Are patients not washed any more in hospital?

[Shortkiwi]

I am a nurse of over 40yrs plus. My 93 yr old father has been in hospital for a week. We have visited every day and had to wash and shave him in the afternoon or evening because it hasn’t been done. When I asked if he could be showered one evening, for the next day, I think they showered him but without using soap or shampoo, basically hosed him down from what he reported. His hair was definitely not washed. His teeth have not been cleaned without us doing them. Shaving is definitely not on the agenda. When I was a young nurse it was a given that patients were bathed each day, either in the bathroom or in bed. Teeth/dentures were cleaned and male patients shaved. We were admonished if these things weren’t done. Dad’s ward was very quiet today with several nurses chatting at the nurses station. They were very happy to get us any personal items we didn’t have. I just think if it wasn’t for us he wouldn’t be clean. He actually said, through his dementia, how much better he felt today after we showered him and washed his hair and said it would last him for a while! Which it won’t of course!
We had a list, in the old days, in terms of total patient care, in which we had to tick off items of personal hygiene for every patient in both our theory and practice. I’m sad for those that might not have relatives to attend to personal hygiene these days. It has never been discussed that we would do it, it’s just not been done. Basically, we have had to take the initiative. Years ago there were charts and care plans at the end of the bed, now it’s all computerised. I can excuse the 3 days of hell in A&E but not these last 4 days on the ward. My Dad is not mobile unless he has a lot of help and he is confused.

We used to wash the hair of bed bound patients when I started nursing 30+ years ago. There is a way to do it, I guess the staff have to want to.

Generations Born Current Ages
Gen Z 1997 – 2012 10 – 25
Millennials 1981 – 1996 26 – 41
Gen X 1965 – 1980 42 – 57
Boomers II (a/k/a Generation Jones)* 1955 – 1964 58 – 67
Boomers I* 1946 – 1954 68 – 76
Post War 1928 – 1945 77 – 94
WWII 1922 – 1927 95 – 100

so boomers 1, 1946 to 1954
and boomers 11 1955 to 1964

Dementia care would ease if there was better and prompt diagnosis. Every time I have had a member of staff with dementia or Parkinsons the medical opinions have been too evasive re prognosis to allow people to take ill health early retirement. The same holds true for other severe mh conditions. Once the diagnosis is confirmed the NHS had to start putting clinical and social care in place.

A colleague has a parent with dementia. They have taken walks along the local motorway. It has taken nearly three years to reach a diagnosis. There are drugs available now to slow it down. There could have been a huge difference had they been prescribed three, even two years ago. The NHS does not want to confirm clinical diagnoses lest it has to pay for them. Gastric bands however, no problem. DD has J Cup boobs which are causing issues with her shoulders. No chance of an NHS reduction despite clinical problems which are being caused that will become chronic. She's having them done in the summer. I am paying and happy to. Similarly I have severe osteoporosis - 6 breaks in 6 years- two collapsed vertebrae. I am 62 and still working full time. I am paying for teriparitide because it is optimal and will keep me well longest. £2.5k.

The NHS has lost its ability to think about whether people are helping themselves or not and about the opportunity cost of more care being needed in the future. I do appreciate the gastric band issue but people can reasonably eat sensibly. DD can't chop off her books herself. I can't stop the osteoporosis myself although efficient diagnosis of graves in the late 80s might have helped.

Meanwhile, patients are treated like pieces of meat, spoken to as though they are thick and afforded no dignity. Poor care, poor communication, wasting time have all become normalised.

When I meet a good nurse they are usually my age, and operating at nurse practitioner level. The standards I have seen in outpatients, A&E and occasionally on childrens' wards have been reprehensible although in the two former I have dealt with junior drs and registrars who need a week or three at charm school.

Sibling, in 30s, was in hospital for days seriously ill. Family took in food as when they remembered to feed them it was inedible. They had a wound which had not been part of the reason for admission become badly infected while they were on the ward, as their room was filthy. The wound stank , I have never smelled anything like it. It was 2-3 days before the request for someone from another department to pop down, take a look and actually do something about it was responded to, such as clean and dress it and start antibiotics. Apparently only someone from that department could do anything. The thought seriously occurred to discharge them, present at A&E or the GP's surgery to get the needed treatment, and then worry about re admission. In essence the care being provided was a bed within walking distance for medication to be delivered and drips changed (although this only when they had time to get around to it, nothing like on schedule, often hours and hours past time), and theoretically, under the eye of trained observations as it was a life threatening situation - except there was no one around to do the observing or respond to bells if a crisis did happen.

It was horrific.

I personally hope more choice over continuing life will be available to me should I develop dementia or cancer later in life. I am looking into doing an advanced directive stating I do not want antibiotics for infections should I develop dementia and do not want investigations etc for cancer should I develop this past 80

It isn't bashing to expect that patients are given water and that checks are made to ensure dementia patients are drinking. Or that people are kept clean. Surely that's a pretty basic ask in a hospital? Food, water and cleanliness?

