AIBU to think that Cameron is telling nurses to do things that they already do?

[MyNameIsNotNurse]

Or aim to do given the oppertunity.
Link

David Cameron's 'ideas'
Hourly checks on patients to make sure they have had enought to eat/drink and are comefortable.
Isn't this just basic care?
Also to have members of the public doing spot checks on their local hospitals, isn't this just going a bit too far?

I would really like him to do a 12 hour shift on a busy ward, with sick people needing more than just the hourly walk around to make sure that things are ok.
What about the patients who are in need of 15 minute observations. Patients with poor mobility who take more than 30 seconds to get to the toilet and needs assistance every step of the way. What about the drug rounds? Then multiply that by 30 pateints for 2 staff nurses (some with little experiance) If 1 patient is really ill thats 1 nurse down so 30 patients beeing looked after by 1 nurse, and maybe 1 or 2 HCA.

Why does he not discuss the staffing issues, which most wards have the mountains of paper work which each and every nurse has to get through every shift which takes away from the care of patients.
Most nurses I know stay behind to finish paperwork, turn into work when they or their family is not well, go without breaks, work 12hours a shift, do extra shifts and Given up our measily 3% payrise over 3 years.

He's just making a lot of noise saying we should do things we already do in order that the public think we're not doing them and we lose support?

That just went straight over your head, didn't it?

I agree attitude makes a big difference. I have seen and heard many small things done/said that made a difference. For example during ONE visit to hospital with my DP for a week I witnessed:

1. I made an informal complaint about a "nurse" to a member of staff. She just snapped back - she isn't a nurse, she is a hca! FFS like I was supposed to know. And she actually didn't talk about my complaint at all.

1. I found a dirty bloody dressing in a bible and told a nurse. She took it off me and promptly put it on my DP's bed before disposing of it. I had been really careful NOT to put it down because of possible infection.

1. Or the HCA whose English was too poor to understand our medical answers in the pre operation assessment form she had to complete with my DP.

1. The other HCA who as soon as he had admitted my DP informed us he couldn't do anything else as he was going to the canteen for his breakfast. Tiny thing, but he could easily have put it as he is now going off the ward and will come back to deal with things later.

1. Another HCA who took the piss out of my DP for reading the guardian.

1. The HCA and nurses who called elderly people by their first name without checking this was okay.

All things that actually are nothing to do with time and totally to do with attutude or ability.

Erm ... I'm startled to see professionals speaking of "professionalism" as if it means looking and acting a certain way, without necessarily doing the job properly. No, I'm not startled: I am saddened and forlorn about it. What training do people receive, when they don't even understand what professionalism means?

Not naming names because [a] it's probably obvious; [b] this doesn't only apply to nursing. Professionalism is doing a job professionally & well, looking and acting the part, owning the responsibility for the job completing the paperwork afterwards.

That part about "owning your responsibility" is somewhere at the core of it - and is also the single most important factor in job satisfaction; the one which every single study shows has been leached away from jobs over the past 10-15 years. Without that, I guess professionalism is an act for some. If you aren't allowed to feel responsible for the outcomes of your work, or to have any say in how you work, then it's hard to feel responsible and proud, isn't it?

I blame SAP, personally, but that's just my own bugbear ... call it too much management, too many box-tickers, what you will. Dave wants us to think he aims to revive the professionalism in nursing but, really, he's just handing out more boxes to tick. Whether that's cynical or thick is a moot point.

Don't any of you want to Froth?

And why do nurses talk so loudly at night on the wards? I'm not talking about during emergencies - but every single conversation. It makes it difficult for patients to sleep, but seems to be so common and I genuinely don't understand why nurses don't talk more quietly at night.

I have had the same experience as judgejudy - nurses too busy chatting at stations to respond to bed call, same happened to dh, mother and grandparents. I've never had a good experience with nhs nurses, probably not the case 100% of the time but when it's your life and death I think a couple more checks are totally reasonable.

Some of the experiences people have had are shocking and I geninuly hope complaints were made about the wards in question as without that change can never be made.

