How much 'caring' do nurses actually do nowadays?

[SLawsonB]

In a hospital ward and A&E etc

Because I have had the displeasure of being admitted twice in 2 months and noticed no caring at all from nurses

They were too busy with notes, ward round help, medication rounds, checking people over to assess them a lot

No bed changing or bed baths. Didn't help anyone with toileting at all, from what I saw

Is this usually the case now and it's all just down to HCAs?

Not a dig at nurses. I saw for myself that they were quite literally running from one task to the next

For someone who's not in the know though, it very much felt like being nursed was from the HCA ladies

I am interested in the job, a lot. But I wonder how accurate HCA work is to really get a feel for it - Because they're too different now and nurses pins are assumably at stake if they mess up etc? So the pressure is different

Also, all obs done by HCA staff

Not a nurse in sight for that.

Does my local hospital just have a particularly high ratio of HCA staff to fill the gaps?

Nurses are now graduate medical professionals. Personal care etc is now the role of HCAs. We have a shortage of nurses as it is. If they were doing personal care as well as what is actually now their job, we'd need multiples if the nurses we have now.

Very little , it’s been like it for many years , it’s not new . I stopped nursing nearly 10 yrs ago and even then , as a registered nurse , the only time I did much hands on patient care was on a night shift . It had really changed from the mid 80s when I started my training and when nurses were actually trained to nurse .

They have been graduates with degrees for years now though?

Anyone training to be a nurse is degree qualified. Even the apprenticeship route and leap from nursing associate to nurse etc

Still at uni for nursing associate qualification alongside working from what I see advertised at my local Trust

I'm aware nurses have been degree educated for a long while now due to outcomes being better for patients if a nurse has a degree

But does this push more advanced skills onto Band 5 nurses as a result?

My Mum has had extensive hospital stays and many admissions, generally most care is given by health care assistants. If a nurse isn’t already busy, tends to be over night, then they answer calls buttons to help with toileting. Nursing has moved on a lot over the last 30 years and they do lots of tasks now which didn’t exist before or were done by someone else.

Nursing is not what it was 40 years ago. It’s much more technical, dynamic, demanding and complex.

Basic care is done by HCAs and nurses do a lot of the stuff house officers used to do.

@Sidge thank you, is a HO the same thing as an F1?

Yes I believe so. FY1.

To be honest everyone’s roles have changed so much. Nursing and medicine is a totally different landscape and has been for some years.

They are. And that's when the change happened. My DD became a nurse at around the same time that the shift happened.
When she decided to be a nurse everyone who knew her said how great she'd be because she's so caring. But she spends most of her time in her ward office trying to juggle staffing, meds, doctors needs, and where patients should be and when (a surgical ward).

I think there has definitely been a shift over the years. I used to be a ‘shop floor’ nurse and during that time I used to provide personal care, do the cv observations as well as doing the things that only a qualified staff member can do, medication rounds, Iv’s, managing acutely ill patients, ward rounds etc. Basically I mucked in with the other staff to get the work done. Now, there are less qualified staff and hcas are up-skilling to take on extended roles ( it’s a positive if staff are able to progress as it increases job satisfaction and improves retention). Plus the demands on the nhs now mean that a blurring of traditional boundaries is necessary for it to continue to function. It isn’t really possible for qualified nurses to do ‘everything’ , there are too many demands on their time and delegating (safely) is actually a key leadership skill . But as a qualified nurse, you should always know what is happening with your allocated patients, what their obs are like, fluid and dietary intake, treatment plan etc - regardless of who is carrying out the actual ‘ task’.

In my recent experience I can safely say that no one does any care in hospital at the moment.

Vulnerable people with high support needs left to their own devices or for visitors to look after.

Basic information not being handed over, putting patients at risk.

Makes me so sad that the NHS is like this now.

