need to write down every ml of liquid taken in and weigh, measure and examine every ml out. Changing bedsheets, cleaning equipment, serving dinners, ordering meds, ordering stock, running to other wards to borrow stock because we've run out, sorting out staffing for the night shift, photocopying, ordering patient notes, ordering tests, making appointments for x ray, echo, endless, endless paperwork. It's all done by those nurses who "can't be bothered" to care for their patients.
Nursing students aren't taught to care anymore... well, I hope that's not true, but one thing I do teach students, especially those who are nearly qualified, is to delegate everything that can be delegated. You will drown if you don't. God I would love to wash a patient, that personal connection is why I came into nursing, but while there are HCA's to do that, I can't justify omitting medications, tests, dressings etc, through lack of time. Everybody has a tale of a family member who wasn't washed, wasn't fed by the lazy nurses obsessed by IV meds and blood pressures, but really, honestly, would you rather that "basic care" took precedence over medications and surgery? Because thats the choice - if those drug-trolley obsessed nurses see the error of their ways and decided NOT to give medications, there is no one else to do it. To be honest, any patients with illnesses that can be cured with a good bath would probably be better off at home.
Not that I don't think washing, and toileting and talking to patients are important. They are, and I hate it when I can't get these thing done properly. I hate delegating it to HCA's, when I'd much rather do it myself. I hate going home, having stayed an hour and a half past the end of my shift, and still feeling like I've done a crap job because I left a patient in pain for far too long. I hate it that my heart sinks when one of my patients vomits and my first thought is "I don't have time for this". I really really hate myself and I try my best to convince myself and my patient that I have all the time in the world to clean them up and change their sheets, because the worst thing for me would be for them to feel bad about it, to let it show how stressed out I am, how the patient in the next bed is crying out for morphine, the patient next to him has started a new medication and needs close observation, the patient in the bed opposite is due in theatre, and how everyone has been served their dinner and they all need help with it, and I can't do any of it while I am helping change sicky sheets. I know it's not their fault, I know, but then I come out of their room, they're all fresh and tidy now, but I run straight into the ward sister - the family of another of my patients has made a complaint about me, they've come to visit and there's Mrs A's dinner sat in front of her, now stone cold, because I haven't taken the time to help her eat it. Lazy, uncaring nurse. And I can't even apologise properly, because Mr B's monitors are beeping, looks like he's had a bad reaction to that medication, and I have to cut them off and deal with that.
Sorry for the rant but I am feeling so down about my job at the moment. 13 hour shifts and we never, ever finish on time. I never take a full lunch break, do hours and hours of unpaid overtime. My back and legs are a mess because I just don't sit down, except on my lunch break, which I don't usually get until about 5pm, after starting at 7am. I can't even get a drink at work, because not only is it 5 minutes wasted, there's also the chance you might need the toilet later, and there's another 5 minutes you can't afford to waste. That's the reality of being a nurse. But all I ever hear is how lazy nurses are, how we don't care about our patients. I know people who have jobs where they are sat down all day, where they go on facebook and text during work hours, who have lunch breaks and tea breaks and don't feel guilty about going home at the end of the day. Yet these are some of the people who feel justified complaining how selfish and lazy nurses are. Did you know the nurses on our ward buy the soap, shampoo and toothpaste for the patients? From the supermarket, out of our own wages, because the hospital doesn't supply it and the patients never think to bring it with them.
Sometimes I'm proud to be a nurse but sometimes I hate it.
badnurse - I agree with everything you have said.
The problem is that nursing care is now done by unqualified HCAs, because they are cheaper to employ than qualified nurses.
Qualified nurses now do an awful lot of jobs that used to be done by doctors. Medicine has moved on so much, nurses do need degrees, they need to be skilled with hardware and software, and much more besides.
What really annoys me is the fact that HCAs are dressed in nurse's uniforms and referred to as nurses, everyone thinks they are nurses, but they don't have the knowledge or understanding to actually nurse patients.
This is not their fault, but it is a national scandal.
As I said earlier, my mum died from starvation and neglect in an NHS ward. If she had been nursed by nurses, she would probably still be here. At the very least she might at least have got some care before she died.