Re the professionalism. From the relative pov a staff member being smart and easily identifiable is essential - I want to know who I am talking to, and the cleanliness and smartness is a must when it comes to first impressions. The ward we spend most time on has wall displays explaining who is who and every bed has a book with information about the ward including uniforms.

The drinking in sight of the public issue doesn't bother me, but that is probably due to the fact I am aware how hard the staff work so don't resent them 5 minutes to drink their tea which will probably be cold by the time they have finished it!

"meal breaks in the nhs are unpaid"

Meal breaks are unpaid in most sectors! I've worked in the private and third sectors for 22 years and never had paid breaks.

I get annoyed at proposals for what nurses should do by people who never have to do it.

Eg feed patients unable to feed themselves. Imagine spoon feeding an elderly confused person, how long might it take for say a bowl of soup and pudding and custard. I would estimate 20 minutes, probably longer. Say there are 6-10 patients in a ward requiring that care then it takes about 2 hours 40 mins for that. Same patients need taken to the loo, helped onto loo, waited on whilst they perform, taken off loo, buttons done up,wheeled back to bed and helped into bed (requirs two people) - about 4 hours. That's nearly one staff working all day just doing that. Meanwhile who is seeing to the other 25 patients. And that's assuming they only go to the loo once a day.

Checking with patients every hour sounds v sensible but if every time they are checked a quarter of patients want something eg cup of tea, drink of water, chat, taken to loo. Then that could be eight x 5 mins for each = 40 mins so the check with patients hourly could cost 2/3 of that nurses daily work time.

DC doesn't know what he is talking about. What we need is complaints by users of the NHS naming and shaming individuals. There is too much talk about 'some aspects of the NHS' and not enough about 'nurse smith in ward X and consultant Y in hospital Z' not providing the required level of care. When staff are actually held accountable we might get the increases in staff etc that are required.

"Eg feed patients unable to feed themselves. Imagine spoon feeding an elderly confused person, how long might it take for say a bowl of soup and pudding and custard. I would estimate 20 minutes, probably longer. Say there are 6-10 patients in a ward requiring that care then it takes about 2 hours 40 mins for that. Same patients need taken to the loo, helped onto loo, waited on whilst they perform, taken off loo, buttons done up,wheeled back to bed and helped into bed (requirs two people) - about 4 hours. That's nearly one staff working all day just doing that. Meanwhile who is seeing to the other 25 patients. And that's assuming they only go to the loo once a day. "

Leave them to starve and soil themselves then I guess. That'll really aid recovery .

Josie although I think I understand your point what an awful attitude to have towards helping your patients. If someone needs help feeding you find time to help them no ifs, buts or maybes that is a basic level of care that should be met.

Sirzy, are you a nurse?

You sound like the people I was aiming my point at. How can a nurse 'find time' if they are already working full speed.

DC says patients must be checked once an hour - as I said in post this could take up most of a nurse's day. Is he providing an extra nurse on each ward to ensure this is done? NO, he is demanding that the existing staff already overworked now find time for this too. The lay public will say of checking each patient 'how reasonable ' and 'that's not much to ask' but my point is that with a ward of 35 and no extra staff that it IS quite alot to ask.

My previous paragraph was to demonstrate just how long it takes to do things such as toiletting confused elderly patients. Whingeing that nurses are uncaring is ridiculous, these jobs take alot of time and the staff numbers must be adequate to provide this care. At present they are not.

I am the daughter of a nurse of 30 years (who even as a senior nurse made time to sit and feed the patients) and I have worked as a hca and again spent the time needed with a patient to ensure they are fed. Sorry that is no to much to ask.

This thread is full of examples of when time can be gained back on a lot of wards. Yes more staff is needed but your attitude came across as a "it takes to long so it can't be done" one surely you can see why in a caring proffession that is wrong?

Look at it from the relatives pov, how would you feel if your mother was left to starve because a member of staff couldn't find time? Or if she was left in soiled clothes because nobody had time to take her to the toilet?

