to understand how it is possible for a patient to starve on a NHS ward?

[GastonTheLadybird]

I don't have much experience of the NHS and I was shocked to read this blog:

here

If this is true, and I guess you have to assume it is, of course peoplemare going to starve on hospital wards. Logistically it just doesn't work.

Surely it could be arranged so that family member could feed the patients? I know I would be happy to do that if my Mum or Grandmother were in hospital. Although I guess it might not be possible for everyone.

[laiyan]

this thread scares me

[StayingDavidTennantsGirl]

Squeezed a quick wee out, surely, thighslapper??

[3littlefrogs]

I qualified back in the 70s. In the last 30 plus years I have done just about every kind of nursing job. I currently work in the community as a clinical nurse specialist, doing a job that previously would have been done by a doctor.

One of the most worrying things I see is the number of nursing roles delegated to HCAs - this happens in all areas of the NHS, in hospital and in the community. As has already been said, the RN is supposed to take the responsibility for the HCA, when, in reality, the training provided for the HCA is inadequate (employers doesn't want to pay for it) and it is impossible to supervise HCAs all the time, whilst simultaneously doing my own work.

I document every single thing now, to cover my own back, usually after the day's work is finished, in my own time.

I take my hat off to the RNs who work in hospital, it must be hell on earth, and I know I couldn't do it now.

[lesley33]

I think part of the problem is the poorly trained HCA's. Like most patients, my parents, who have been in hospital a number of times, don't know the difference between nurses and HCA's and so refer to them all as nurses.

Although many have been kind, there have been basic errors made. This includes putting down trays of food/drink where my dad hasn't been able to reach it, 2 HCA's performing tasks such as a bed bath on my mum while talking amongst themselves and ignoring my mum (she said it made her feel like a piece of meat) and not doing mouth care when my dad was unable to eat or drink.

The attitude and behaviour of some has also been appalling. For example, 2 HCA's making faces and poking their tongue out at the nurse in charge behind her back; calling my mum a snob because I took her the Financial Times to read which she wanted; and not tidying away a hoover which sat at the side of one patients bed for 3 days.

[RottenTiming]

During Labour's boom years additional money was put into the NHS but the majority of it ended up, as predicted by some of us, increasing the pay of those already in post.

Doctors, nurses other HCP's, managers and administration staff, across the board all saw their pay rise in excess of inflation under labour and the general thought where I worked was that at last staff were being able to "catch up" pay wise. Catch up with what, or from what, I never knew but there was certainly no collective discussion by staff representatives of how to use the additional money to provide a better service by increasing support staff to free the nursing staff up.

Until the ward staff feel they want to do something about failing the patients in their care by ensuring that every patient is treated as if they were a memeber of staff's own beloved relative, nothing will change, funding increases will be gobbled up by pay increases and don't get me started on the farce of increasing funding at the same time as increasing employer's NI contributions such that a substantial amount of the funding increase went straight back to the government in monthly payroll taxes.

[3littlefrogs]

Ah yes.....my trust ran a weekend workshop for management to "brainstorm" ideas to improve service. Glossy handouts were produced, guest speakers were paid, catering provided.

The conclusion reached by this very expensive exercise? Staff should treat patients as they would wish their relatives to be treated.

Gosh - I would never have thought of that.

Sadly, the training and resources simply are not there, at the coalface, however well intentioned the staff may be.

[Newjobthankgod]

Lesley we already explained a couple of pages back why the trays are put out of reach initially. This is because the HCA has to get many many trays out to 30 people in a short time and then go back and help. Most of the patients are so frail and demented or suffering from delirium that they will pour hot soup over themselves, their neighbour, pour food on the floor causing their neighbour to slip and fall. So yes the tray needs to be kept out of reach until the hca can get back. Unfortunately kitchen collects the damn things back in too fast-less than 15 minutes from the trolley arriving on the floor.

The ward staff must have written 100 letters and contacted management another 100 times about this.

Rotten, Agenda for change gave many people pay cuts. UK RNs are earning half as much as their US counterparts.

I think UK hca's earn more than US hca's though. But hca's are not nurses.

The ward staff really has no no control. We have filled in 100's of incident forms, demanded change etc etc. At staffordshire complaints about this kind of stuff from Nurses was found in the directors rubbish bin. Ward staff are trying but the people who have the power won't listen.

i really wish you guys would read threads before posting.

