To think the nurses shouldn't keep telling my uncle that my dying grandma is sitting up in bed and eating?

[deaconblue]

My grandma is 88 and has been in hospital with a chest infection. My mum and 2 brothers were told yesterday she probably only has 48 hours to live. My other uncle lives further away and has been ringing to check on her. Yesterday he was told her SATS were much improved (they are significantly worse) and this morning he was told she was sitting up in bed, having eaten a good breakfast (not true, she can't sit up and hasn't eaten for 4 days)
If staff do not know the answer to a relative's question why on earth do they not go and find out an accurate answer? He had decided not to make the 2 hour trip today because of what he was told this morning and now may not make it before she dies.

POFAKKEDD - no one is saying that. What was said was that staffing levels in geriatric/medical/surgical wards are woefully inadequate for the amount of patients/conditions they have.

The two things are totally different.

Maybe one of the MN campaigns should be a legal ratio of RN's to patients on general wards?

Australia has a legal ratio of 1RN to 5 patients on their wards. Compare that to the average NHS hospital ward 1RN to 16 patients.

POFAKKEDDthechair, I wasn't looking for sympathy, I was trying to show the totally unreasonable levels of stress and the unreasonable expectations of the general public in relation to nurses.
As a relative who has seen all this woeful lack of care directed towards the elderly in the NHS what have you done about it?

Although I am not working in the NHS anymore I still actively campaign for better conditions for patients and staff and for improved nurse patient ratios something that has been proven to better the level of care.

I?ve seen all the sides, I was a nurse for nearly 20 years, and I?ve had a parent die that had multiple hospital admissions and have recently been a patient.
I?ve seen the level of qualified nurse staffing fall as money and resources are diverted from elderly care to the more ?glamorous? areas. The pot of money is finite if a hospital has a budget of 100 million and the local paper run a ?exposé? of how the children?s ward is going to lose beds I am happy to bet any money that suddenly the cash to maintain those beds will be found and where will it be drained from? Guess! (before any one starts jumping on me in support of better hospital care for children, I?m not against it, it is just a fact of life that closure of children?s beds will arouse more public anger that a decrease in care for the elderly)

You would be hard pressed to find any nurse that has worked in general care i.e.: A&E, medical wards surgical wards, elderly care out patients, which has not experienced both physical and verbal abuse. The situation that I described isn?t even on my 10 list, it just happened to be one of the final straws.

Not directly related to an OP, but a lady I used to work with was rung up by the police and told that her 17 year old son had been killed in a road accident[shocked]. They didn't even check that she had anyone with her. Fortunately she did, and he took the phone from her and got the details about where her son was and then drove her there :(:(.

Don't know if this has been said before as haven't read whole thread, and don't wish to seem disrespectful in any way at this sad time for you OP, but it's often the way that they get better before they go, and I say that as someone who is not in any way blinkered to the shortcomings of the care system.

My nanny recovered to the point that when we left her in hospital one night, there was even talk of her being well enough to come home and have care. The next morning we had the call to say she'd passed away in her sleep.

Agree with Kitta. On general wards the Nurses have to make a lot of tough decisions about who will get care.

Our small ITU often has 10 staff on duty to 8 beds. But even if they had 6 Nurses to 8 beds they would still be better equipped to cope and know their patients than a general ward Nurse.

If anyone wants to understand even more about what is going on may I suggest militant medical nurse's blog? Google it.

Pofakkedthechair,

The mix geriatric patients in with acutely ill medical patients these days on general medical wards. These wards get starved of staffing, resources etc. It is no wonder the care is terrible.

I am 100% sure that if you were in the shoes of one of those RN's you would do no better. There is no way you would get to all of the people you are responsible for, even on a 12 hour shift with no break. The amount of time spent on paperwork, phone calls etc that you would have to deal with tin order to get life saving drugs etc for your sickest patients would ensure that your little medically stable 101 year old in the corner would be left to her own devices. You have to constantly prioritize.