So why not make highly qualified nurses into medics (ie, semi doctors) and give HCAs proper training so that they are proper nurses, in the old-fashioned sense. Perhaps not quite as cheap as HCAs, but less expensive than nurses are now?
We already do that. Many services are run by clinical nurse specialists, both in hospital and in the community. Think of chronic diseases such as diabetes, heart failure, arthritis, kidney disease for example. Long term management is now done by CNS, not doctors. CNS are cheaper than doctors.
We also have nurse practitioners in acute settings such as A&E, and minor illness practitioners in general practice and family planning. CNS are cheaper than doctors, but generally are very highly trained and give good care.
Where standards have fallen, IMO, is on the wards, especially WRT the care of elderly patients - i.e. medical wards. With an aging population, who have multiple health problems, and complex nursing needs, it is simply not good enough to have maybe one qualified nurse on duty and a few untrained people doing the actual care. But it is cheaper than paying qualified nurses.
We used to have state enrolled nurses who were usually excellent IME. But they were phased out.
Training costs money. Also you need to ensure a basic level of numeracy and literacy before you can train anybody...............................
I have worked with one or two really good HCAs, but however well intentioned people are, if they are untrained, it is never going to work.
Have to agree with everything said here by bednurse , tirednurse and nakerednurse.
I qualified in '86 and nursing care has changed so much in the yrs.
I now work in the community and find pts are sometimes traumatised by their stay on an acute ward.
Community care is also being squeezed ,caring for an elderly pts needs in the 30 mins I get allotted (including travel time) is difficult.I spend a large % of it doing documentation to cover my arse.
Also never ever finish work on time and rarely get a lunch break.
The problem boils down to £££ , not enough trained staff ,especially now that nurses do tasks that used to be done by docs taking us away from the basic care that pts need.
I left the ward because it was too stressfull not being able to deliver the care properly.
Matrons in my experience are often doing admin roles only. Waste of an experienced nurse .
The first time I saw a British hospital was when I went to look at the local maternity ward to have my baby. I cried. I could not believe that hospitals like this still exist in the developed world. The care was so poor that I ended up with PND.
Last Christmas I ended up in hospital with Pneumonia and discharged myself. Had animals been treated in the same way the RSPCA would have been on the case. There seems to be a lot of criticism on those unqualified health care workers, but in my experience they cared a lot more for the patients than the nurses did. The caring profession seems to have stopped caring
I'm paying for private healthcare, I think is it is just a shame that it is not possible to have access to a private A&E.
I frankly don't understand why people want to keep the NHS going. Why not look at models such as Spain, Holland, France, Belgium etc...
Interesting article in the Observer here about how things are done in Spain. Do you think a campaign for the abolition of visiting hours, and better facilities for families (e.g. fold-out beds or reclining chairs) to stay with their relatives would help?
Where I come from this patients can also have someone to stay with them if they wish to do so, however, in these cases patients will be in a room on their own with their own facilities as to not to disturb other patients.
I know what you mean OP. The ONLY way a person in hospital gets cared for is if there is a family member/friend there all the time to do the caring and also be their advocate. Hospitals should be more honest and sort out the set up so it is the same as it is in India and other developing countries where it is overtly expected that family does the caring. It is so dishonest in this country as some people still expect care during hospital stays. Nobody who has had friends or family in during the last 10-15 years though I think.
'honestly, would you rather that "basic care" took precedence over medications and surgery?'
There's little point in the latter without the former.
'One cousin is now in very bad shape with stomach cancer after being told for 3 whole years by his GP that his health concerns were 'all in the mind'.'
This is more common than you could imagine. My gran died of a heart attack on her bathroom floor. She had been in agony for such a long time. Turns out she did have stomach cancer, despite being sent to a psych for the imaginary pain. She didn't need to suffer like this at all.
I've talked about this a lot to a lot of people and have been VERY surprised to find out how many other people this has happened to. Absolutely awful
I speak as one myself and I think that most HCAs are perfectly able to wash and dress a patient and do obs and other basic care.
I have been doing the job for 17 years now, so obviously know nothing!
Maybe instead of criticising, you could offer them your superior wisdom and train them to do it properly.