[3littlefrogs]

I worked in USA in the 80s. I earned twice as much in the states then as I did in the NHS. I think that has always been the case.

In those days in USA we got 10 days paid holiday a year. Anything more had to be taken as unpaid leave.

Staff get much more paid leave in the UK - I wonder how much of an impact that has on staffing levels and costs? I am not complaining, but it must make a difference, surely?

In my job, I really struggle to cover AL. I reckon we need to employ an extra nurse, and delegate more work to untrained staff, just to cover leave.

[Newjobthankgod]

@a Rotten, it is people like you who think that Nurses are getting big pay rises and don't understand the treat the patients like you would your family mantra that really unnerve me. If my own grandma was on my ward I wouldnt be able to care for her either and she would meet the same fate as all the others. Management will not play ball. The ward staff are fighting hard believe me.

This is why I got my kids the hell out of the UK. After years of fighting for better care for patients and not being listened I realised that NHS wards will always be unsafe because they are not resourced properly. So I got my family the hell out. The frontline staff has the least power and control.

[Funtimewincies]

When I was in hospital after an ectopic 6 years ago there was an elderly woman in the opposite bed. Every mealtime, some cheerful nurse would put her food down on the mobile table at the end of the bed and half an hour later would whisk it away with an equally cheerful 'oh not hungry Mrs Jones?'

I could barely get to the loo at this stage so I called a nurse and pointed out that Mrs Jones (who also needed help going to the loo) could neither reach her food nor had the strength to pull the table to her.

Next mealtime, same thing . Mrs Jones didn't want to make a fuss because she could see how busy the ward was.

[Funtimewincies]

By the way, this lady didn't appear to be in danger of not being able to feed herself. At least, not at the start of my stay.

[SusanneLinder]

My Dh is a newly qualified RMN. He can't get an NHS job even though he has been qualified 6 months, due to so many jobs being downgraded (interview today yipee). He has never ever thought it wasn't his job to wipe arses or feed patients. He is agency nursing cos medical wards have to get RMN's in to "special" their most difficult patients.
Amazing they spend so much money on agency staff, when they could just employ full time workers :(

[lesley33]

Newjob - Sorry I know that is not always the case. A friend has just had abdominal surgery. She is in her 30's, is not confused or demented. Her tray of food and drink was often put out of her reach. Nobody came back to move it closer so she could eat.

[ggirl]

sorry haven't read whole thread but that militant nurse blog is very true to life on some wards
I gave up nursing for a few yrs because I was so stressed out from working in those conditions..unable to sleep worrying, after work.
Am now on lovely eldrely rehab ward , patients get much better care. We take them from the acute hopsital and some of them and their relaitives are traumatised by the experience when they reach us.

We have protected meal times because it works on our ward. It isn't written in stone though , I called a patients daughter yesterday and asked her to bring in some food as her mother was refusing everything I offered.

[Newjobthankgod]

Funtimewincies, As we have pointed out on this thread REPEATEDLY the people who hand out and collect in the trays are not nurses they are carers and kitchen staff who dont have any idea about the patients. There is usually one nurse on duty and she is getting overwhelmed by stat orders, meds and other tasks that only a nurse can do while the trays are being handed out and collected in.

Most staff you see on the wards are not nurses, they have never attended nursing school. The nursing profession cannot control these people and we cannot make management get rid of them and hire more nurses instead of untrained people. It's really sickening that people think that the ward staff are all nurses. Most of the people you see answering call lights, helping patients to the loo and collecting trays are not nurses. The Nurse is on her bloody own handling all the tasks (and there are a lot of them) that only a Nurse can do.

It's not like I can dump the blood transfusions, drugs, IV meds, theatre checklists, phone calls from relatives, assessments and doctors orders onto the kitchen staff and collect the bloody trays in myself. I bloody wish I could.

[Newjobthankgod]

and you want to blame a nurse for what the kitchen assistant or an HCA did Leslie? We say anything to these employees and we get told where to go. Wouldnt it just be better if English hospitals would just staff their wards with actual Nurses?

We used to have some real good, caring and experienced HCA's. Then the hospital decided that the 8 quid an hour that they were earning was too pricey. So the HCA's were replaced with horrid snot nosed 16 year olds that are called cadets and apprentices. And of course 90 year old Gladys thinks that the snot nosed 16 year old who has no understanding of her condition and got an attitude on with her is a "nurse". So she starts telling anyone she comes into contact with that the "nurses" are all mean.