Oh here is that link. militantmedicalnurse.blogspot.com/2010/07/nurse-annes-information-pamphlet-for.html

Agedknees my general medical ward is getting up to one nurse to 16 patients. Anything more than 1 to 4 increases mortality rates on a general floor.

and there is a recruitment freeze.

And what does the NMC do about it Loves. And the RCN. Nothing.

Its not that nurses want to neglect people, just that there is only so much one person can do.

On an aircraft there has to be a number of flight attendants due to safety.

The same thing should happen on hospital wards.

My mum was put on a general medical ward when she was repatriated from India with multiple fractures of the pelvis (had been pinned before she was moved) and head injuries.

She didn't know (becasue of her head injury) she couldn't and shouldn't get out of bed - but the ward staff wouldn't or couldn't put up her bed bars becasue "that would infringe her liberty"

After she broke her jaw in a fall having tried to go to the toilet herself, they moved her to be a bed they could see from the nurses' station :(

The day after her case was raised in the local paper, a space suddenly came up in the specialist unit

To be fair on my dad (who, as a medic himself), had gone to the paper in desparation, not at the care she was getting in the ward, where he recognised that the nurses were doing their best but were not geared up for -or trained to deal with - someone with a head injury - but out of frutstration at how poorly the transfer from India had been managed - and the contrast with the excellent care she had got in India (albeit at a cost - covered by insurance)

The NMC doesn't do anything. I phoned them to tell them that I was left as the sole RN for 25 patients ranging from confused elderly falling out of bed to acute stepdowns from ITU. They told me that I should get a new job if my current one is dangerous because if anything happens I will be investigated.

I asked them if they were aware of the nurse recruitment freezes that have been happening for years. There are no jobs for nurses in the NHS in my old trust area. New grads can't find jobs. The wards are appallingly short staffed and the trusts are losing more Nurses through natural wastage but not replacing those of us who quit.

They only people they do hire are very young and inexperienced people who have no nurse training and really cannot do anything. This makes it look like the ward is well staffed to the public. But we all know that even if you have 100 ward assistants the ward is short staffed without enough RN's.

The NMC and RCN for whatever reason are refusing to go after the NHS for intentional short staffing of the wards. Yet they love to witch hunt the nurses.

They are launching investigations at Nurses for not filling in the care plans. But what happens when we do try and fill them in at any point in our shift? The visitors start bitching and screaming about the Nurses ignoring the patients to do paperwork. Christ it isn't like I will have another Nurse to carry on with the patient care while I fill in the stupid paperwork.

The trust refuses to pay staff for staying over at the end of their shift to do paperwork. So what happens is that we are staying over two hours unpaid at the end of our shifts to fill in paperwork.

Anyway it's not my problem anymore because I quit. The people of the UK deserve to have all of their Nurses jump ship to the US an australia.

How sick is it to leave one RN for 25 hospital patients because you don't want to invest in Nursing and then accuse the overwhelmed RN of neglecting patients of out cruelty. The UK sucks. I got a job in country with nurse ratio laws.

Could not agree more, Loves. Nursing on a UK general ward is a thankless task.

Every shift stay over to do your paperwork. Then get abused by visitors because you are sitting at the desk instead of answering bells. Yes, I am sitting at the desk IN MY OWN TIME, doing the paperwork because if I don't I will have my registration taken off me by the NMC.

I'd like to ask them how many times they work a 16 hour day only to get paid for what...12 hours? But I still have to pay whatever child care provider is watching my kids for all those hours.

Let's see we started at 7:30 AM and handed over to the oncoming night shift at 8:30 PM. We were officially off duty at 9 PM (which is when they stop paying you) but it takes an hour to hand over. So it takes until 9:30 PM to tell the night nurse everything she needs to know.

So at 9:30 PM you start doing legally required paperwork that you can only get done when another Registered Nurse takes over for you. Finally leave around 11:30 PM. The trust subtracts 1.5 hours pay from your shift for breaks you could not ethically take because your patients would have been harmed. And they stopped paying you at 9PM.

