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.

They didn't think something was amiss with LL though, many she worked with remained friends with her and they went out together, I'm sure if they felt silenced at work they wouldn't feel obliged to socialise outside of work if they felt she was killing babies. A doctor highlighted a correlation and she was put on desk duties far away from patients whilst they investigated.

I'm not saying standards are aspirational at the moment, but being able to keep someone alive will always take priority over small things yes, and that's the reality at the moment. Its why so many are leaving in part as they can't provide the level of care they want to and its upsetting and dangerous.

Of course people work for money, who the fuck doesn't. Your post shows a great deal of ignorance into the level of knowledge required these days for nurses and medics (and other HCPs). Yes of empathy is important but if that's going to be your main criteria at expense of actual training then quite frankly speechless. The level of autonomy I had as even a newly qualified midwife was actually quite scary in hindsight- without a degree/formal training programme goodness knows how many women and their babies would have fared.

and not the earliest point your can clock off and go for a beer.

And also why shouldn't healthcare staff leave when their shift finishes?

No one is denying it happens. There's good and bad in every profession sadly..
People, including me, are saying they haven't experienced it as they actually care about their patients and do their utmost best to make their stay as pleasant as possible.

No one is saying its okay though, just highlighting the reality that it's not down to being lazy and they just can't be arsed. Perhaps then people would put the energy they have towards them lazy NHS slaves into pressuring the government into doing something- something worthwhile.

There was a big recruitment drive during Covid and from what I heard interviewers were told to employ anyone, even ones who would normally be rejected. The result of this is a load of staff that are lazy gits and do the bare minimum they can get away with, not prepared to work and that adds more onto those on shift with them. I for one am sick to death of carrying people, picking up others slack.

And yes I do complain about it, staff have been banned from taking shifts on my ward because they won't do the job properly.

Yes this, and it happened in the police force too. Far too many were rushed through and now look at the state of things today - and serial rapists operating for 17 years in what appears to be full view. 800 further police officers are being investigated for more than a thousand offences between them.

I am not suggesting nursing or any care work is above the normal mistakes of other professions. I am not suggesting for one minute it is an effortless job - or that it doesn't take biblical amounts of energy and empathy when totally overstretched 90% of the time. Of course there are many professionals that are operating to very high standards and the patient in mind, but this is becoming less of the norm and more the exception. The worse things get, the more likely we will lose the best nurses, conversely, because good care always starts with self care.

I am saying what we have now is not even reaching basic standards any longer, not because of 'lazy nurses' or incompetence - but because for far too long we have taken the profession for granted. There has not been enough investment and care - nowhere near enough investment in salaries and packages to attract and retain the best people, and what we have now is a worn out, unmotivated, exhausted work force in a creaking system that is failing everyone, and some people are dying because of it. In spite of all the goodwill and intentions people are left lying in vomit, urine and their own stools. Unwashed for weeks. Hygiene is seen as 'luxury' rather than a cast iron necessity and a very important line of defence against serious infection.

The NHS is collapsing as we speak, and the unwashed neglected patients are just one side of it, and probably in the scheme of things the least of it.

But somehow from a patient's point of view, even if I have been failed repeatedly at various stages during my care, and I am still alive, being clean is the only thing I have left. I can deal with pain, I can deal with being hungry, I can deal with my surgery going wrong and too much medication. I can not sit in my own squalor for days or weeks on end, for so many people THAT is the one thing that will break them.

I had a job within supported living before I did my training it was amazing. We got to go the cinema and cook meals, help them with their independent living skills. I regularly worked over time as it didn't feel like work . I felt I was making a difference . I did my training to earn more money and have a bit more autonomy over how services are run. If I didnt need money I'd go back to supported living in a heart beat. I've always passionately cared about patients , the sad fact is there isn't enough staff and people are much sicker. Many wouldn't bother training if it's not for the financial rewards. Same for any other job.

@Swissmountains I'm sorry but the suggestion that patients are left unwashed for weeks is clearly ludicrous.
I'm not minimising the poor care people are posting about but for once let's have a thread about decent care and the 'NHS saved my life'.

If you have 40 patients 3 are really poorly and you have 2 nurses and 2 HCAs , your time will be disproportionately taken up by the poorliest. You will have to administer meds , repeat OBS , bloods, paperwork . Keeping someone alive is more important than personal care it absolutely should be done , but the staffing pressures are immense. 40 patients many will need hoisting , toileting turns , dysphagia full assistance with feeding. It's not possible to give the best or even ok care with 4 members of staff to do everything at once for 40 people.

There should be legal minimum safe staffing brought in with legislation for ratios.

@Swissmountains you were left for hours on the floor in an NHS ward ?