<said as someone who witnessed a trained nurse grab the knee of someone with a fractured femur and move his leg>
27 years actually, typo.
Well on my ward they have just redeployed 4 Qualified Nurses and replaced them with 4 HCA's.
Now we have an issue with covering sickness, annual leave and maternity with bank or agency Qualified staff.
We often run with 2 Q staff for 30 elderly, high dependant, confused and wandering patients. All with complex medical/nursing needs.
This is with 6 HCA's in the morning, 3 in the evening and 2 at night.
The pressure on all staff is unbelievable. Morale is at an all time low and everything now seems to be task focused. Got to get this done, that done and no, I don't have time to sit and chat with patients.
Even while giving personal care to a patient, we have to get it done asap because one or two patients are trying to climb over the bed rails, or the buzzers are going etc..
The answer is not cutting the amount of HCA's and replace with Q's. Extra pairs of hands are never a bad thing.
The answer is employing more Qualified Nurses. Increasing the amount of staff on the wards is the answer IMO.
Sadly it will never happen.
We are being told to try and adapt to the situation and get on with it. By people who have never worked on our ward!
I havn't read the whole thread as I've been in hospital.
I can come in to help. I was thinking about the old ladies in the beds near me that couldn't manage eat.
Would a ward like volunteers? I'd be very happy to help.
I'm so annoyed that I can't find out 'how'.
Loads of leaflets all over for others eg. AgeUK but non for the hospital.
from what i saw, the key thing lacking was management,
some staff did less than the bare minimum, leaving others to do twice as much consequentially.
if management enforced personal accountability - handovers (so if a staff member hadn't got sth done, they could be challenged on it, but also simply to ensure continuity of care), proper written communication (again, through good management making sure it happened)
management seem to rely too much on process without the necessary oversight to ensure the processes were followed.
and the culture of fear of litigation and negative press seemed to stymie proper investigations of wrongdoing - higher-ups didn't want to uncover staff wrongdoing because the hospital as a whole would be liable.
Great post, Badnurse. You really made me see how it must be for you all. What a shame.
From what you've said, all you need is more qualified nurses. Why isn't the government giving the hospitals enough money to employ as many as they need? And why can't HCAs be given more training - if necessary, on the job?
I think the government is deliberately running down the NHS in order to justify their decision to privatise it all. It costs so much they just want rid. And private companies certainly aren't going to sacrifice their profits by paying for qualified professionals.
About hospitals in Spain, the patients' relatives bring in their food, too.
My own family seems to have been so lucky. We've always received absolutely excellent care from NHS hospitals all over England and Scotland, for the last 50 years, the latest in March. That's cancer, a road accident, falling off a cliff, broken arm, brain surgery, meningitis, all sorts of gynae things, several babies ... When kids have been in hospital, parents have been allowed - encouraged - to stay.
My American friends think the NHS is amazing, and we are so lucky - and so mad to think of getting rid of it.
HCA's are supposed to go on training days. These study days are often cancelled because of a lack of staff on the ward's.
When I started 11 years ago, we were not allowed to start the job without completing the relevant study days.
Now we have new members of staff, who have been doing the job for about 8 months, who have yet to do a manual handling course.
Our area has a team of volunteers who go not hospitals in order to feed those who cannot feed themselves. Can't think of their name off the top of my head but know they exist.
I left nursing simply because I could no longer stand by and watch the erosion of basic care. When I started I had time on the wards to do nice things like foot baths and foot massages (important to keep an eye in feet...especially in those with diabetes), mow that simply would not happen as there is far less time.
The rot set in during the late 80s and early 90s (Conservative Govt) and continued into the late 90s and early 00s (Labour Govt). Conclusion is none of them gave a toss......
How we treat our sick is appalling...we have great medical care out there but it's worthless if we don't spend time ensuring basic needs are met. Patients on the whole welcome their medical care but its no good if they are not helped to be clean, nourished and to feel valued....and they would generally like that with a smile too. Not too much to ask in my opinion.
I'm glad I've read this thread - it's a subject I was thinking about just last night. I'm a second year nursing student on placement & last night I spent an hour just holding the hand of a patient who was dying and talking to her while we waited for her family to arrive.
