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What are *you* going to do about the poor standard of nursing care in hospitals?

(93 Posts)
tirednurse Wed 28-Sep-11 09:44:38

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,

PeachyWhoCannotType Wed 28-Sep-11 14:27:43

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.

MrPants Wed 28-Sep-11 14:54:36

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?

GrimmaTheNome Wed 28-Sep-11 15:01:25

> 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.

TheGashlycrumbTinies Wed 28-Sep-11 15:09:59

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.

sieglinde Wed 28-Sep-11 15:40:47

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).

CogitoErgoSometimes Wed 28-Sep-11 16:55:54

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.

lemonbalm Wed 28-Sep-11 16:59:50

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.

lemonbalm Wed 28-Sep-11 17:00:23

Sorry, so much death.

nackerednurse Wed 28-Sep-11 17:15:28

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.

tirednurse Wed 28-Sep-11 17:19:16

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.

lemonbalm Wed 28-Sep-11 17:22:52

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.

GrimmaTheNome Wed 28-Sep-11 17:34:15

> 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.

breadandbutterfly Wed 28-Sep-11 17:47:14

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?

TooManyBlossoms Wed 28-Sep-11 18:01:15

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.

tiredgranny Wed 28-Sep-11 20:30:22

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

Sirzy Wed 28-Sep-11 20:38:28

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!!

nackerednurse Wed 28-Sep-11 22:01:33

The modern matrons at my trust spend ALL their time in meetings, collecting audit data, costing services etc.

badnurse Thu 29-Sep-11 00:32:49

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.

nackerednurse Thu 29-Sep-11 19:51:16

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.sad

missymarmite Fri 30-Sep-11 00:12:44

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?

nackerednurse Fri 30-Sep-11 08:01:19

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.

nackerednurse Fri 30-Sep-11 08:07:14

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.

ggirl Fri 30-Sep-11 08:54:59

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 .

Jinx1906 Mon 03-Oct-11 10:03:42

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...

Bramshott Mon 03-Oct-11 10:21:01

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?

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