Problem with these threads is that posters who describe incidences of abysmal care are unconditionally believed and commiserated with.
Nurses who apologise for said care but defend their own practice and that of colleagues are 'closing ranks'...I don't really know what @Swissmountains wants us to do. We report poor practice, we fail student nurses who are not meeting their competencies, we have safety huddles every shift, we revalidate every 3 years and have to provide evidence from 5 service users that we are competent compassionate professionals.

Are you insinuating that the long long list of posts on this thread reporting exactly that are all lying?

If so, you are in denial about the true reality for thousands and thousands of patients.

I see who you are.
Another one blaming the patients.

And I am not expecting you personally namechange unless you are deliberating ignoring or neglecting patients (no one has actually admitted to that so far on here) to change anything.

We are simply sharing our experiences, our heart break and our call for something to change fundamentally within the NHS. We simply can not go on as we are.

You can call it lying or misleading or whatever about our posts, and our dying parents and all the things that are happening right now on the wards, but I am going to turn this around and ask YOU why are you lying?

Are you delivering high standards of care every day, does every patient get washed, changed, fed properly and looked after?
If so, where on earth is this NHS hospital that we can all rush to for proper care?

Your defensive posted can be filed with all the others, but no one is blaming every nurse, but the culture has become toxic, and the inability to see and understand what we are saying is part of the problem.

I do but it's not NHS 8 patients 8 HCAs and 3 nurses on shift. Everyone is well looked after personal care attended too. Personal care isn't rushed neither are meals/feeding. All patients are on 1:1 observations it would cost a fortune but I'd love NHS wards to be more like mine.

I know your post isn't directed at me, but I can guarantee you when I'm on shift every patient, yes every single one, gets washed, dressed, oral care and fed properly. It's the least I can do for them.

I am so glad to read some patients are still being washed. I really am, and thank you for caring about your job and the people you care for.

I know it is not easy at the moment, and lord knows you deserve a pay rise and some (even if I don't agree with the other strikes) I hope your profession will continue to be prioritised in the future.

It was not my experience always, to have good care, as you know, but I had very good experiences as a child and young adult for my long stints in hospital and try to hold on to those memories and remember there are good eggs out ther.
I hope once things have settled down after a long pandemic, and the flu etc rates fade we will be able to move on to something better, but I fear we simply can not sustain the level of care in the long run with so many ageing pensioners and the population as a whole, as it stands. I am not PM and it is not my issue to solve. Hopefully someone more informed than me can put together a plan for the future that works for everyone in the NHS, especially the patients.

As a good friend of mine who works as a medic in our local A&E said the NHS would work perfectly if it were not for the pesky patients. He always says that over a drink and for some reason it always makes me laugh. The stuff he puts up with, no wonder he feels like he does.

My mother and father were both in hospital last year. They were both washed every day and had sheets changed every day. They were in different hospitals and especially in one hospital the care was outstanding. A friend was also in hospital and I visited her every day. She could wash herself but also had her sheets changed every day.
Three different hospitals and all got good care.
Care tends to be not as good in A and E side wards and admission wards because they are not proper wards and people are supposed to be in there very temporarily. But at the moment are sometimes there longer than they should be.

@Swissmountains nurses are sharing their experiences too. Is that not
important ?
And yes all my patients get washed, pressure area care etc but then I work in an area which has one to one/two nursing. Put me in an environment with a worse unsafe ratio then I would struggle.
Numerous nurses have posted on here explaining why care is sub optimal. Maybe listen to them. But no it's easier to think we spend most of our shift chatting at the nurses station, ignoring call bells, mocking patients, laughing and joking, that's the real reason care is so bad....
You really cannot have been on MN long if you thought nurses were universally liked and admired here. If only..

Just want to point out that DLA and carers allowance for people were stopped if they were in hospital for more than 28 days because it was deemed that the NHS would be doing the caring not the carer.

I have been on here for decades, but I don't like getting involved in bun fights and arguments so few of us have any power to change, so no, I have not read any bashing threads about nurses, mostly I have read glowing threads of how amazing the NHS has coped over covid etc. Most people moaned about the teachers and how they were gardening and sunbathing instead of teaching...so I don't know the history.

I care about the nurses experiences too, and I have acknowledged every single point they have made over the course of this thread. To be completely fair about this, the nurses are not lying in the own vomit and urine, relying on someone else to help - they are in the stronger position out of the two. They have the option to leave, a patient doesn't, and therefore there is a power imbalance that exists.

Some nurses do mock, are rude, dismissive, negligent and are checking their phones rather than helping patients - yes. Too many of them. That is not to say there are not a great number of nurses working their socks off to care for patients properly. What we are talking about on here is a lack of washing and basic care. If you want to start a thread about nurses conditions please go ahead, but this thread is about the unwashed patients that have had a lack of basic care and their experiences.