I spent half an hour reassuring a patient who has just found out her cancer has spread and is now having to think about palliative care. Yet more time with someone who needs to be given psychiatric care, but there's no space anywhere else for her so she's on a medical ward. In particular, she is being let down - not receiving the specialist care she needs, yet taking up so much of our time that other patients aren't getting the care they deserve either.
Yet, once I'm qualified I won't have this time. It's so disheartening - everyone I've worked with has cared. They never get out on time, never take enough breaks (none at all on night shifts, there's not enough staff), buy toiletries from their wages (or bursary, in my case) and still there isn't enough time.
I'm really questioning if I should continue.
Yes hurriccanewyn you must continue to fight and correct the apathy in nursing. If people like you give up the NHS is doomed here speaks an old Registerd Sick Cildrens Nurse/SRN/SCM. Please don't give up.
What can we do about it. We can lobby the government to introduce a legal qualified staff to patient ratio in hospitals.
Says a nurse with over 32 years experience.
But it won't happen because it will cost too much. So keep the present staffing levels and blame the lazy, uncaring nurses for bad care.
The lack of qualified nurses on shift and the over use of HCA's who are untrained and poorly paid is a large part of what is wrong with the care in hospitals at the moment.
The ratio of qualified staff to patients is appallingly low in comparison with other countries, who have legal nurse patient ratio's of 1 to 5 whereas we have 1 to 12 or 15 on nights.
As a nurse I was taught how to assess and check my patients during basic care. This was an opportunity for me to assess nutrition, skin integrity, circulation etc, to have a little chat and see how my patients where feeling and to allay anxieties. HCA's are not trained for this and just go in and wash the patient.
Because the qualified nurse no longer does this, due to lack of time and management pressure, she misses a vitally important part of her patients care and its like nursing blindfolded. But to those outside nursing they don't value this basic care and think its 'just a wash' and any untrained person can do it.because its cheaper.
Currently poor care is dumped solely on nurses shoulders which suits managers, the government and the media as it makes a great story for them,and means their own management and cutting of staff is overlooked. what we need is people fighting for the right to qualified nurses having legal patient ratios and there are e petitions going, but its proving very hard to get the signatures needed as the media isn't interested in taking up this cause. and I think people honestly don't understand why care is so poor in hospitals at the moment. To them anyone in a uniform is a nurse, when often they are untrained HCA's.
If you or your relatives are getting poor care, ask first what the qualified staff ratio is and then take the managers to task over why its so low. They need to be held accoutnable for the decisions they make, instead of the nurse who is doing 13 hour shifts and 2 hours unpaid overtime, just trying to cope with the huge workload.
Its also false economy to have such low levels of qualified nurses, many studies have proved that survival rates increase dramatically when the ratios are adequate and that for every patient a nurse has above 5 patients the death rate within 30 days of admission increases by approximately 7% for every patient she has.
These studies have been around for years yet no one acts on them and until litigation costs outweigh the cost of employing more nurses, nothing will be done.
Meddie, I think we are singing from the same song sheet. Agree with every word you have written.
Even worse-there are many newly qualified nurses who cant get sodding jobs!
I've been an in-patient in 3 separate hospitals within the same city over the past 3 years. On each occasion I have not had friends or family with me to help/visit.
1) Major NHS hospital. Gall bladder removal. Operation that had been postponed from the previous week when I had been fully prepared for theatre but op had then been cancelled as they had run out of operating instruments. I was left in severe pain. Nurse removed cannula incorrectly so my blood spurted on the sheets. I was left to sleep in these bloodied sheets. Actually, I couldn't sleep for the pain and the fact that there were only 2 nurses on night duty for a ward of about 20 people and one nurse spent the whole night trying to deal with a dementia patient who insisted on walking around, screaming and disturbing the rest of the ward. No follow-up appointment. Discharged to GP care.
2) Private hospital. GA for orthapaedic operation. Own room, TV, newspapers, psyiotherapy consultation immediately prior to operation, meal ready for me when I came round. No pain. Left hospital with a set of follow-up appointments.
3) Major NHS hospital. Biopsy. Superb treatment with care and compassion from real nursing professionals who took time to listen, put me at ease, took obs every 30 minutes and shared their own tea and biscuits with me after my procedure. They were wonderful. I felt they took extra care with me because I was alone.