You can do that now. Problem is too few do it. DH and I have one and DD is fully aware of our wishes and has a copy.

@LionsandLambs ive actually found many don’t want treatments etc but get talked into by family despite actually expanding the positives and negatives

Yep this is why people need to start talking about these things with their family at a young age and keep talking.

Yes in an ideal world all of things would be possible, but your ire is misplaced towards the nurses you deem as lazy rather than a system which is fucked. I am sadly realistic rather than uncaring or unkind.

I've worked in the NHS for many years, I have washed hundreds of patients, held their hands as they die, comforted bereaved families, cared for people after their death with dignity and respect, ran myself ragged to ensure patients get the care they need at great detriment to my personal and mental health. Do you not think we would love to have the time to phone families? To be able to answer phones promptly? To be able to do basic care? Of course we would.

These are valid criticisms but people like you who blame the staff without considering why they can't do this isn't helping to make things better.

@Lilibert456 India is definitively not a "third world country" whatever that means. Its a a rapidly developing country with a lot of rich people, a lot of poor people, and as with most places, cutting-edge healthcare available to those who can pay for it. My experience of Indian healthcare was that it was clean, fast, efficient and effective, but more of an expectation that the doctor knows best, don't ask questions just take what you're prescribed. Rather like it used to be in the UK a few generations ago.

The trouble is, you don’t know how you will feel at the time.

My dad had all that. All meticulously planned. Made everyone aware of his wishes.

Then he was diagnosed with colon cancer at 80. He was fit as a fiddle, fitter than someone in their mid 60s (his dementia hadn’t reared its ugly gear yet) the consultant said to operate, he was in perfect health to do so.

His wishes of no treatment went out the window. My youngest at the time was 3, he wanted to live. He was desperate to fight it and afraid to die.

He took the operation and treatments.

He always said he would kill himself if he developed dementia, he saw his sister in law suffer for years.

When that came, he still wanted to live.

I don’t think we can ever say how we will feel when we get there.

So unprofessional

There's not enough staff for a start, but bloody hell how miserable would it be to be stuck in a make shift 'ward'. Delirium amongst other things is a real risk for elderly patients in hospital, somewhere with even less stimulation is going to be awful and cause a lot of deteriations. If there was sufficient investment in staff and the social care sector there would be enough staffed beds. The reality is though the population as it is can't be cared for by the NHS as it is, but no government will have those difficult discussions I doubt.

@Kevinyoutwat and that’s fair enough everyone will feel differently but I work with those patients every day and I categorically
do not want it for myself

H2bow, sorry not having it. 'People like me' are all over this thread and people like you are not getting it.
NHS workers are able to hide behind the 'too busy' smokescreen too easily to excuse poor care. We accept it because to speak up is not the done thing.
There are plenty speaking up on this thread, and a few who just are not listening.

So did I working in care. I don’t want that either or to end up like my dad, he’s trapped in a living hell.

But there is still that small possibility that when the time comes I will feel differently. He was resolute that he wanted to die with dignity and in his terms and it gives me so much pain to see what’s happening to him.

We all need to speak up and complain about poor care.

We are emotionally blackmailed into not.

Search the threads on here about people wanting to sue the NHS, they get absolutely ripped apart.

I got a diagnosis last year and it was absolutely horrific. There was no aftercare. My disease was written on a piece of paper and it was up to me to research it. My only care and management has come from an online support group. I said the same thing last year. If I was a dog, I would be treated better from a vet and their veterinary nurses.

I would encourage anyone who has recieved poor care to report it, it is unacceptable. But what you have posted is about your expectations as family and not about the care of your father and you aren't listening to people saying what the reality of A&E is. If you feel moaning about it will drive progress then up to you, if you want actual change then hopefully you'll be behind striking staff and pressurising the government for pay rises to help attract and retain more staff. To point out the insanity of the current situation, the proposed minimum legal staffing numbers during strike action are more than we sometimes have working on a ward on a standard day. I'm not going to apologise for not seeing the issue with someone being asked to call the ward and having to wait a bit when it means they have been caring for patients in front of them.

What is the training process for nurses these days? I presume they are funding their own qualifications / degree course?

Yes, its £9k a year and although you get a £5k bursary, the placements were you are basically used as an extra pair of hands are unpaid. If you're a mature student you also need evidence of recent study, so have probably spent £££s on an access course. It's very intense and although you can do bank shifts for money, it's hard to do many. There are a few more apprentiship type routes now but you invariably have to start as a HCA, very valuable experience but not everyone can afford to be on just above minimum wage. You can get a maintenance loan but this will come out of your wages.

@PoIIyPandemonium im in Scotland, worked in care since I was 18, as a home carer then in a cottage hospital and now been with DNs for 6 years, I’m doing my training through the OU so seconded for placements then back to my usual job in between all uni work online. Very competitive as fully funded only 5 or so places per health board but all of them usually qualify maybe 1 or 2 won’t finish

Agree