Seriously I hope all UK nurses immigrate.

[3littlefrogs]

The situation is not helped by the fact that everybody wears the same uniform. Even the cleaners wear a uniform that is very similar to the nurses' uniforms. At least in the US only nurses wear nurses' uniforms.

We know what the different colours mean, but the patients and visitors don't.

[StayingDavidTennantsGirl]

Perhaps what is needed is some specific practical nursing qualification, and a minimum number of practical nurses per ward - some sort of training and qualification for HCAs? And some sort of rule that only a trained nurse or trained practical nurse or a student nurse could take away patients' trays.

Newjob - your frustration comes through so clearly in what you write - and I imagine it is what is driving so many nurses out of the profession - when you can see things that you know need doing, but have such a huge workload already that you'd have to be able to be in three places at once to get it all done - it must be absolutely soul-destroying.

[Newjobthankgod]

I agree about the uniform thing. Nurses at my hospital really pushed to get uniforms that clearly identified qualified nurses. We got shot down on that. Management wants the public to think that all staff are nurses. They don't want you to think otherwise and they control the uniforms.

I think that all RN's in the UK should all show up for work one day in old fashioned uniforms with a cap. That way, the patients and visitors would SEE how few nurses are around. It would be a way of kind of striking and getting our point across without actually walking out on patients.

The practical nursing thing has been shot down as well. Management wants as much unskilled labour as possible. When we still had EN's they would often find themselves as the only Nurse on duty working with care assistants. They were doing the job of an RN (i.e. getting murdered in paperwork, having so many qualified nurse only tasks to do, and being the only qualified on shift) that they were walking a mile in the same shoes that RNs were wearing yet getting paid a lot less.

Rather than staffing the wards with both RNs and ENs every shift or paying ENs better to reflect their role;management just got rid of them all together.

[cuteboots]

when my grandad was in hospital we were told he was refusing to drink but my mum tried to give him a few sips of water and he almost ripped the glass out of her hand as he was so thirsty! I think nurses all have so much paperwork to do that the basic nursing skills are unfortunately falling by the wayside.

[Oblomov]

My fil, died in hospital. Later turned out that that they thought he was refusing to eat. Becasue he left all his meals. Turned out he couldn't eat becasue his dentures had been removed and no one had noticed. Admittedly he had not starved to death, but this mistake contributed to his weakness and was one of the causes for him dying. You wouldn't think such a thing could go unnoticed, but it did.
My mil was there frequently, and my sil visited and she is a nurse. But no one mentioned his failure to eat.
Unbelievable.

[lesley33]

NewJob - But patients and their families don't know if staff are nurses, catering staff or HCA's. So they use the generic label of nurses.

I had a member of staff in a ward get angry at me when I referred to another member of staff as a nurse. FFS I didn't know what their job title was. Why does it matter if patients and their families refer to someone who may be a HCA or catering staff as a nurse or not?

[StayingDavidTennantsGirl]

Staff should wear badges that say clearly who and what they are. But I'm willing to bet that there would be the same objection to this that Newjob and her colleagues faced when they wanted uniforms that clearly marked out which staff were nurses and which ones weren't - that if people could see how few actual nurses were on the wards caring for their relatives, they would be furious.

Given what Newjob has said about the huge, near-unmanageable demands on registered nurses today, I am surprised that more aren't leaving the profession or going abroad where things are better.

Patients deserve better than this and so do nurses!

[Funtimewincies]

I appreciate that newjobthankgod but it was impossible to tell who was supposed to be doing what. I also appreciate that nurses are not responsible for handing out meals and feeding patients but the lack of food being eaten by this patient was, I would imagine, of medical importance. Yet, while nurses were standing at the nurses station, chatting about their weekend plans, this woman was simply not getting food, for mealtime after mealtime after mealtime. Wherever the responsibility lay, this elderly and increasingly lethagic patient was in trouble and, for whatever reasons, nobody but the other patients on the ward seemed to think that it was important.

[StayingDavidTennantsGirl]

Funtimewincies - are you sure that the staff standing at the Nurses' Station were nurses? Might they have been HCAs or other staff instead?