IMO a lot of nurses have developed a distaste for actual nursing, hence the need for HCAs.

Josie your post shows exactly the need for Cameron to have said what he has.

I worked in the nhs and my mother was a nurse in the good old days (worlds apart from nursing now imo).

I just don't think that there is enough staff to do all that is required to provide good care particularly for v elderly and confused.

I had an op in 2008 and was in one night. Won't go into details but staff were frenetic as they (she as there only seemed to be one nurse) tried to cope, she worked an extra 45 mins or so doing handover (after 12 hr shift), no chat with patients, bedridden patients were seen to but that was it. Food horrible, tea ugh. even the tea lady worked at a trot. Don't think nurse got her evening meal.

No time to 'care'.

My mum's been a nurse for 35+ years in respiratory wards, and is now a nurse practitioner. She's wonderful at her job, as the cards and presents she receives from grateful past patients every year testify. But that in itself speaks volumes - she would see it that she does her job to the best of her ability, and the level of care she delivers is what every patient has a right to expect - but from their point of view, it is extraordinary.

Christmas cards and presents, I should say!

My grandmother has been in a geriatric care ward for the last four months, this I the fifth time she has been admitted to the same ward and each time the standards for her care have fallen.

The first occasion four years ago, they were fantastic, the nurses saw to her complex medical needs, she was comfortable, surrounded by people, taken to the day room for company when she was able to get about, she would tell me how great the nurses were with confused patients.

Jump to last year, her inability physically to take care of herself or toilet herself, in agonising pain every minute with severe lymphodemea and cellulitis, kidney disease and rheumatoid arthritis, the care was a little less, I spoke to the ward sister, who told me about the influx of elderly patients from around the area, a ward had closed, in fact an entire hospital had closed, most of the staff were surplus to requirements, essentially there were double the patients and glad the amount of staff needed to provide good care for them, but they managed, experienced nurses who had seen it all and who fought to encourage older patients to not just give in, to fight to get back to health.

See that's something that's lost when we talk about hourly check ins, those elderly patients who need the time invested to encourage, motivate and re-hab back to their home before nursing care.

This last time my grandmother has deteriorated, she is in the throes of psychosis due to kidney failure and potassium poisoning, she is in an awful way, unable to bear weight her only option is nursing care if she makes it out of hospital, the nurses now have even more patients, these patients are long term admissions on a re-hab ward, they can't feed themselves, bath, toilet or dress themselves, but rather than put the people into a nursing home environment they are in a hospital, because the funds are not being invested in long term category the elderly qualified and experiences nurses who should be working to support those people who are unable to be discharged medically are essentially babysitting patients. Well, not all of them, my grandmother broke the nose of one and hurt her very badly so they are a nurse down de to a confused and unwell woman being convinced that the person trying to help her was actually a wolf.

It is a dire situation that in elderly care I have seen get even worst in the last tree years, it is all well and good for someone to rush in with a quick win, but a long term plan is what is needed, because come retirement age if I am in a state hospital then I have doubt the care will be just as poor now, DC having the luxury to be able to provide a sunny future for himself without the obstacles many of us have will mean it is never something he truly understands.

Sorry that's so long.

Apologies for the typo's as discussed on a previous thread it is almost impossible to scroll back on a mobile device

I can't believe that people are begrudging nurses a drink! IMO it's not unprofessional to have a cup of tea on the go, that is the least of the problems. Reading this thread it seems as though nurses feel hard done by just because of attitudes like this. How can we complain about patients not being given drinks but refuse them to the nurses?
Problems are deeper rooted than tea or no tea.

I'd like to add to this thread, I qualified as a nurse back in 1988 and the first 5 years of my career were spent very happily on a Care of the Elderly ward.
I absolutely LOVED my time there and among the things I did (including basic nursing care) were dealing with very complex needs while trying to maintain some basic dignity for patients. We even did trips to the pub for lunches with ward funds which were so enjoyed by those patients who could attend. I can remember relatives turning up to see an elderly aunt to be told "ooh she's gone to the pub but will be back soon", needless to say they thought this was great.