Now facing an imminent and major 4th operation in yet another hospital within the same city and am terrified.
Good post bad nurse. Interesting to read about a 'normal' day for a nurse. Evens out the argument.
I just want to add my support to what badnurse said.
I really couldn't agree more with her description of a day on an average ward. She has summed it up brilliantly.
I should add, I am not a nurse, but I am HCP, but I see exactly, precisely what today's nurses are up against. I think the point of abandoning 'the drugs trolley' in favour of 'basic care' was very well made. There simply isn't time to do both well, and the simple fact remains, whilst a patient left lying in their own dirt for far longer than is 'acceptable' is bad, that has considerably fewer 'long term consequences' than giving the wrong drug, the wrong dose or even none at all to that patient.
We simply cannot afford the Florence Nightingale 'image' of nursing we all treasure in our folk memory; far more people are living into an until very recently unimaginable old age; many live alone; the NHS cannot legally (and wouldn't morally) practice 'age discrimination' (which, as an aside, leads to the situation I witness on a daily basis where very elderly, bed bound, utterly confused and frightened (if they're conscious at all) Alzheimer-suffering people are as kindly and carefully as possible, manhandled into the xray department, onto the CT scanners, into the MRI scanners having scans (some of which involve injections that really can compromise failing kidneys yet further) all to rule out that possible cancer that just might be a causative factor of that elderley patient's condition. No one's going to 'treat' it in such a frail and elderly person (often with co-morbidities, ie other more immediately 'threatening' illnesses that really will kill them); they're not fit for anaesthetic thus won't be operated on- all it does is add a sentence to the post-mortem report... why? because if we don't, we stand a risk of being sued for age-discrimination for choosing not to put that person through that pointless, maybe humiliating, often frightening ordeal.)
DH was in an ENT ward in a large DGH for 2 nights and 3 days last week on IV antibiotics. He was in a 6 bedder. Of the other 5, one was a young thug recovering from a pub beating; one was a middle aged self-caring man with a sinus infection, the other 3 were very old and bed bound, requiring all their needs to be met for them. One of them was bed-blocking (awaiting a social services report). Now, this was an ENT ward, not a geriatric or medical ward, yet 50% of the patients were in need of a far higher input of care than the one nurse there could possibly provide. So even ENT is now moving towards a branch of 'elderly care'- but the staffing model just hasn't kept up because it can't afford to.
If we want to carry on with our current 'model', we either need to accept we have to pay far more into our National Insurance, or we have to ration 'free' health care, or we have to pay for it through private schemes. Or we need to put limits on compensation payouts, accepting that honest mistakes happen, and that to scan 50,000 people so as to ensure we don't miss that condition in one isn't cost effective. I think you would be stunned by a) how many 'just in case/cover my arse' examinations and tests are done within the NHS these days, and how much money is spent either defending actions or just paying them out prior to court as Trusts can't afford the possibility of losing.
What we don't need to do is bash those poor people struggling at the coalface of our stressed, creaking system as it currently stands. Or limps.
About to start work as a HCA, I am keen, caring, well educated, have common sense and am told I am going to be trained very well to carry out basic care need, this is the role of a HCA, I am a little upset to read how badly thought of they are, if nurses dont go into it for the money then surely that can be said even more so for the HCA's. I am going into this job becasue I want to care for people and free up nurszes to do their role.
I was a HCA working in acute wards until very recently.
I am educated in health care, as were many of my colleagues.
I have been asked a few times recently if I miss my old job. I miss the times I got it right, when you knew you had made a patient more comfortable, when patients thanked you, when you felt like you had made a difference, however small.