Tell the managers that you need more staff and want to get paid for all the hours you work and they tell you that you should be more "organised". That really means that you should ignore patients and do paperwork in their view. The relatives and patients will be angry at you for this. They don't get angry at management. Oh and the NMC will pull your registration when a patient deteriorates and you didn't see it because you actually took your break.

I wonder how many other jobs out there actually put you at risk of being charged for manslaughter for taking a break and refuse to pay you as well?

Tell the unions and they tell you there is nothing they can do since Nurses cannot strike.

Ha ha happy days.

Nursing : patient ratios on the gener
al wards are terrible. I would hate to work there myself.

It is no wonder that the information given out on the phone is sometimes suspect. The nurses in ITU are generally in a much better position with a 1:1- or 1:2 patient ration.

Agree with all the other posters though. Families need to nominate one person to communicate with the hospital and then disseminate the information. Many ITUs have this policy and it saves a lot of time. It is not our job (as NHS staff) to compensate for internal family politics (and I speak as someone with huge family politics myself).

I personally find the demands on me to respect patient confidentiality and the cavalier manner with which families expect information very difficult to balance. When someone is competent and capable we really shouldn't be giving any information out about them at all without their express permission.

I was a newly qualified nurse on an acute Neurosurgery Ward. I had 12 patients from the acute bays in the morning, and by the afternoon, someone had gone home on a half-day, so my patient load went up to 18. I had been qualified 6 weeks. I was petrified because I knew that I physically didn't have time to care for all the patients, and added to that, they were so spread out, that I had one set on one leg of a right-angle ward, and another set on the other - I had to physically abandon my acute patients to care for my chronic patients. It can take 10 minutes to change a soiled patient, which is a big problem when you have 4 patients on 15-minute observations.

everything LovestheChaos has said rings true to me too. i was so keen to be a nurse and did so for 5 years...i have been away for six and her posts have brought me out in a cold sweat remembering the anxiety i had trying to manage the work load and genuinly caring about people and still thinking about them when i got home.

a soul destroying job

i hope the op gets some closure for her and her family

All of the posts here are very distressing. But patients are not part of the structure that nurses experience every day. It is an institutional problem, and you can't work somewhere where these expectations are normalised, and then expect patients and their families who have perhaps found this their only experience of NHS hospital care to simply put up with normalised institutional practices that are shit.

Rather than resenting them, nurses should see the discomfort of patients and their complaints/abuse as part of the criticism that ought to get things changed. Instead of being defensive, perhaps you could get your union to set up a ward petition, then everytime someone complains you can say 'yes, the level of understaffing is shite, why don't you sign here to demand more resources?' Or remind them to make sure they vote? Or ask them to get involved?

If you turn it into them attacking you, instead of recognising they are frustrated with the lack of funding and this is their way of expressing it, then nothing will change because you will be more entrenched in your position, and they will know no better...

Absolutely agree with you in principle WilfShelf. But the realities are that for some patients and some relatives, the hospital experience triggers huge emotional responses that override sensibilities, and they behave in ways that would be absolutely shocking and unbelievable in the outside world.

I remember vividly collecting a patient for surgery (I worked in theatres). It was close to midnight, it had been decided that the patient wouldn't have general anaesthetic, but would have local. Mainly because there was no anaesthetist available due to other emergencies, and the patient was at risk of decline without urgent surgery. The patient had been told that he may get either method depending on circumstance.

We had rushed around getting a theatre, getting a post-op bed etc, so that the patient got the best care. The whole team had been called in from home, and willingly attended - it was our job.

I did not anticipate having to consider my escape route, checking subtly behind me to make sure I had a clear path, as the relative squared up to me because she thought general anaesthetic was 'kinder'. Her fury was breathtaking, and I was at serious risk of harm. I had to carefully 'talk her down', explaining again what had already been explained - her relative needed surgery NOW. A general anaesthetic was higher risk, and would cause an unsafe delay.

