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.

RosesAndHellebores if the working conditions are so great why is there a shortage of workers in hospitals? They can’t recruit enough staff despite going and begging to developing countries for staff. As for the sick pay, whilst you could have potentially a long time off, what you can’t have is a few incidents of minor sickness despite working with many horrible infectious diseases. You always come on these threads to criticise all nurses: health care workers based on a few of you anecdotes.

Yes higher salaries - with a good standard of living achieved
Well rested nurses that don't need to work ridiculous hours to cover a lack of staff
Support and care packages to help with their training
Incentives to train in the first place, incentives to stay with the NHS

It is not hard, we just need the will to do it as a country.

If the nurses feel cared for and supported, they will be able to do the same for the patients.

I've been nursing 32 years, although not on the wards for many years now. I was an in patient twice recently and horrified at some of the changes. Granted, they were busy. As we always were. But what happened to the old 'back rounds' where two nurses went from bed to bed of the whole ward with a trolley once or twice a shift? Toileting people, turns, fresh water etc etc. Each patient just given the once over.

Nursing stopped being about care and more about meeting medical needs when it became a degree entry post.

HCAs are now what used to be considered nurses and nurses are like junior doctors

@OrlandointheWilderness I hear what you say but suspect some of that module relates to death, expected and unexpected and what's witnessed in the job from a tragic perspective circumstance. You know, leg ripped off in a car accident; face destroyed by an abusive partner on the end of a hammer. Those are atrocious things to have to deal with and perhaps the "attitude" in relation to those just having a heart attack or broken hip is explained by it But the system isn't working.

I wonder how the wages of lower ranks in the army compare? The problem is that nursing as it traditionally existed and that is essential has been removed from the day job of the degree nurse. I remember the halcyon days of sen and srn - the former doing the more practical stuff. I am not wholly persuaded that "nursing" and the definition of nursing requires a degree. Sadly many HCAs do what SENs used to do without the dignity of the title.

@RosesAndHellebores actually very little of that module was concerned with traumatic events, the majority deals with the day to day strains.
Actually I do agree with you in that I don't think nursing should be a degree role.

I wonder how the wages of lower ranks in the army compare?

But it's not overly comparable is it? Private roles in the army do not require a degree (aside from a few which pay a higher wage on passing out)- someone who leaves school with minimal qualifications can go on to earn a very decent wage in the military. They also get very heavily subsidied accommodation (either in the block or on the patch), extras like away from home and get you home pay, an annual training allowance amongst other things. In what way is a junior rank role related to a career that requires a degree anyway?

@H2bow I sort of agree but the army doesn't necessary provide skills for work for life although I think it does equip people for hard work and getting on with it.

The big difference is that you don't hear soldiers complaining when they have to go to war. Nurses, however, who are trained to deal with disease, never stopped complaining during covid. A comparator would be kit provided for the Falklands war which was not adequate.

The difference there was he still had capacity to make his own decisions. The advanced care directive comes into play when you no longer have that capacity.

@cptartapp they still have them. At our trust we have rounding sheets that you tick off as you go round checking on patients.
Patients on the wards are very different from 15 years ago. More complex, sicker, comparable to HDU ones back in the day. That's why we have EWS to identify the poorliest. That's also why we have outreach nurses from crit care who step in to help. One seriously ill deteriorating patient may require one to one nursing whilst the other 7 just have 1 HCA doing the cares. Add to that the medics not being available can make it a very stressful situation.

It depends what trade, infantry etc aren't going to be overly transferable, but you get learning credits and time to do courses once you've put notice in to leave, many get forklift licenses etc- not overly exotic but useful. If you join the signals for example you can get a lot of very useful experience and one issue is lots leave after a few years because they can earn a lot of money in the private sector with the stuff they've learnt and experienced. If you join the right trade you can set yourself up really well, many people get funded degrees as well during their careers.

Haha if you think soldiers don't complain about going on exercise, being duty, general crap that comes with it, deployed then I'd be interested how many you've met. The reason you don't hear about it as they aren't permitted to join a union and depending on role and clearance can't speak publicly about stuff really. Yes ineffective kit is outrageous, I don't feel like anyone just accepted it though or that the public would be like ah thats fine. The vehicles in afghan that were woefully unfit for purpose (dangerously so) were switched out quickly as a priority. And rightly so.

We weren't equipped or adequately prepared for a pandemic, I am glad nurses spoke out and complained about conditions, it was an absolute shit show and we lost many staff, many of which will have been due to lack of equipment and resources, it's sad. There is a world of difference between doing your job and putting yourself at risk to do it because the government hadn't prepped despite being warned for many years about it.