I don't miss the sense of dread I got during handover. When every single patient, out of 30, needed all cares and I knew that it was just me and the other HCA who had to do it all because the patients were so unwell the qualified would be busy all night with meds, obs etc. I don't miss finally getting to someone at midnight who had been waiting since 7pm because I had not had a minute until then to help them. I don't miss coming on to a ward at 8pm and having to pick up and clean every single cup that was out on the ward before I can even offer people a cup of tea because the catering staff finish at 5pm and the day staff had have no time to do it. I don't miss announcing 2 hour waits at the outpatient clinic because the doctors didn't turn up on time for clinic. I don't miss running out of clean sheets, towels, soap, gloves, pillow cases and having to beg other wards for spares. And all the while I am doing this I know that patients are waiting for me. I don't miss the times that three buzzers were going off and the staff nurses were busy and I had to decide which person to take to toilet first, and then dealing with the aftermath. I don't miss mopping up dirty bathrooms at 3am because the cleaner forgot to do them, and as I do it I know people are waiting for my care. I don't miss being sworn at, spat on, assaulted at work. I don't miss checking patients and realising that the person before me didn't change their dirty (dried on) sheets. I don't miss arguing with colleagues about how someone really doesn't need to get up at 7am, we can make them toast when they wake up! I don't miss not sitting down all shift and going home feeling guilty because I didn't have time to do everything that needed doing.
This is controversial, but nursing seems to be one of the few professions that seems to think that people cannot both care and be well educated. Nobody judges teachers, occupational therapists, physiotherapists for being too educated to care or make a difference, but they all have degrees.
The answer is more staff, more qualified, more unqualifieds.
been reading this with interest after a really crap day at work.
Am working in Community Care mainly with people with dementia and their carers.
It's shit in the community too. Services are being cut back and roles which a few years ago were deemed too specialised for lower bands and HC support workers are now being given out to these roles. I actually work with superb HCSW, but it is still a worry as we are told to supervise this work and no doubt will be held accountable if it goes wrong.
As said before, we need more staff at all levels, but managers , who may not have seen a real life patient because they don't have them where they came from eg Sainsburys!!, are making decisions about how and what services should provide.
Twice I have been told to "lower my standards"!!
Yes there are bad health care workers as in any job but please , there are many more of us trying to do our best and suffering ourselves as a result.
Ask any GP which is the main group of workers on anti-depressants?
So where do the hospital Consultants feature in all this?
As I patient I have always been placed under the care of a Consultant while in hospital.
Why are they not raising merry hell? Or are they? I would have thought they had a vested interest in ensuring their patients were properly cared for. After all, it looks bad on their statistics if patients die through neglect or get HAIs.
Why do they never see their patients lying in blood-stained sheets or in their own urine, or comment that obs have not been taken at the correct times (as the nurses were too busy with an unrealistic workload) etc etc
Consultants don't have the power they used to. Certainly not on my ward anyway.
The power and the decisions no longer rest with the Ward Manager, who are skilled nurses btw. Some people don't realise they are ward sisters but have the title of manager.
The power and decision making lies with Senior Nurses or Directorate Managers who have to answer to the Chief Executive.
Senior Nurses/Directorate Managers are clinically trained but have not worked on a ward in years. Our Senior Nurse is supportive though, Directorate Manager- not so much. They are the ones that work with the budgets.
One thing I will say, hopefully without outing myself, two weeks ago we were so short staffed - 2 Q and 2 HCA's. The wardmanager asked for permission to go to agency for one Q staff. Guess what she was told? Be imaginative with your staff because we are not paying for agency!
That's 4 members of staff for 30 elderly, confused and wandering patients.
The people making these decisions have no idea what it is like to work on a ward these days.
Just read that last post again. I could have shorted it to say that basically, the power and control of staffing levels lies with whoever holds the purse strings.
Not the Consultants, Ward Managers or Nurses.
Thanks Goat. That was interesting to know. No hope of change in the future then
I had a recent stay in NHS hospital and it was bloody fantastic. I had a severe asthma attack and for the first 12 hours was absolutely terrified. I then spent two further days on the ward and all the staff were amazing. So kind and caring
I sent an email to the hospital as I am sure they get plenty of dissatisfied ones!!
I've been very surprised in various hospitals at just how rude some nurses are allowed to be to patients, for no reason, snapping 'Oh grow up' to patients asking for news on their discharge arrangements, for example.
When I had pre-eclampsia just before having my DD, I was in a maternity ward for three days with a 15 year old girl who was terrified and cried a lot of the time, and not a single member of staff ever came to comfort or support her. Obs and tests frequently went undone.
These events were all over 16 years ago. How can it have got worse?!