I was a nurse in a nursing home and some days on a 12 hour shift the only time I would see residents was to give them tablets. It was all medication rounds which took forever, care plans and sorting out staffing issues/ supervisions/ appraisals. I was actually told by my manger not to help the support workers and to concentrate on paperwork. I don't miss it!

I’ve just been to a uni open day for nursing and we were told that hca are the equivalent to a nurse approx 40 years ago and a modern day nurse was trained to the same standard as a junior doctor 40 years ago.

What are the education and training/assessment requirements for HCA’s?

Nurses are very caring but the personal care like washes is fine by HCAs. Nurses have a more complex role of all iv infusions , overseeing the HCAs , some management decisions, dressings, development into specialist roles, staff management etc

In mental health nursing the only tools we have are ourselves , and we care enormously.

Our work is literally to the detriment of our own physical and mental health .

Box ticking for the most part. Nursing a computer. If you haven’t ticked the box, you haven’t done it.

Should we be training hca as we used to train nurses then? And value it as a caring role?

Good post OP. I've been in hospital a few times over the last few years. On surgical wards most nurses seem to spend large amounts of time around the nurses station. They don't appear to be doing much. Urine bottles go unemployed, dressings not renewed. The whole NHS seems designed to fit the people who work there, not for the patients

@ScierraDoll your experience maybe. Most shifts I’m on I don’t stop. That and the endless paperwork/computer stuff.

ICU is very nursing care focused.
we get to do bed baths, assess skin from head to toe, do dressings and wound assessments.
Review and administer medications, we give 100% on a very intensive level.

It is however now a luxury to go home and know that I have done everything I possibly can to ensure that my patients are well cared for, pain free, warm, safe, clean, fed and hydrated. This is sadly not true for most of my burned out and frustrated (wonderful) ward colleagues.
I feel deeply for them.

It’s not all that wonderful though as we are regularly moved to the wards where staffing is dangerous. So we have insights into how it is. The result of these frequent moves is of course, many many colleagues are leaving, sometimes leaving the nursing Profession completely.

@statetrooperstacey · Today 00:04

I’ve just been to a uni open day for nursing and we were told that hca are the equivalent to a nurse approx 40 years ago and a modern day nurse was trained to the same standard as a junior doctor 40 years ago.

40 years ago nurses training was a three year course with regular exams and finals which they had to pass to be admitted to the Professional Register.
What 3 year course and exams do HCAs do now to give them equal knowledge ?

Granted, nursing is more complex now and most nurses have mountains of paperwork and admin to complete which they didn’t have years ago.
Not to mention drug rounds, making up IV meds ( only doctors were allowed to do this previously) ward rounds, updating relatives on the phone or in person, speaking to other medical professionals re patient care , complex discharges ( could spend half a shift on the phone).Add to this, having to sort out staffing shortages and having to deal with “ patient flow”
So patients are in their rooms and hardly see a nurse and think it’s because “ it’s quiet “🤣

And while at the desk trying to sort all this out, you get the random visitor walking by and seeing you just as you take a moment to chat to your colleague ( god forbid if you happen to have a cuppa handy because you didn’t get your break ) and they think you’re just sat at the desk doing fuck all !

Nurses are also reminded : “ If it’s not down on paper, it didn’t happen”

"The whole NHS seems designed to fit the people who work there, not for the patients"

This is the most ill informed and quite frankly laughable statement I will probably read all year.

If only you knew.

Registered nurses are graduates with important qualifications for delivering medical nursing, I'm glad they aren't spending their time on personal hygiene tasks that are rightly the job of HCAs with minimal qualifications. There's far too much actual nursing work needing to be done on each ward for nurses to do HCA tasks. Keeping the notes updated and making sure all medication is accurately dispensed isn't trivial and you seem to be categorising this as "not real nursing". Nurses will also do the more skilled and complex practical tasks like changing wound dressings and maintaining the function and hygiene of cannula lines etc. I think maybe your idea of what a nurse's job is aligns more closely with an HCA role and you just need a vocabulary shift.