It was impressed upon me in training that my job was to do all the things a patient could not do for themselves such as helping them eat/drink if they were unable, helping thm with washing and toilet needs etc.

The rot came with cuts galore and non-nursing managers who decided that they should not be "paying highly qualified nurses to give bed baths" totally missing the whole point of nursing care. A bed bath may not seem a very technical thing for a "highly qualified nurse" to be doing but it's so much more than that. During the wash you can see the patients skin, you can pick up on small changes which might lead to pressure sores, you can talk to the patient and hear worries/concerns, they may even tell you about symptoms suggestive of other problems.
I tried in vain to explain this to a non-nursing manager friend I had - to no avail, the cuts came. Initially it was just the number of staff being cut but it soon moved to "skill mix" abnd the need to "let nurses manage and unqualified staff give the actual care". Well - fine but eventualy thr numbers of qualified staff overseeing and managng the care soon dwindled which is why it is now more difficult for newly qualified nurses to find work.

HCAs are trained and I have met some really good ones in my time but there are many who (like some nurses) are not so good.

It's not a case of nurses "not being bothered", it's a case of nurses being totally removed from basic care by their superiors.

I'd love to go back to Elderly Care but sadly I suspect it would not be the lovely job I remember.

The rot that you saw happening dilly, it has taken route, my grans care was far superior three years till now... It is just not possible for nurses to spread themselves any thinner, HCA may support but can also be a hindrance (my grandmother being told to pull herself together and not being helped to the commode because she was lazy), the ward sister, who in my untrained opinion is someone committed and just amazing has said to me that the majority of their patients have no medical needs to be in hospital but have no where to go that can cope with their care needs, so they are left on wards, prone to infections and the hospital walls are at times the last they see.

But then I am speaking as someone who does not work in this area, add into this the inevitable duplication of work common to a bureaucracy, well, a lesser person just would leave a job like that.

Blimey! I realise my lesser person comment sounded like an accusation what I should have said is in a world outside of the public services the average Joe would not work under the conditions the staff in that area do.

Gosh - I am shocked by some of the venom expressed on here.

My DS has had hospital care, my mother has had extensive treatment for cancer in various hospitals and I can only express my gratitude to all the staff who did everything they could to make things better.
In the years of treatment Mother has had, I have never felt she was neglected/people were unkind/unthoughtful. It was obvious the nurses were vv busy but all her needs were attended to.

Thank you from me anyway.

The rot partly comes from a society which values image and success over dignity, self respect and humanity

all those being venomous towards the nursing profession would expect those values to apply to nurses. sacrafice, working long hard hours vocationally and expecting low pay, care etc

but when society as a whole does not uphold those values, well how can you expect a single profession to carry the baton?

half those that would criticise are projecting their own issues onto the profession and you don't know what it is like to work in a job that is no longer valued. beauty, money, power and fame are revered and yet somehow we expect nurses to be what has been lost to humanity

if you care so much try to change the values of our society

I agree to an extent that nurses image plays an important part in the care given, but is not the be all and end all of nursing care. It is what you are first judged on before you even open your mouth. But a well preened nurse is not always the first one to get her hand dirty! And as for Doctors, some have personal hygiene issues which are far more evident than a scruffy nurse!

As reguards feeding/toileting patients, let me set the scene:
There are 2 RN's 2 HCA's its 12 o'clock and drug round, people need pain killers etc. also at 12 the lunches are served, you have 4 elderly patients who all need feeding, at least 1 HCA is occupied by actually serving the meals, because the ward assistants arn't actually allowed to go near patients.
Which leaves 1 HCA feeding 1 patient which takes approx 20 mins, 1 RN dishing out drugs which are a necessity, which leaves 1 RN who is toileting antother patient with poor mobility.
In the mean time the other 3 patients who are unable to feed themselves food is getting cold, and you are not able to re-heat food.
What are nurses supposed to do in this situation?
Leave someone on the loo, or break off from the drug round, in which case people are left in pain?
And this is just in 20 minutes of the afternoon.