I've been qualified 20 years and am now a senior manager having been student nurse, staff nurse and a specialist nurse.
The state of our hospitals and especially nursing is shocking.
Just in the last 3 months my father and I have both been patients and the nursing care has been pretty awful.
My father admitted to a surgical ward with renal colic (kidney stones) one of the most painful things there is. I practically had to sleep by his bed for 4 days until he had surgery as the nurses just would NOT give him the painkillers he needed. They wanted him to manage on paracetamol but he needed stronger stuff. The sheer annoyance and irritation at his complaints of pain. "Mr ...... you really should give the paracetamol a chance" to my father curled up in the foetal position barely able to speak from acute pain.
Myself admitted for cellulitis (arm infection) needed IV antibiotics. Nine doses of IV antibiotics and not ONCE did the nurse return to take down my drip. Each time I had to ring my bell or call out after an hour or so after it finished to be met with eye rolling, tutting and sighing. Not one nurse flushed the cannula after taking the drip down (correct procedure). I felt an utter nuisance.
I despair that someone I know and love will need nursing care.
There are too many managers, too much paperwork/audits/meetings, too much cost-cutting.
My dh is a consultant in a busy hospital in a challenging/very busy/economically deprived area.
He is in his late fifties, and is of the generation that worked hundreds of hours unpaid overtime for many years in order to qualify and pass post graduate exams.
He works every week day from 8 am to 8 pm. He brings paperwork home and works till 10 or 11 pm every evening. He is on call every fourth week, meaning he works his usual 12 hour day all week, and then the weekend as well. He goes in to the hospital and sees every one of his patients on Saturday and Sunday. This week he has had 4 emergency calls at around 3 or 4 in the morning.
The European Working time directive does not apply to consultants.
Recently the Trust informed all the consultants that they would not be paid for working past 5pm. They have more recently been informed that they must do a ward round at 8 am every day. Nowadays, consultants do not have their own wards - their patients are scattered all over the hospital. It can take a whole day to do a ward round. Quite how the clinics, operations, teaching the students etc is going to be fitted in is a mystery.
There are no longer enough qualified nurses to accompany the ward round, so communication is compromised.
Junior doctors work far shorter hours then their predecessors. The consultants who are qualifying now have around half the experience of DH's generation.
As has already been said, consultants have very little say in what goes on in terms of patient care. Things will only get worse. NHS Trusts are in so much debt just with the PFI initiative, that there is little chance of more money for nursing staff.
A few years back DH did report a serious drug error made by a nurse. He realised it was probably a combination of staff shortage and delegation of innappropriate tasks, but as the patient could have died, he couldn't ignore it.
He was treated as if he was deliberately undermining/criticising the nursing staff. You can't win.
I thought AtoZ's post above was interesting, as are yours, MrsConsultant.
I think more challenge by consultants of nursing care standards can only be a good thing - at the top as well as in the wards.
PFI - don't get me started.
But consultants can 'challenge' all they like- that won't miraculously conjure up the required number of qualified personnel on a ward, will it? That remark is up there with nursing managers telling coal-face staff who have gone to them saying they are dangerously short-staffed, that they must be 'more imaginative' with their workload management
When a consultant neurosurgeon can be suspended for weeks for allegedly "stealing" a spoonful of croutons from the staff canteen, requiring several life saving operations to be cancelled, you get a rough idea of just how much respect NHS trusts and their chief executives have for consultants.
Most of them are just watching their backs and hoping to retire asap.
I said nursing care standards.
Mrsconsultant- one I know was suspended for taking a paracetamol or similar from the ward drugs for his own headache.
Though the harsh reality remains, consultants could be both the death or the saviour of the NHS...
Linerunner - if the consultant, who is technically responsible for diagnosis, treatment and management of the patient, is unable to express an opinion regarding the nursing care of that patient, I wonder who else can?
All that matters are tick boxes and spread sheets. Cost savings are the most important thing in the current climate, not patient care.
Join the discussion
Registering is free, easy, and means you can join in the discussion, get discounts, win prizes and lots more.Register now
Already registered with Mumsnet? Log in to leave your comment or alternatively, sign in with Facebook or Google.
Please login first.