@Swissmountains I'm sorry but I just cannot understand why you correlate degree educated nurses with the failure to provide compassionate care. The entire world holds registered nurses at graduate level and allows us to become accountable professionals legally and professionally responsible for the care we are providing registered under a professional body (NMC). Nursing has vastly changed in the past 40 years and the level of complexity requires critical thinking a much higher level. I work admitting acutely unwell patients and I cannot imagine being able to provide intermediate life support in a cardiac arrest situation with a high school level education, we decide what concentration of morphine or insulin needed is going into the syringes we are making up, what antibiotics are compatible, one mathematical mistake and that person is dead. And thats just on a ward level ceiling of care, critical care is a whole other level, nurses are the ones operating ventilators, titrating pressors to keep someones blood pressure just high enough to perfuse their organs but not so high that they stroke out, they look after ECMO and dialysis - one tiny mistake or loss of concerntration and their patient is dead.

Nurses who haven't nursed in years who say "oh back in my day the care was better because these new nurses are too posh to wash" simply do not understand the role of a registered nurse in 2023 and it does not help the publics perception and for the majority of times it is completely untrue. We have to do 2300 clinical hours as part of our training and a vast chunk of that is personal care. I feel so passionate about washing my patients because there is no other acitivy I can assess their mood, cognition, mobility, skin, temperature, oral health, nutrition in such a quick time.

The NHS is crumbling and the refusal of the government to put mandated nurse to patient ratios is part of this. Reasearch in the US has shown that every patient above ratio is 7% more likely to die. The toxic and bullying culture of NHS whistle-blowers throughout the years is part of this. Staff and patients should be able to escalate concerns without retribution. The complete inefficiency of management in the NHS is part of this...my last trust only 14% of staff had an annual appraisal, how can you possibly get rid of lazy incompetent staff if you have no record showing that they are lazy and incompetent? No other sector would get away with that.
I am first to call out poor practice, first to the nurse concerned and then I escalate as required. I am disgusted with the care provided in the NHS at present, corridor nursing is the most undignified, unsafe practice and I come home crying most shifts having had to nurse extra patients in unsuitable areas. But if every hospital is over capacity in the next 30 miles they can't just close the doors, we need to keep accepting.

This thread has been horrible to read the failures of care, so much of it so unacceptable and should never have happened and has left so many with ongoing trauma. I hope that none of my patients have ever experienced this at my hands. At times I have to make impossible decisions, ie a skin check for one patient could go an hour overdue while I make up and administer multiple IV antibiotics, catheterise, begin non invasive ventilation, continually monitor vital signs, take multiple emergency blood samples and obtain IV access, do an ECG for someone who has become unwell because immediate threat to life will always be at the top of my priority list.

@Beseen22 very interesting post.

In the excellent ward I was on recently, nurses did no hands on washing or bed changing, the entire thing was run by lots of HCAs with one or two nurses responsible for several wards, doing the medications and more complex medical tasks. So, it's not a 'too posh to wash' situation, because that's not the job of the nurses.

What should be the nurses job IMO is to have an overseer of the HCAs on the ward, like a Matron or nurse manager, so that the right tone is set from the start, and expectations of standards is transmitted to everyone. I've noticed, having also worked with different GP practices over the years, that culture is everything, so you will have one GP's practice where they are empathic and lovely to their patients, and one where they are dismissive, rude and even neglectful in operationalizing care, and they are funded under the same rules. It's about everyone being on board with the tasks, and setting standards for everyone to follow. I do think though that a laugh and a joke are necessary to HCAs; it's a gruelling and tiring and at times quite grim job and so being able to have an upbeat positive environment is a good thing, whereas laughing at individual patients or rolling eyes isn't ok. I could tell the HCAs on the ward where I was felt part of a team, and that's so important for morale. I don't know if it is significant, but many came from other countries and hadn't trained in the UK, judging by the accents and chat (many chatted with patients about going home to their home countries, for example).

I completely agree with so many if not all of your points.

The nurses' role has changed beyond all recognition, and many do more of a doctor's job and many people, myself included, we don't know much about it and conflate that all care (inc HCP) is done by the nurse, and who can tell the difference if you don't know how the uniforms work etc. They assume that a nurse will be caring for them, because that is what used to happen. HCAs were not nurses, and nurses were nurses caring for patients and beyond a few minor recordings their job was to look after the patient. Does a person need a degree to be a HCP? I am simply pointing out that more than academic ability surely the most important skill in this industry is to care and connect with people?

I agree we should have better ratios, and it is not a mere goal rather than an every day reality, the care would be improved over night. The gov might say that there aren't the nurses available, well then they need to make nursing an attractive degree and pay an outstanding salary and career advancements. You can't run decent health care on a shoestring.

As you say about it is about training, monitoring and having the wards run effectively with proper assessments made carefully and maintained over time to weed out those that should be working with patients.

Then we come back down to does this model even work now? Can it ever work with the population as it is? I don't know the answer. I suspect we are going to find out very soon though.