I did it. I had to, but I surely shouldn't go to work to be in fear of my wellbeing?

Wiltshelf,

The Nurses don't resent the patients. We have already done everything you have suggested as far as petition etc. We do understand why relatives and patients are angry and frustrated. The managers know what they are doing when they intentionally understaff and underresource the wards. They not only know what they are doing (the bastards) but they also know that the public will take it out on the frontline staff.

Even if you empathise with the patients, after a few years of it you get burned out over taking abuse for things you cannot control. We do tell the patients to complain about staffing levels. We have written to our MPs etc etc etc. There is nothing you can suggest that we haven't already done.

The only thing for UK nurses to do is abandon this country.

Lougle makes a good point about the hospital environment triggering unreasonable behaviour in normally kind, sensible patients and visitors.

Wilfself, I'm also a nurse and every word written on this thread rings true.

The mangers dont ;listen to nurses, the band 8's may if you have a good one, but the ones in charge of the budget don't.

I suspect a lot of patients and relatives have no idea of NHS politics and the restrictions under which we work. One poster mentioned the lack of bed rails - and was upset by the lack of them and disbelieving of the answer. Sadly that is general policy (although the policy usually cites elf and safety). If people knew the hoops we had to jump through to satisfy criteria for funding, the irrelevant paperwork that takes time away from patient care, the conflicting policies we have to contend with, they just wouldn;t believe it.

There have been many times when we are aware that the patient has been on the receiving end of substandard service - I dont try ad justify it anymore, I agree and tell them how to complain.

I think a lot of hcp (despite what you may think from MN ) are on the side of the patient and are burnt out, generally pissed off with the constraints that are institutionally imposed on practice. The trouble with a lot of complaints is that they focus on the shop floor (not to say they shouldn't) but whether anyone higher up thinks what was our responsibility is debatable. I have lost count of the number of times that a manager has said we have to do something eg an audit, and when told we have no spare staff to do it the answer is "tough - you have to do it. Dont care how"

I think the only way things will be stopped from getting worse is if the public is truly aware of what goes on and kicks up a fuss. The NHS is publicly funded and people should be more aware of how it is run.

The senior hospital managers are frequently too concerned with budget and make short sighted decisions,they dont listen to the staff (think Stafford) the RCN tbh is as useful as chocolate teapot when it comes to dealing with teh government (any government). Therefore more public awareness of behind the scenes management would be better. Don't just be fobbed off with blaming the nurse on the ward.

Why do patients really starve is hospital? Is it really because Nurses "cannot be bothered"? . No. militantmedicalnurse.blogspot.com/2008/03/protected-meal-times-what-fucking-joke.html

militantmedicalnurse.blogspot.com/2008/03/protected-meal-times-what-fucking-joke.html

Well frankly after seeing my mother and a dear elderly friend die as a direct result of poor care in the NHS system, I am really not interested in how defensive anyone feels. I am quite appalled actually that my rather considered and mild criticism of the NHS care that my mother and another elderly friend received that directly led to their decline and death has led to posters here in the NHS being outraged. I'm not going to go into the details of their care and why it led directly to their death, it is too painful and too appalling.

Do you really think anyone is interested in my complaints? What on earth is anyone going to do about it? We expressed our concerns [calmly and politely] many times whilst my mother was alive, and also whilst my elderly friend was alive. Nothing was done. The reason nothing was done is the situation is endemic amongst care for the elderly - I have spent a lot of time in those places in the last few years and witnessed apalling care for many vulnerable older people.

I have also said how grateful I am for the wonderful care my father received in ITU.

Underfunding and undertaffing is of course the main problem. But from my experience there is also a deeply ingrained institutional and casual disregard for the elderly in the NHS and care homes that will never be addressed.

No one is denying that the care is poor for general medical patients. We are simply telling you why it is poor. No point complaining to the nurses as they cannot change anything and the managers who control the budget do not respond to the complaints of nurses and doctors.