I think, unpopular view though it may be, is that something significant has been lost with the overfamiliarity and informality. If a nurse addresses a patient as Joan and their consultant as Dr, Mr or Ms Bloggs it indicates the patient is a subordinate stakeholder and respect for the patient is negated.

It is atrocious in the context of equality. Why would any nurse address a patient as though they meant less than a Dr.

The Dr/nurse relationship is a whole other ball game but I wouldn’t address another human with more respect than they afforded me. I think it's at the heart of much that is wrong with the NHS.

My grandmother called her family Dr, "Draper". Never, ever would he have dared to have called her Marina. The difference- money changed hands for the formative years of their relationship. Money still passes hands, albeit not directly. The subordination and expectation of gratefulness exists in no other professional relationship. What prevails in the NHS is actually alarming from an equality perspective

If ever I am at my most vulnerable I expect to be addressed as Mrs Hellebores by those who afford another stakeholder respect. I certainly never expect to be addressed as "love", darlin, sweetheart, etc. I think many in the NHS need a module about basic manners.

The government or NHS England @H2bow Remeber that chap Sir Simon Stephens who was more or less invisible.

As I am sure you know unions spin in accordance with their political ethos rather than what is right for their members or other stakeholders. It isn't always edifying.

When I was in hospital the only time the nurses worked at any pace was when the consultants were round. The rest of the time they were chatting at the nurses station. I remember one consultant getting cross that they weren't bothering to wash patients.

Sadly with nearly full employment, the calibre of nurses may be low, due to other better paid careers being available.

I was talking to the people who said they would refuse cancer treatment etc after a certain age. He always said he wanted to do that, he was adamant that’s what he would do. then when faced with it, changed his mind.

Nothing to do with lacking capacity in that situation.

Now that he does lack capacity, he has a DNR and palliative care only plan which his dr asked my permission for. Which I said yes to. But I know it’s not what he would want now. In the last few years he made me promise that I would make them resuscitate. It wouldn’t be in his best interest at his age and with dementia. But he thinks it’s like the films - your heart stops beating, a dr restarts it and you jump out of bed and have a second chance of life completely healthy and unscathed.

I completely agree, it feels patronising, although I think the intention is to be friendly.

@Swissmountains it's all a bit pass ag though isn't it? And if one dares to invite a little equality one receives the carefully curated NHS eyeroll. How long is the module for that I wonder?

@Kevinyoutwat I have cared for older people and younger people with life limiting illnesses. Nearly all change their minds about what level of incapacity they would want to live with in future, when they actually get there.

@PoloAllsort 😂

Can't say in the 15 years of nursing I have ever called anyone love, darling or sweetheart or any other pet names.
That is covered in communication.
It's good manners to ask what the person would like to be called. Most patients ask to be called by a first name (which could be middle name or other random name they have been called in life which isn't on official documentation)
Only 1-2 people have asked to be called by Mr or Mrs surname.
A lot of patients are nervous around doctors and like a nurse to be a go between and want a real chat with someone on their level about their care plan and what the doctor has said.
What I don't like is when hospital trusts wanted everyone's full name on their 'hello my name is' badges and I covered mine up.
My surname isn't very common, we had a lot of people who are well known to the police and my dad was a police officer. Hell no I don't want everyone to know my surname.

This is hugely offensive , there has not been a pandemic in living memory so no I don't think HCPs were expecting one. A very dear colleague sadly lost their life. How to manage a pandemic isn't really taught as part of the curriculum many mucked through. I could have easily quit my job my DH earns 6 figures and sat on my arse , I didn't I went to work and worked through it.

@RosesAndHellebores you have no idea what traumatic things I have witnessed or dealt with as a nurse.... no idea! Nursing your colleagues as they die is one of them!
You also cannot compare and you know nothing about what soldiers go through either... nor do you want to.... the stories I have heard from my colleagues who are army nurses,NHS nurses and what I have gone through myself are all traumatic...as well as what my dad has dealt with as a police officer. You just a cannot compare!

Survival instinct is strong.

My gran was in with a broken ankle 6 years ago and wasn't washed once. I visited every single day so I could wash her. She had been in a week when I noticed she hadn't had her hair washed.

My mum was in a cottage hospital in Northumberland during Covid. I could only visit once as I'm hundreds of miles
away. I have to say she received excellent persona care. They showered her, cut and styled her hair and she was given snacks and fluids every hour. They really nursed her back to a better state than she was in before.
I realise this is the exception and my poor dad did not receive this level of care in the weeks before he died.